Sleeve gastrectomy and its modifications

Initially sleeve gastrectomy (SG) was performed as an open procedure in 1988, known as Hess and Marceau’s technique, which is actually the first stage of the bilio-pancreatic diversion-duodenal switch (BPD-DS). It was proposed in 1993 as a single weight-loss procedure defined by Johnston, later known as operation Magenstrasse and Mill. In 1999 Gagner was the first to describe laparoscopic SG technique. Therefore SG became popular and one of the most common bariatric surgery procedure in the world. The method has many technical differences. Unfortunately, there is still no strict standardization of the method. With the development of technology, robotic surgery has taken its place in bariatric surgery field. A lot of new studies on robotic SG (RSG) have recently been published. Also there are several technical conflict, such as distance from the pylorus, resection of greater curvature, size of the antrum, use of bougie, fundus resection, whether or not reinforce the staple line, identification and repair of the hiatus. There are also some contraindications for SG. Barrett’s esophagus is a one of them. These variations in the technique affect the complications and effectiveness of surgery. In this study, we aimed to discuss the development and modifications of SG steps of with the current literature review.