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Sleeve Gastrectomy

Definition and Use

Sleeve gastrectomy is a novel weight-loss surgical procedure, which seems to hold the potential of becoming an effective alternative stand alone procedure for weight control in high-risk super-obese patients.

Description

Sleeve gastrectomy, an advancement of the Magenstrasse and Mill technique, has been originally introduced as the initial risk reduction procedure as part of a two-stage restrictive-malabsorptive Roux-en-Y gastric bypass maneuver in super-obese patients. During sleeve gastrectomy the gastric volume is restricted and the fundus is separated from the rest of the stomach. Effectively, the stomach is converted into a narrow tube (Magenstrasse).

Advantages

Sleeve gastrectomy is simpler and thus safer than the full Roux-en-Y gastric bypass. This becomes especially important in patients who represent great perioperative risk. On the other hand, sleeve gastrectomy hold to potential of being more effective than purely restrictive manuvers, such as gastric banding. During sleeve gastretcomy the gastric fundus is removed which is the main site of ghrelin production. Ghrelin is an appetite-stimulant enteric hormone, and decreased ghrelin levels are thought to contribute to the weight-loss effects of Roux-en-Y gastric bypass. Recently, sleeve gastrectomy was shown to lower levels of ghrelin and produce effective weight loss which raised the potential of using sleeve gastrectomy as a stand alone procedure in high-risk super-obese patients.

Sleeve gastrectomy in rats

The Integrative Core Laboratory investigators are in the process of adapting the human sleeve gastrectomy procedure to rats. This project is led by Dr. Peter Lopez, a young academic surgeon who recently joined the Integrative Core Laboratory team. Please, check back later for details.

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