Sleeve technique is a recent bariatric procedure (it has been practiced in less than 10 years) and has been evolving with great global acceptance and presenting good results in multiple centers nationally as well as internationally. It consists of building a new stomach with the shape of a thin tube by removing 70% to 80% of the original stomach, which will restrict the food intake. It also presents a hormonal control of hunger for reducing the production of ghrelin.

ADVANTAGES:

• It does not exclude duodenum from the food path, so it does not interfere with the absorption site of iron, calcium, zinc and B complex vitamins, decreasing the need for long-term use of vitamins;
• If the surgery is unsuccessful, it can be transformed into any other regulated bariatric technique;
• It allows access to the biliary and pancreatic ducts by usual endoscopic methods;
• It doesn’t require anastomosis or rotation of the bowel.

DISADVANTAGES:

• Irreversible method, which can produce complications of high severity and difficult treatment as the occurrence of fistula near the angle of Hiss (esophagogastric), but with low incidence.
• Although there are data demonstrating acceptable weight loss (better than that obtained with the adjustable gastric band), this weight loss appears to be lower than other divert procedures such as Gastric Bypass;
• The long-term results of the procedure on the durability of weight loss and the control of diabetes and associated diseases are not yet fully understood.
• It tends to worsen gastroesophageal reflux disease in some patients, due to the loss of anti-reflux mechanisms, and in a very low percentage of cases, there may be a need for a new surgical procedure (revision surgery).

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