Skip to main content
SpringerLink
Log in

Sleeve Gastrectomy for Morbid Obesity

  • Review Article
  • Published:
Obesity Surgery Aims and scope Submit manuscript

The rising prevalence of morbid obesity and the increased incidence of super-obese patients (BMI >50 kg/m2) seeking surgical treatments has led to the search for surgical techniques that provide adequate EWL with the least possible morbidity. Sleeve gastrectomy (SG) was initially added as a modification to the biliopancreatic diversion (BPD) and then combined with a duodenal switch (DS) in 1988. It was first performed laparoscopically in 1999 as part of a DS and subsequently done alone as a staged procedure in 2000. With the revelation that patients experienced weight loss after SG, interest in using this procedure as a bridge to more definitive surgical treatment has risen. Benefits of SG include the low rate of complications, the avoidance of foreign material, the maintenance of normal gastro-intestinal continuity, the absence of malabsorption and the ability to convert to multiple other operations. Reduction of the ghrelinproducing stomach mass may account for its superiority to other gastric restrictive procedures. SG should be in the armamentarium of all bariatric surgeons. Nonetheless, long-term studies are necessary to see if it is a durable procedure in the treatment of morbid obesity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Gumbs AA, Modlin IM, Ballantyne GH. Changes in insulin resistance following bariatric surgery: role of caloric restriction and weight loss. Obes Surg 2005; 15: 462–73.

    Article  PubMed  Google Scholar 

  2. Hickey MS, Pories WJ, MacDonald KG Jr et al. A new paradigm for type 2 diabetes mellitus: could it be a disease of the foregut? Ann Surg 1998; 227: 637–43; discussion 643–4.

    Article  PubMed  CAS  Google Scholar 

  3. Cottam DR, Mattar SG, Schauer PR. Laparoscopic era of operations for morbid obesity. Arch Surg 2003; 138: 367–75.

    Article  PubMed  Google Scholar 

  4. Rosenthal RJ, Szomstein S, Kennedy CI et al. Laparoscopic surgery for morbid obesity: 1,001 consecutive bariatric operations performed at the Bariatric Institute Cleveland Clinic Florida. Obes Surg 2006; 16: 119–24.

    Article  PubMed  Google Scholar 

  5. Gastrointestinal surgery for severe obesity. National Institutes of Health Consensus Development Conference Draft Statement. Obes Surg 1991; 1: 257–65.

    Google Scholar 

  6. Ballantyne GH, Gumbs A, Modlin IM. Changes in insulin resistance following bariatric surgery and the adipoinsular axis: role of the adipocytokines, leptin, adiponectin and resistin. Obes Surg 2005; 15: 692–9.

    Article  PubMed  Google Scholar 

  7. Proceedings of the ASBS Consensus Conference on the State of Bariatric Surgery and Morbid Obesity: Health Implications for Patients, Health Professionals and Third-Party Payers, Washington, DC, USA, May 6–7, 2004. Surg Obes Relat Dis 2005; 1: 105–53.

    Google Scholar 

  8. 2004 ASBS Consensus Conference on Surgery for Severe Obesity. Surg Obes Relat Dis 2005; 1: 297–381.

    Google Scholar 

  9. Marceau P, Hould FS, Simard S et al. Biliopancreatic diversion with duodenal switch. World J Surg 1998; 22: 947–54.

    Article  PubMed  CAS  Google Scholar 

  10. Ren CJ, Patterson E, Gagner M. Early results of laparoscopic biliopancreatic diversion with duodenal switch: a case series of 40 consecutive patients. Obes Surg 2000; 10: 514–23; discussion 524.

    Article  PubMed  CAS  Google Scholar 

  11. de Csepel J, Burpee S, Jossart G et al. Laparoscopic biliopancreatic diversion with a duodenal switch for morbid obesity: a feasibility study in pigs. J Laparoendosc Adv Surg Tech A 2001; 11: 79–83.

    Article  PubMed  Google Scholar 

  12. Gagner M, Boza C. Laparoscopic duodenal switch for morbid obesity. Expert Rev Med Devices 2006; 3: 105–12.

    Article  PubMed  Google Scholar 

  13. Gagner M, Steffen R, Biertho L et al. Laparoscopic adjustable gastric banding with duodenal switch for morbid obesity: technique and preliminary results. Obes Surg 2003; 13: 444–9.

