Sleeve gastrectomy is a bariatric surgical procedure involving resection of the greater curvature of the fundus and body of the stomach to leave approximately 15% of the original gastric volume (60-100 mL), thus creating functional restriction. The postsurgical gastric pouch resembles a banana-shape 1.
It was originally proposed as the first part of a two-stage operation in obese patients with a BMI >60 kg/m2 or in high-risk patients. The weight loss in these patients was deemed successful and it began to be used as a standalone procedure 1.
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Radiographic features
Fluoroscopy
- long tubular gastric pouch with an abrupt widening of the distal end of the pouch (secondary to preserved gastric antrum)
- linear streak or outpouching of contrast may be seen within non-excised fundus which can mimic extraluminal leakage 1
CT
- narrowed, tubular (banana-shaped) stomach which has a smaller calibre along its long axis, with abundant mesenteric fat at the expected location of the excised stomach
- staple line identified along the greater curvature of the gastric pouch
Complications
See article: sleeve gastrectomy complications.