The Perfect Sleeve Gastrectomy

Sleeve gastrectomy (SG) is the most common bariatric procedure performed worldwide, more than 55% of bariatric procedures are sleeve gastrectomies. This title will be comprehensive and detail all the approaches used in performing sleeve gastrectomy, offering readers all the tools needed to perform the perfect SG.

Obesity has become a major global problem that continues to spread in both developed and developing countries. It costs more than any other health problem due to its prevalence and its many costly complications such diabetes and heart disease as well as in disability and loss of productivity.  While prevention of obesity is the best approach for the future, the current problem lies with managing those who are already obese or morbidly obese who constitute close to two thirds of the population in many countries such as the US.  Diet, exercise, and behavioral change are the mainstays for any meaningful attempt for significant and durable weight loss. Unfortunately, for those who are morbidly obese, these measures alone almost consistently fail to achieve acceptable weight loss in the long term.

Today, bariatric surgery is the only evidence-based treatment for morbid obesity with a low complication rate and acceptable results in the long-term for both weight loss and resolution of comorbidities.

Despite the data, the acceptance of these operations was limited due to fear of what was perceived as major surgery. Today, applying minimally invasive technology to these complex operations made them more acceptable to patients due to decreased pain, faster recovery and fewer overall complications. This, in addition to improved outcomes as we went further along the learning curve, has made these operations more common and helped growing the field to be an independent specialty for surgeons and perhaps a new specialty for gastroenterologist.

In these exciting times, the 5 international editors (one of them, Michel Gagner,