Sleeve gastrectomy

Published on 09/04/2015 by admin

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Last modified 09/04/2015

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CHAPTER 28 Sleeve gastrectomy

Step 2. Preoperative considerations

Patient preparation

Sleeve gastrectomy may be performed on those patients who qualify for bariatric surgery (i.e., meet National Institutes of Health (NIH) criteria and have satisfied a multidisciplinary evaluation by a weight-loss surgery team). This operation has been generally offered as an “initial stage” in patients who are at high risk for other more traditional bariatric operations. Sleeve gastrectomy is considered for the following high-risk patients:

After significant weight loss, these patients may undergo a “second-stage” operation with conversion to either Roux-en-Y gastric bypass or biliopancreatic diversion with duodenal switch. With excellent initial weight loss results and increasing experience with the operation, many groups are now offering it as a stand-alone procedure in average-risk patients.

Special attention in the history and physical should elicit any signs of liver disease and cirrhosis. In diabetic patients, if there is a clinical suspicion of gastroparesis, gastric emptying studies should be considered. Preoperative upper endoscopy should be performed to diagnose hiatal hernia and rule out gastric lesions or helicobacter pylori infection.

Equipment and instrumentation

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