The sleeve gastrectomy is an operation in which the left side of the stomach is surgically removed. This results in a new stomach which is roughly the size and shape of a banana. Since this operation does not involve any "rerouting" or reconnecting the intestines, it is a simpler operation than the gastric bypass or the duodenal switch. Unlike the Lap-Band® procedure, the sleeve gastrectomy does not require the implantation of an artificial device inside the abdomen.

Patients who should consider this procedure include:

1. Those who are concerned about the potential long term side effects of an intestinal bypass such as intestinal obstruction, ulcers, anemia, osteoporosis, protein deficiency and vitamin deficiency.
2. Those who are considering a Lap-Band® but are concerned about a foreign body inside the abdomen.
3. Those who have medical problems that prevent them from having weight loss surgery such as anemia, crohn's disease, extensive prior surgery, and other complex medical conditions.
4. People who need to take anti-inflammatory medications may also want to consider this. Usually, these medications need to be avoided after a gastric bypass because the risk of ulcer is higher.

It might also be a good option if patients have a problem with their lap band requiring revision, have already lost a lot of weight and don't want a full bypass. The weight loss seems to be a little better and more rapid than the lap band (60 - 70% EWL) over two years. There is still no long-term data.

What advantages does it have?

1. It does not require disconnecting or reconnecting the intestines (no dumping syndrome).
2. There is no malabsorption of nutrients therefore avoiding anemia, osteoporosis, protein deficiency and vitamin deficiency.
3. Only surgery that substantially removes the "hunger hormone" Ghrelin.
4. It is a technically a much simpler operation than the gastric bypass or the duodenal switch.
5. There is no foreign body inside of you.
6. It does not need adjustments or fills (adjustable band patients must come back for fills).
7. Preserves the pylorus (most patients should not get dumping syndrome).
8. It may be a safer operations for patients with a body mass index (BMI) more than 60. It may be used as the first stage of a 2-stage operation.

The term “revision” is applied when one weight loss procedure is converted or transformed into another one. (For example; a Lap-Band® system to a Mini Gastric Bypass or to a Gastric Sleeve.)

Dr. Alvarez is one of the top surgeon’s performing revisions to a Gastric Sleeve. Approximately 37% of Dr. Alvarez’s surgeries are revisions from a previous Lap-Band® to a Gastric Sleeve. Dr. Alvarez has also performed revisions to a Gastric Sleeve in patients with a previous open Vertical Banded Gastroplasty, open and laparoscopic Nissen Fundoplication, open and laparoscopic Toupet, open Belsey Mark IV, among other surgeries.