Sleeve Gastrectomy (ISG) : The Birth and Evolution of Laparoscopic

 

Is sleeve gastrectomy the result of an omphaloskepsis? Omphaloskepsis or navel contemplation of one's self is known to be an aid to meditation. The word originates from the Greek omphalos, signifying “navel” and skepsis, meaning “viewing”. In Hinduism, the navel is the site of a powerful chakra. focal point of mediation, the site of the universe, but it is also the exit ofthe sleeve gastrectomy specimen, transcending a powerful individual change.

 

The sleeve gastrectomy follows the duodenal switch evolution, but its originators did not create the concept of a stand alone or staged procedure called “sleeve gastrectomy”. Doug Hess and Picard Marceau altered the open biliopancreatic diversion, modified it, and called it duodenal switch, generally called “DS”, in 1988-90, with the needs for a major gastrectomy to diminish the acid load on the duodenal ileal anastomosis, causing dramatically less anastomotic ulcers [1, 2]. In Marceau’s description, the BPD distal gastrectomy is replaced with a “65% to diminish the acid load on the duodenal ileal anastomosis,

causing dramatically less anastomotic ulcers [1, 2]. In Marceau’s description, the BPD distal gastrectomy is replaced with a “65% parietal cell gastrectomy” along the greater curvature: note that this was not called “sleeve gastrectomy” at the time, leaving a stomach of at least 200 mL [3].

 

I'initiated, as a principal investigator, a small animal swine pilot project in May 1999 at Mount Sinai School of Medicine where I had been an attending and professor of surgery. with the help of Dr. Gregg Jossart who was a clinical fellow in laparoscopic/bariatric surgery at Mount Sinai School of Medicine in New York under my directorship, has since served as the Director of Minimally Invasive Surgery at California Pacific Medical Center in San Francisco since 1999, assisted by Dr. John de Csepel, who was my research fellow and resident at the time from the same organization, who is now the Chief Medical Officer & Vice President of Medical Affairs for Medtronic's