This is background information about the Sleeve Gastrectomy.  It was first used in weight loss surgery by Dr. Hess in 1988, and published in the literature in 1993.  This is the restrictive part of the duodenal switch operation.  This is not a new concept.  As more people wanted weight loss surgery who were heavier, had high risks; with more significant medical problems, Sleeve Gastrectomy was used as the first operation (stage) in a 2 staged approach.  The rational was to have a shorter, less complex initial procedure, followed with weight loss and improvement in the risks related to obesity. Afterthe expected improvement, a mal-absorption component (small intestine bypass) was to be done as a final stage.  Dr. Gagne in NYC performed the first Laparoscopic, Sleeve Gastrectomy.   The initial outcome after the LSG is very effective.  The weight loss is in the 46-83% range with greater than 53% weight loss has been noted in 6 months.  The weight loss is similar to the Roux-en-Y Gastric Bypass.  The associated medical conditions improved as anticipated.  These results are generally holding for the long term.  Adding the mal-absorption component after initial weight loss has for most not been required.  However, having stage 2 done is an option for those with inadequate weight loss or weight gain.  The complication rate is less than 3% which is less than that seen with gastric bands and compared to gastric bypasses. Another positive for the Laparoscopic Sleeve Gastrectomy is there is no foreign body implanted.  In my "opinion" I think the Laparoscopic Sleeve Gastrectomy will replace the Laparoscopic Band in the next 3 to 5 years.  Dr. Gonzalez will discuss this new use of an older procedure at the May 12, 2008 meeting.