Plastic surgery tunisia
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Sleeve gastrectomy is a relatively new procedure first developed in Leeds as a stand-alone operation rather than the first part of a duodenal switch procedure.

A tube not much greater than 1 cm in diameter is introduced into the stomach by the anaesthetist, and using this as a guide, a stapling machine is used to convert the upper two thirds of the stomach into a long thin tube (or sleeve). It is really an adaptation of some older and now obsolete procedures suitable for keyhole surgery. It takes time for food to travel down the narrow gastric sleeve, and meal size is thus reduced.

As with gastric bypass, that the majority of patients who have a sleeve gastrectomy have lower levels of hunger, possibly because much of the upper part of the stomach has been removed, or in the case of the gastric bypass, is no longer accessible to food. Weight loss with sleeve gastrectomy is similar to gastric bypass in many patients, and it also appears to be an effective operation to bring about resolution of high blood pressure and diabetes.

One of the attractions of sleeve gastrectomy is that there is no interference with the small bowel, and the normal controls that regulate emptying of the stomach are retained.

The downsides to this procedure are that some people don't experience the degree of weight loss that one would hope for, and about 2% of patients have a leak from the upper end of the state line and can be very difficult to treat.

Sleeve gastrectomy is particularly indicated where it might be difficult to bring the bowel up to the gastric pouch as is necessary for gastric bypass. Such difficulty occasionally occurs unpredictably and is commonly present in patients who have undergone a lot of previous abdominal surgery or who have a large hernia the middle of the abdomen.

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