Laparoscopic Sleeve Gastrectomy: The Technique

Abstract

Sleeve gastrectomy is presently the most popular weight loss procedure globally. The only absolute contraindication to this procedure is the presence of Barrett’s esophagus. Comprehensive preoperative workup, optimization of comorbidities, and adequate preoperative preparation are of paramount importance. Preoperative patient counseling should focus on caution about variable impact of surgery on symptoms of gastroesophageal reflux, if present. Though technically less complex than the gastric bypass, meticulous technique and avoidance of certain pitfalls are essential to achieve an optimal outcome and minimize serious complications including leaks. It is recommended to adopt an unhurried approach during stapling to avoid narrowing at incisura angularis, twisting of sleeve, and ensure adequate hemostasis at the end of the procedure.