Robotic Sleeve Gastrectomy
Robotic Sleeve Gastrectomy
Sleeve gastrectomy or sleeve gastrectomy is a restrictive surgery and is the partial removal of the left part of the stomach. The left lateral part of the stomach is released from the distal to the proximal part of the stomach. After the fundus is completely released in the upper part of the stomach, the left side of the stomach is removed. At this stage, the gastric tube in the desired calibration is placed orally on the patient. Thanks to the devices we call staplers, the stomach is closed and then cut with three rows of staples from the side of this tube. The procedure is completed by either closure of the remaining stomach part of the patient with a second layer of suture (this is our preference) or topical application of tissue adhesives to the staple line. After the excised part of the stomach is taken out of the abdomen, the small trocar sites are closed and the procedure is terminated. The surgery can be performed laparoscopically or robotically.
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The stomach, which has a normal volume of 1.5-2 L, becomes 150-200 mL after this surgery and causes a restriction in food intake. Weight loss in the patient is not only limited by the volume of the stomach, but also a decrease in the ghrelin hormone, an increase in the feeling of satiety, an acceleration of gastric emptying, and an acceleration of the passage time of the small intestine. Ghrelin is an endogenous hormone consisting of 28 amino acids and stimulates appetite and food intake. Thus, it causes the accumulation of fat mass in the body and the release of growth hormone. This hormone is mainly released endogenously by the gastric fundus cells, but also from the duodenum, jejunum, ileum, lung, kidney, heart and adrenal glands. In gastric sleeve surgery, the fundus is taken during the removal of the left part of the stomach. Thus, the removal of the region that releases the most Ghrelin hormone in the body causes an increase in the feeling of satiety.
The American Society of Metabolic and Bariatric Surgery has defined sleeve gastrectomy surgery as an acceptable method for the extremely morbidly obese patients as the first stage of gastric bypass or duodenal switch surgeries. Gastric sleeve surgery is one of the most frequently performed procedures in the field of obesity surgery in our country.
