Sleeve gastrectomy (also called gastric sleeve) was originally performed on extremely obese patients, with a body mass index well exceeding 50 or 60 or more, where the risk of performing a gastric bypass or duodenal switch procedure may be too large. A two-stage procedure is performed: the first is a sleeve gastrectomy, and the second is a conversion into a gastric bypass or duodenal switch. Patients usually lose a large quantity of their excess weight after the first sleeve gastrectomy procedure alone, but if weight loss ceases the second step is performed.
For patients that are obese but not extremely obese (BMI 35-40), sleeve gastrectomy alone is a suitable operation with minimum risks. The sleeve gastrectomy currently is acceptable weight loss surgery option for obese patients as a single procedure. Most surgeons prefer to use a bougie between 32 - 60 Fr with the procedure and the ideal approximate remaining size of the stomach after the procedure is about 150 mL.
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