Longitudinal gastrectomy, or sleeve resection, refers to gastrestrictive surgery, that is, based on the narrowing of the upper gastrointestinal tract to restrict food intake. The English-language name for this intervention, Sleeve Gastrectomy (sleeve resection of the stomach), quite accurately reflects the essence of the operation, which consists in the formation of an extended narrow gastric "sleeve" to impede the passage of solid food in the area from the esophagus to the antral (final) stomach.
In the present, the most commonly used of restrictive interventions is the installation of an intragastric bandage and laparoscopic horizontal gastroplasty using a silicone bandage. What is the principle of this technique?
New in this operation is the maximum possible narrowing of the lumen of the stomach all the way from the esophagus to the antrum. As can be seen in the figure, only a very narrow "sleeve" remains along the small curvature (the left lateral part of the stomach), the bottom and the body that are to the right of the intersection line are completely removed.
A uniformly constricted stomach undergoes uniform pressure and can not stretch out in any one place, as is the case with vertical bandaged gastroplasty. Food, passing along a long and very narrow "vertical" overcomes significant resistance and, lingering, causes a persistent feeling of saturation with a very small amount. In this way. Longitudinal resection of the stomach occupies an intermediate position between the gastric banding and gastric bypass.
Disadvantages of longitudinal resection of the stomach:
- Due to the fact that the stomach is made as narrow as possible, the first two to three months the food runs very poorly, which can cause considerable discomfort.
- In many patients (approximately 30%) who underwent gastrectomy surgery, heartburn develops. It is recommended to take omez (omeprazole) in order to reduce the production of hydrochloric acid.
- Suppuration of a postoperative wound.
- Insolvency of seams.
- Common nonspecific complications: pneumonia, pulmonary artery thromboembolism, etc.
Advantages of longitudinal gastrectomy:
- Absence of the need for adjustments in the postoperative period in comparison with the gastric band.
- Absence of foreign body in the body.
- The ability to relatively easily convert sleeve gastrectomy into gastric or biliopancreatic bypass if necessary. To do this, simply complete the operation with an "intestinal stage."
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