    Article  PubMed  Google Scholar 

  14. Mognol P, Chosidow D, Marmuse JP. Laparoscopic sleeve gastrectomy as an initial bariatric operation for high-risk patients: initial results in 10 patients. Obes Surg 2005; 15: 1030–3.

    Article  PubMed  Google Scholar 

  15. Nguyen NT, Longoria M, Gelfand DV et al. Staged laparoscopic Roux-en-Y: a novel two-stage bariatric operation as an alternative in the super-obese with massively enlarged liver. Obes Surg 2005; 15: 1077–81.

    Article  PubMed  Google Scholar 

  16. Regan JP, Inabnet WB, Gagner M et al. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg 2003; 13: 861–4.

    Article  PubMed  CAS  Google Scholar 

  17. Catheline JM, Cohen R, Khochtali I et al. [Treatment of super super morbid obesity by sleeve gastrectomy]. Presse Med 2006; 35:383–7.

    PubMed  Google Scholar 

  18. Langer FB, Bohdjalian A, Felberbauer FX et al. Does gastric dilatation limit the success of sleeve gastrectomy as a sole operation for morbid obesity? Obes Surg 2006; 16:166–71.

    Article  PubMed  Google Scholar 

  19. Moon Han S, Kim WW, Oh JH. Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obes Surg 2005; 15: 1469–75.

    Article  PubMed  Google Scholar 

  20. Baltasar A, Serra C, Perez N et al. Laparoscopic sleeve gastrectomy: a multi-purpose bariatric operation. Obes Surg 2005; 15: 1124–8.

    Article  PubMed  Google Scholar 

  21. Langer FB, Reza Hoda MA, Bohdjalian A et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg 2005; 15: 1024–9.

    Article  PubMed  CAS  Google Scholar 

  22. Milone L, Strong V, Gagner M. Laparoscopic sleeve gastrectomy is superior to endoscopic intragastric balloon as a first stage procedure for super-obese patients (BMI ≥50). Obes Surg 2005; 15: 612–7.

    Article  PubMed  Google Scholar 

  23. Lee CM FJ, Cirangle PT, Jossart GH. Laparoscopic vertical sleeve gastrectomy for morbid obesity in 216 patients: report of two-year results. SAGES 2006 Final Program 2006: 88.

  24. Cottam D, Qureshi FG, Mattar SG et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc 2006; 20: 859–63.

    Article  PubMed  CAS  Google Scholar 

  25. Sue-Ling DJAH. Surgical Management of Morbid Obesity, 3rd Edn. Oxford: Butterworth-Heinemann, 1995.

    Google Scholar 

  26. Baltasar A. Modified vertical gastroplasty: Technique with vertical division and serosal patch. Acta Chir Scand 1989; 155: 107–12.

    PubMed  CAS  Google Scholar 

  27. Johnston D, Dachtler J, Sue-Ling HM et al. The Magenstrasse and Mill operation for morbid obesity. Obes Surg 2003; 13: 10–6.

    Article  PubMed  Google Scholar 

  28. Sapala JA, Wood MH, Sapala MA et al. The micropouch gastric bypass: technical considerations in primary and revisionary operations. Obes Surg 2001; 11: 3–17.

    Article  PubMed  CAS  Google Scholar 

  29. Carmichael AR, Sue-Ling HM, Johnston D. Quality of life after the Magenstrasse and Mill procedure for morbid obesity. Obes Surg 2001; 11: 708–15.

    Article  PubMed  CAS  Google Scholar 

  30. Carmichael AR, Johnston D, Barker MC et al. Gastric emptying after a new, more physiological anti-obesity operation: the Magenstrasse and Mill procedure. Eur J Nucl Med 2001; 28: 1379–83.

    Article  PubMed  CAS  Google Scholar 

  31. Carmichael AR, Johnston D, King RF et al. Effects of the Magenstrasse and Mill operation for obesity on plasma leptin and insulin resistance. Diabetes Obes Metab 2001; 3: 99–103.

