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Laparoscopic Sleeve Gastrectomy
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This is a restrictive procedure.
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During sleeve gastrectomy, approximately 70 – 80% of the stomach is removed. Using specially designed surgical staplers, the surgeon removes the outer curve of the stomach, converting the sac-shaped stomach into a narrow vertical tube that is shaped like a banana. This new gastric tube will have a total volume of less than 100mls, effectively restricting food intake. The distal (lower) end of the stomach and the pylorus (the valve that regulates emptying of the stomach) is preserved. This allows food to hold up in the stomach for awhile, causing a feeling of fullness early on, even after small meals.
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Apart from the fact that this operation creates a new stomach with a markedly reduced capacity for food, sleeve gastrectomy may also have significant effects on hunger mechanisms: Ghrelin, a hunger-stimulating hormone is produced mainly by cells in the fundus of the stomach. Since the fundus is removed during this procedure, there is a decreased capacity to produce Ghrelin after sleeve gastrectomy. Consequently many patients report that although they are able to eat much less than before, they do not experience the frequent hunger pangs that plague dieters.
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Like most restrictive procedures, this operation works best in people who are 'big meal' or 'volume' eaters.
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If you are motivated, willing to comply with dietary plans and able to exercise regularly, the sleeve gastrectomy will produce very good results. On average, the sleeve gastrectomy produces better weight loss than gastric banding.
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Laparoscopic Sleeve Gastrectomy may not work as well on 'sweet eaters': people who consume a lot of high-calorie, energy dense foods like ice cream, soda, candy, sweets, chocolate, etc.
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In our experience, patients who snack and graze all day by eating small handfuls of nuts, chips and other junk foods also may not do well with sleeve gastrectomy. These patients never overeat and feel full so they get no benefit from the gastric restriction; instead, they consume a steady stream of calories through the day.
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- This operation is NOT reversible
- Unlike gastric banding, it does not involve placement of a permanent implant or foreign body
- It DOES involve cutting & stapling of the stomach but there is no rearrangement or rerouting of the intestines. There is very little risk of developing nutritional deficiencies after this procedure
- It is associated with a low surgical risk. Most surgeons consider the surgical risk for sleeve gastrectomy to be in between the risk of gastric banding and that of gastric bypass
- The average hospital stay following this procedure is between 2 – 3 days
- Laparoscopic Sleeve Gastrectomy has been shown to result in excellent weight loss. On average, patients lose 55 – 70% of their excess weight. These figures approach weight loss produced by more extensive surgical procedures such as the gastric bypass
- This is a relatively 'new' bariatric procedure and for that reason we do not know if the excellent weight loss that sleeve gastrectomy initially produces is maintained after many years. Recently published data report that excess weight loss at 6 years after surgery is approximately 53 – 55% [1], [2]
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