Sleeve – Gastrectomy  Food restrictive operation Production of hunger hormones reduced More effective then LAGB Procedure  6 cm cranial from pylorus , greater curvature dissected up to the angle of hiss. Use of 60mm stapler all the way up. First 2 green than blue. Use of staple line enforcement material or over suing is optional  and should be decided due to personal preference or  upon the particular case. Stapling over bougie , different sizes made no difference. 38 – 42 fr.ch   Hospital stay between 2-4 days Drain is kept for appr. 10days and removed in the office. Gastrografin swallow performed routinely 1 p.o day and liquid diet started, to be continued for 4-5 weeks. Patient put on 100 g protein in liquid form 5 p.o day until is able to eat meat Results All patient lose weight. Long term results (over 5 years not yet available). Life quality better than LAGB. Patient satisfaction is high. Beside food restriction appetite inhibition is remarkable. Vitamin substitution necessary in the beginning. Complications • One fistula (post gastric banding case). • One pancreatitis two weeks post operative. • One case of stress ulcerations about 4cm distal of G/E junction, completely      obstructing gastric tube. • Conversion to gastric bypass. 1 case of post operative bleeding. No      intervention needed
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