Gastric Sleeve

Laparoscopic sleeve gastrectomy involves surgically removing 85% of the stomach, resulting in a new stomach roughly the size and shape of a banana. It is a purely restrictive operation and generates weight loss by restricting the amount of food (and therefore calories) that can be consumed. The procedure is also believed to effect the gastrointestinal tract hormones responsible for control of hunger and diabetes.

Laparoscopic sleeve gastrectomy is for patients with a body mass index (BMI) greater than 35 kg/m2, or as the first of a two-step surgery process for patients with a BMI of 50 or greater, with the second bariatric surgery taking place once the patient’s weight has fallen to a point where other forms of surgery are viable. It is also used in high risk patients who may be poor candidates for the laparoscopic gastric bypass.

After Surgery

A typical laparoscopic sleeve gastrectomy patient can expect to spend one night in the hospital and be on a liquid diet for the first week following surgery and gradually progress to soft proteins then solid food.

Advantages
  • Although the stomach is reduced in size and the amount of food you can consume is restricted, the stomach still functions normally and most foods can be eaten in small amounts.
  • The portion of the stomach that produces ghrelin, the hormone responsible for appetite and hunger, is removed. This results in a reduction of appetite.
  • There is no disconnecting or reconnecting of the intestines, lessening the risk of complications.
  • Because there is no intestinal bypass, patients don’t experience complications such as intestinal obstruction, “dumping syndrome,” anemia, osteoporosis, and protein deficiency.
  • The procedure is performed laparoscopically even on patients weighing more than 500 pounds.
Disadvantages
  • Because the stomach is removed, the procedure is not reversible.
  • There is a greater potential for insufficient weight loss or weight regain because the procedure does not limit the types of food that can be eaten.
  • Chronic anemia due to Vitamin B12 deficiency may occur. The problem can usually be managed with Vitamin B12 pills or injections.
  • The procedure involves stomach stapling; and, although the risk is minimal, leaks and other complications related to stapling may occur.