[Will laparoscopic sleeve gastrectomy continue to exist as a stand-alone procedure? : A procedure critical...

Sleeve gastrectomy is currently the most frequently performed bariatric procedure worldwide; however, with respect to a certain need for revisional surgery (due to reflux disease or weight regain) there is an ongoing discussion about the value of sleeve gastrectomy in terms of a stand-alone procedure.

The aim of this article is to critically discuss whether sleeve gastrectomy can still be considered a stand-alone procedure.

The current literature was searched for results after sleeve gastrectomy and the recommendations regarding this procedure are discussed.

Currently approximately 50% of primary bariatric procedures are sleeve gastrectomies, which has become a well-established stand-alone procedure. Sleeve gastrectomy leads to good mid-term results; however, the results of the Roux-en-Y gastric bypass are comparatively superior in terms of type 2 diabetes remission, control of preexisting or de novo reflux disease and weight loss. The mortality is comparable; however, the morbidity is lower after sleeve gastrectomy but there is a relevant rate of fistulas of the stapler suture.

Patients considered for sleeve gastrectomy must be informed of the procedure-specific risks, including the unforeseeable need for revision or redo surgery firstly due to weight regain or failing to reach the individual therapy target and secondly for worsening of a preexisting or de novo reflux disease.