MORBID OBESITY > Laparoscopic Sleeve Gastrectomy

Patient and Port position: Patient is placed in modified Lloyd Davies position.
Pneumoperitoneum is created by veress needle through 10 mm Supraumbilical skin incision which was later on is converted into 10mm camera port.  5mm epigastric, 12 mm right and 10mm left mid-clavicular line ports, 5 mm left anterior axillary line ports are placed.

STEPS:
Initial step is to visualize all quadrants of peritoneal cavity, liver surfaces and esophageal hiatus. Omentum is divided close to the greater curvature of stomach, started 2 cm proximal to pylorus till the angle of His. Gastric sleeve created by the sequential firing of staplers (green or blue cartridge depending on thickness of stomach wall) over a 36 F gastric calibration tube starting 3cm proximal to pylorus till 1cm away from angle of His. Gastric Sleeve is checked for leak by Methylene blue dye test.