Tube Gastrectomy

This is a relatively new approach. It is the first component of the duodenal switch operation and involves removing the lateral 2/3rds of the stomach with a stapling device. It can be done laparoscopically (keyhole surgery), but is not reversible. It basically leaves a stomach tube instead of a stomach sack.

This is the first component of a BPD-DS, where the stomach is reduced in size by removing the lateral 2/3rds, leaving the stomach in the shape of a tube.

Sometimes it is offered to patients as part of a two-stage Bypass operation, particularly if they are super obese (BMI>60) because it allows good weight loss until the patient gets down to a safe weight and the more radical bypass can then be offered laparoscopically when they are at a safer weight.

The residual stomach capacity is about 200 mls, so a generous entrée should be possible.

Issues with Tube gastrectomy

• Stomach tube may stretch up over time leading to late weight regain. The extent of this is currently unknown.
• The amount of weight reduction is in the region of 40-60% of excess weight lost over the first 1-2 years.
  • It is a good option for people living in remote areas because it is a "set and forget" operation, which requires little post-op follow up or nutritional supplements,
  • There is no malabsorption to nutrients,
  • If weight is regained, the second stage of the BPD, the intestinal bypass, can be added... often laparoscopically as well.

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