الفهرس 
aim of the workOnly 14 pages are availabe for public view
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Abstract
Obesity is a common disease affecting more than 1.7 billion of population per year. Bariatric surgeries offer the only means of delivering sustained weight loss in severe obese patients. LSG is an effective surgical option as s primary procedure for weight loss. LSG achieves weight loss by gastric restriction and decreasing the circulating level of ghrelin hormone which play a key role in the energy balance.
The major complication for LSG is postoperative gastric leak, The use of staple-line reinforcement either through suturing or buttressing with biological or synthetic material is a hotly debated topic, reinforcement do not reliably reduce staple line leaks in sleeve gastrectomy.
There is an overall tendency toward more restriction of the final sleeve by using a smaller bougie and leaving shorter antrum. Different studies were able to show that AP-LSG and AR-LSG are both efficient techniques regarding weight loss and improvement in co-morbidities after surgery. There is a hard believe that both techniques are valuable surgical alternatives for selected patients with morbid obesity. Long-term follow-up data and larger studies highly needed to confirm these results.