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Longitudinal or Sleeve Gastrectomy (Sleeve Gastrectomy)
Last reviewed: 08.07.2025
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Longitudinal gastrectomy, or sleeve gastrectomy, is a gastrorestrictive surgery, i.e. one based on narrowing the upper gastrointestinal tract to limit food intake. The English name of this intervention, Sleeve Gastrectomy, quite accurately reflects the essence of the surgery, which consists of forming an extended narrow gastric "sleeve" to impede the passage of solid food in the area from the esophagus to the antral (terminal) section of the stomach.
Currently, the most commonly used restrictive interventions are the installation of an intragastric band and laparoscopic horizontal gastroplasty using a silicone band. What is fundamentally new about this technique?
What is new in this operation is the maximum possible narrowing of the lumen of the stomach along the entire length from the esophagus to the antral section. As can be seen in the picture, only a very narrow "sleeve" remains along the lesser curvature (the left side of the stomach), the fundus and body located to the right of the intersection line are completely removed.
The uniformly narrowed stomach is subject to uniform pressure and cannot stretch in any one place, as happens with vertical banded gastroplasty. Food, passing along a long and very narrow "vertical", overcomes significant resistance and, being delayed, causes a persistent feeling of satiety with a very small amount of it. Thus. Longitudinal gastrectomy occupies an intermediate position between gastric banding and gastric bypass.
Disadvantages of longitudinal gastrectomy:
- Due to the fact that the stomach becomes as narrow as possible, the first two to three months food passes very poorly, which can cause significant discomfort.
- Many patients (approximately 30%) who have undergone sleeve gastrectomy develop heartburn. It is recommended to take omez (omeprazole) to reduce the production of hydrochloric acid.
- Suppuration of a postoperative wound.
- Failure of seams.
- General non-specific complications: pneumonia, pulmonary embolism, etc.
Advantages of longitudinal gastrectomy:
- No need for adjustments in the postoperative period compared to a gastric band.
- Absence of foreign body in the body.
- It is possible to convert a sleeve gastrectomy into a gastric or biliopancreatic bypass relatively easily if needed. To do this, simply add an "intestinal stage" to the operation.
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