Laparoscopic sleeve gastrectomy: an innovative new tool in the battle against the obesity epidemic in Canada.

Obesity can be considered to be one of the most important chronic diseases facing Canadians of all ages. Whereas patients with a very high body mass index may have the most to gain from procedures such as Roux-en-Y gastric bypass or biliopancreatic diversion/duodenal switch, the increased risk of postoperative complications often makes them poor surgical candidates. As a result, several "bridging" procedures have been proposed to impart clinically effective weight loss and reduce the risk of complications and improve outcomes in the definitive weight-loss procedure. In this article, we provide a review of the evidence in support of laparoscopic sleeve gastrectomy as an innovative new surgical procedure used as a bridging procedure in patients with severe obesity and discuss new findings for its possible role as a definitive procedure for some individuals with less severe obesity. Finally, we comment on a possible approach to introduce this innovative new procedure to Canadian bariatric centres.