Programs : Advanced MI & Robotic Surgery

Sleeve Gastrectomy, or 2-Stage Procedure
The sleeve gastrectomy is an operation in which the left side of the stomach is surgically removed. This results in a new stomach which is roughly the size and shape of a banana. Since this operation does not involve any “rerouting” or reconnecting of the intestines, it is a simpler operation than the gastric bypass.
Unlike the LAP-BAND® procedure, the sleeve gastrectomy does not require the implantation of an artificial device inside the abdomen. For certain patients, in particular those with a body mass index greater than 60, the sleeve gastrectomy may be the first part of a 2-stage operation. In the staged approach, the operation is broken down into two simpler and safer operations. In the first stage, a sleeve gastrectomy is performed. This allows patients to lose 80 to 100 pounds or more, making the second part of the operation substantially safer. Some people lose enough weight that they do not need any more surgery. For those who continue to the next stage, the second procedure is usually performed eight to twelve months after the first. The “sleeve” stomach is converted into a lap band or gastric bypass.

Advantages
• Safer and simpler than gastric bypass
• If weight loss is successful, may not need second operation
• Weight loss after first surgery makes second surgery safer.

Disadvantages
• Two operations: two-stage patients face the risks of surgery twice.
• Newer technique. There is not as much long-term follow-up data as with RYGB.
Some insurance companies consider this technique to be investigational and
refuse coverage.
• Hospitalization: Usually two to three days in the hospital.
• May require an open incision instead of laparoscopic technique.