Potential Advantages:
People are attracted to the fact no re routing of the intestine takes place with a Gastric Sleeve.
Also, there is no gastro-jejunostomy to either leak or stricture. There may be less vitamin and mineral deficiency issues
as there is no malabsorption component. There is no foreign device that requires adjustments as in
gastric banding. Technically, the procedure is easier to do than either banding or bypass and may result in a
shorter hospital stay.
Potential Disadvantages:
Weight loss is
similar to banding but probably less than usually achieved with bypass. The leak rates from this long staple line along
the stomach is about the same as the leak rate from a RNY gastro-jejunostomy anastomosis. The body of the stomach
is removed, gone forever and not reversible unlike banding and in theory, RNY bypass.
Staging Procedure: The Gastric Sleeve was initially thought of as a procedure
to be done only in the massively obese population, BMI over 60 or even 70 in hopes of doing an easier operation and bringing
the BMI to a more moderate level, for example to the low 40s and then doing RNY or DS to achieve final success, a BMI closer
to 30 or less. This clearly remains the mainstream use of the gastric sleeve but lately surgeons are doing it as
a primary procedure for weight loss in a wide range of BMI patients as it is gaining more acceptance and popularity.
