• Relatively new operation
• A restrictive type procedure                                           
• Can be used as stand-alone procedure for those with BMI <55 kg/m2
• Or as a staged procedure before gastric bypass for high-risk patients with BMI >55 kg/m2
• Weight loss of 50% of excess weight, similar to Lap-Band
• Higher weight loss can be achieved depending on patient’s commitment
• Operative time = 1.5 hour
• Hospital stay: 1-2 days
• Return to work in 1 week

How does it work?

• 85% of the stomach is removed creating a banana shaped stomach that holds 100-120 ml in volume (depending on the surgeon)
• Removes the centers that produce the hunger hormone (Grehlin)
• Expectation of weight loss 1.5-2.0 lbs/week

Advantages:

• Physiologic procedure
• No intestinal re-routing
• No implantable band or other foreign body
• Low malnutrition risk
• No diarrhea, anemia, dumping syndrome, osteoporosis, or vitamin loss
• Can be used as a bridge operation to gastric bypass if weight loss is not adequate
• Good for patients with existing anemia, Crohn’s disease and other conditions that make them high risk for intestinal bypass

Disadvantages:

• Slower initial weight loss than gastric bypass
• Not reversible

Surgical Complications:

• 1% possible leak that may require surgery