Sleeve Gastrectomy as a Stand alone Bariatric Procedure for Obesity: A Technology Assessment

Judith Walsh, MD, MPH



In This Article


Bariatric surgery might be indicated for individuals who are unable to control their weight with conservative measures. The current standards of care for bariatric surgery are the RYGB and LGB. SG was initially used as the first part of a two part procedure, but subsequent information has suggested that SG alone may be enough for some individuals. SG is technically easier than RYGB and so is an attractive surgical option especially in morbidly obese patients.

The results of multiple case series and retrospective studies have suggested that SG as a primary procedure is associated with a significant reduction in excess weight loss. The complication rate ranged from 0–4.1% and complications included leaks, bleeding, strictures and mortality.

Only two randomized controlled trials have compared SG to another surgical procedure. These trials included a total of 112 participants who were followed from one to three years. Among the 80 participants followed for three years, there were a similar number of complications in the SG and the RYGB groups, although the complications in the SG group were more severe. To date, long term outcomes from registry studies are relatively limited, but longer term follow-up will provide additional important information. Future studies will hopefully provide additional information on the relative efficacy and complication rates in larger number of individuals and also on the long term benefits and risks of the procedure. Some of the ongoing trials should hopefully answer some of these questions in the future.


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