The procedure was originally conceived of in England and has been further
developed and utilized in the U.S, Germany and Belgium. The technique is an
improvement over earlier gastroplasty procedures which included placement of
foreign bodies, and left the excess stomach intact. It was originally used for
very high BMI patients (~ 500 lbs.) to try to reduce the overall risk of
surgery. It was then followed by a second surgery when the patient had lost
enough weight to safely go through a second procedure like the Gastric Bypass.
The new procedure was started in England about 7 years ago as a stand alone
procedure for patients of BMI’s of 35-45. It proved to be quite safe and
effective even at 7 years post op.
U.S. studies have been very impressive; in one study of almost 100 very high
risk, very high BMI patients there were no deaths, and only 1 leak, and 1
Dr. Owens has used this procedure for high risk, high BMI patients with good
It can be considered by patients who are:
- Concerned about bowel obstructions and leaks that may occur with Gastric
Bypass due to the re-arrangement of the anatomy required.
- Concerned about the dietary changes and vitamin supplements required by
- Concerned about the foreign body introduced with the Lap Band placement
- Concerned about the need for follow up, fills required with the Lap Band
It should also be considered for patients weighing over 500 lbs, patients
with existing anemia, Crohn’s disease, or other conditions that make them too
high risk for Bypass procedures.
The Inverted Sleeve Gastrectomy by Dr. Owens
After several sleeve gastrectomy procedures, Dr. Owens perfected the
procedure by making an inverted corner at the gastroesophageal junction. This
improvement was found to reduce the likelyhood of leakage and heartburn
incidences. This gastric sleeve improvement was published in
the official Journal of the American Society of
Metabolic and Bariatric Surgery and can be further studied
How does Sleeve Gastrectomy work?
Restricts food intake without the bypass of the intestines. The stomach is restricted by dividing it
vertically, creating a small vertical stomach pouch shaped like a banana. The
new stomach pouch measures 2-5 ounces. The remaining part of the stomach is
removed. The portion of the stomach that is removed is thought to be responsible
for secreting Ghrelin, the hormone that is responsible for appetite and hunger.
By removing this portion of the stomach, the appetite hormone is reduced to
almost nothing, usually causing a loss of appetite.
The removed part of the stomach is also the portion thought to “stretch” the
most. The new stomach pouch holds only small amounts of food, causing the
patient to feel full.
The nerves to the stomach remain in tact, preserving the functions of the
stomach while reducing the volume it can hold.
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Benefits / Risks comparison to Gastric Bypass/ Lap Band
Sleeve Gastrectomy vs. Gastric Bypass:
- Weight loss amount/ speed expected to be similar
- Appetite suppression similar, and thought to be longer lasting
- No dumping. Most foods can be consumed, but in small portions.
- Potentially safer: minimizes leaks at new
connections, long term complications, risk of ulcers, bowel obstructions.
- Potentially safer for high BMI, or other high risk patients
- No Iron Deficiency
Sleeve Gastrectomy vs. Lap Band:
- Faster weight loss
- More appetite control
- Less follow up required – no fills.
- Safety: Does involve stapling, therefore leaks and other related
complications can occur.
- Eliminates potential for erosion or slips.
- Not reversible/ adjustable