TECHNICAL PROCEDURE: WHAT IS THE SLEEVE GASTRECTOMY? (1st part)

The sleeve gastrectomy is the restrictive part of a more extensive, mixed restrictive and malabsorbtive operation, the BPD/DS.There are two principles: a food restriction owing to a partial 'sleeve' gastrectomy, creating a sort of gastric tube; and a malabsorptive part: the 'bilio-pancreatic diversion' in a variation called 'duodenal switch' by Hess and Marceau.
Theses procedures are complex and we will get back to them later on. For now, we shall here describe the so called 'sleeve' part. There is indeed a current momentum, and it is often proposed as a sole operation. The stomach is cut with staples all along, so that it becomes a slim channel making it possible to decrease noticeably the food intake.
We shall examine further on the results and side-effects of the procedure; let us notice that gastric tissues have a degree of elasticity leading to a temporary food restriction that is due to fade out as time goes on.
Here is the figure of the operation: gastric trans-section is performed with stapling devices that ensure a safe healing of the tissues.

* Laparoscopic sleeve gastrectomy: a multi-purpose operation. A Baltasar et col. Obesity Surgery 2005, 15: 1124-28.