    Article  PubMed  CAS  Google Scholar 

  32. Carmichael AR, Tate G, King RF et al. Effects of the Magenstrasse and Mill operation for obesity on plasma plasminogen activator inhibitor type 1, tissue plasminogen activator, fibrinogen and insulin. Pathophysiol Haemost Thromb 2002; 32: 40–3.

    Article  PubMed  CAS  Google Scholar 

  33. Baltasar A, Serra C, Perez N et al. Re-sleeve gastrectomy. Obes Surg 2006; 16: 1535–8.

    Article  PubMed  Google Scholar 

  34. Deitel M, Gawdat K, Melissas J. Reporting weight loss 2007. Obes Surg 2007; 17: 565–8.

    Article  PubMed  Google Scholar 

  35. Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg 2006; 16: 1450–6.

    Article  PubMed  Google Scholar 

  36. Hamoui N, Anthone GJ, Kaufman HS et al. Sleeve gastrectomy in the high-risk patient. Obes Surg 2006; 16: 1445–9.

    Article  PubMed  Google Scholar 

  37. Roa PE, Kaidar-Person O, Pinto D et al. Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obes Surg 2006; 16: 1323–6.

    Article  PubMed  Google Scholar 

  38. Mognol P, Chosidow D, Marmuse JP. Laparoscopic sleeve gastrectomy (LSG): review of a new bariatric procedure and initial results. Surg Technol Int 2006; 15: 47–52.

    PubMed  Google Scholar 

  39. Silecchia G, Boru C, Pecchia A et al. Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on comorbidities in super-obese high-risk patients. Obes Surg 2006; 16: 1138–44.

    Article  PubMed  Google Scholar 

  40. Gagner M, Rogula T. Laparoscopic reoperative sleeve gastrectomy for poor weight loss after biliopancreatic diversion with duodenal switch. Obes Surg 2003; 13: 649–54.

    Article  PubMed  Google Scholar 

  41. Feng JJ, Gagner M. Laparoscopic biliopancreatic diversion with duodenal switch. Semin Laparosc Surg 2002; 9: 125–9.

    Article  PubMed  Google Scholar 

  42. Consten EC, Dakin GF, Gagner M. Intraluminal migration of bovine pericardial strips used to reinforce the gastric staple-line in laparoscopic bariatric surgery. Obes Surg 2004; 14: 549–54.

    Article  PubMed  Google Scholar 

  43. Consten EC, Gagner M, Pomp A et al. Decreased bleeding after laparoscopic sleeve gastrectomy with or without duodenal switch for morbid obesity using a stapled buttressed absorbable polymer membrane. Obes Surg 2004; 14: 1360–6.

    Article  PubMed  Google Scholar 

  44. Givon-Madhala O, Spector R, Wasserberg N et al. Technical aspects of laparoscopic sleeve gastrectomy in 25 morbidly obese patients. Obes Surg 2007; 17: 722–8.

    Article  PubMed  Google Scholar 

  45. Melissas J, Koukouraki S, Askoxylakis J et al. Sleeve gastrectomy: a restrictive procedure? Obes Surg 2007; 17: 57–62.

    Article  PubMed  Google Scholar 

  46. Kotidis EV, Koliakos GG, Baltzopoulos VG et al. Serum ghrelin, leptin and adiponectin levels before and after weight loss: comparison of three methods of treatment – a prospective study. Obes Surg 2006; 16: 1425–32.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. New York-Presbyterian Hospital, Division of Laparoscopy, and Department of Surgery, Weill-Cornell College of Medicine, New York, NY, USA

    Andrew A. Gumbs MD, Michel Gagner MD, Gregory Dakin MD & Alfons Pomp MD

  2. Department of Surgery, Joan and Sanford I, Weill Medical College of Cornell University, New York-Presbyterian Hospital-Weill Cornell Medical Center, 525 East 68 Street, PO Box 294, New York, NY, 10021, USA

    Michel Gagner MD

Authors
  1. Andrew A. Gumbs MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michel Gagner MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gregory Dakin MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alfons Pomp MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michel Gagner MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gumbs, A.A., Gagner, M., Dakin, G. et al. Sleeve Gastrectomy for Morbid Obesity. OBES SURG 17, 962–969 (2007). https://doi.org/10.1007/s11695-007-9151-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-007-9151-x

Key words

Search

Navigation