A Sleeve gastrectomy (SG) removes approximately 75-80% of the stomach to leave a narrow stomach tube which restricts food intake. Hunger level is also significantly reduced with the removal of fundus (upper stomach) which produces hunger-hormone Ghrelin.
SG typically results in 25% to 35% body weight loss (50 to 70% of the excess weight). Most of the weight loss occurs in the first 6-8 months. The drastic weight loss may lead to improvement, and even complete remission of many of the obesity-related co-morbidities such as type 2 diabetes. Laparoscopic SG is most commonly performed bariatric surgery worldwide.
SG is advantageous over gastric bypass because it is a simpler and safer operation. It results in less vitamin and micro-nutrient deficiencies than the gastric bypass procedure and it generally does not cause dumping syndrome.
The main disadvantage of SG is the 1-2% risk of stapleline leakage. Sleeve leaks are more challenging to manage than gastric bypass leaks because of the high pressure in the gastric sleeve. Another drawback of the SG is the development of acid reflux in 11 to 33% of patients resulting in prolonged use of anti-acid medications, and sometimes even revisional surgery.