Laparoscopic Sleeve Gastrectomy (Gastric Sleeve)

Also Known As Tube Gastrectomy

Also known as gastric sleeve or tube gastrectomy, is where approximately 70 – 80% of the stomach is completely removed effectively turning the stomach, which is like a big bag normally into a small tube.  The biggest advantage is that there is no foreign device to fail or cause obstruction and there is no major alteration in the gastro-intestinal tract. 

Effects of Surgery

Patients will feel full with an entrée size portion, but also once they get beyond the normal post-operative recovery period can eat most foods, which is a major advantage over gastric banding.

The other major effect of the procedure is to remove the part of the stomach that secretes Ghrelin, a hormone that plays a major role in determining how hungry we get.  When normal people go on a diet as they lose weight the stomach starts to produce more and more Ghrelin, which acts on the brain to increase appetite. 

Often people who are dieting have the sensation that they are starving to death.  Patients who have had a sleeve gastrectomy generally have a greatly reduced appetite, and as they lose weight they do not suffer the hunger pains experienced by dieters.

Will This Weight Loss Procedure Suit You?

Sleeve gastrectomy is suitable for most morbidly obese patients.  It has a clear role in super obese or high-risk patients where it may be used as the first operation in a staged 2-part surgery to greatly reduce the operative risks in these patients.  Following the sleeve gastrectomy patients are allowed to lose weight for 12 months at which stage they are reassessed to determine whether they have lost enough weight which many will have. 

If weight loss has not been satisfactory patients can then have a second operation where they are converted to either a gastric bypass or bilio-pancreatic diversion procedure. This combination or 2 stage approach greatly reduces the risk in other wise high-risk patients and ultimately allows a much more effective procedure to be performed. 

Sleeve gastrectomy as a stand-alone procedure may also be performed in individuals as an alternative to either laparoscopic gastric banding or laparoscopic gastric bypass.  It is an especially good option for country patients as there is not the same need for intensive follow up and readjustments required with gastric banding.

How LSG (Gastric Sleeve) Works

The laparoscopic sleeve gastrectomy is a relatively new weight loss procedure.  It is a restrictive procedure and works by limiting the amount of food you can eat at any one time.

A laparoscopic sleeve gastrectomy (LSG) involves removing approximately two thirds of your stomach, turning your stomach into a thin tube or sleeve.  The normal stomach acts as a large bag, storing food as you eat, and with a sleeve gastrectomy, you are able to eat a normal diet but in much smaller portions. 

In addition, the portion of the stomach that is removed produces a hormone called ghrelin which makes you feel hungry when your stomach is empty.  By removing this portion of the stomach, even though you are eating
less, you do not feel hungry and therefore you lose weight

Advantages of LSG

The advantage of the sleeve gastrectomy is that your anatomy is not altered.  You are able to eat a normal diet but in entrée sized portions.  This is felt to be particularly beneficial for men as men’s dietary issues tend to be related to portion size rather than the consumption of high calorie sweets and desserts. 

The laparoscopic sleeve gastrectomy does not require the same degree of intensive follow up as the laparoscopic gastric band and therefore may be better for country patients or patients who have to
travel widely in relation to their work.

The laparoscopic sleeve gastrectomy produces rapid weight loss with maximal weight loss usually attained within 12 to 14 months.  Most patients can expect 60% to 65% excess weight loss.  A laparoscopic sleeve gastrectomy usually involves a two night stay in hospital. 

Obviously, as the resected part of the stomach is “in the bin”, the procedure is not reversible and in addition, there is limited long-term data weight loss data beyond seven years.

Risks Of LSG

Specific risks related to the laparoscopic sleeve gastrectomy include a staple line leak.  The stomach is divided and closed with a stapling device.  The staple line has to heal and there is a small risk that it could leak.  If this was to happen, you would require further surgery, usually laparoscopic, and possibly a stay in intensive care.  If the leak is not controlled and infection results, this can become life threatening.  In addition, the staple line can bleed.

This is usually managed without the need for a return to surgery and occurs in less than 1% of cases.  Less common complications are impairment of the stomach’s ability to empty and stricturing or narrowing of the stomach tube.  These complications occur in less than 1% of cases.

To find out more about this weight loss procedure, please click here to arrange a free, obligation free consulation.

ADVANTAGES

  • Performed laparoscopically, with fast recovery and short hospital stay
  • Effective short to mid term weight loss with average of 60% excess weight out to 5 years.
  • No foreign body
  • Wide range of foods tolerated

DISADVANTAGES

  • Not reversible
  • Long term outcomes not known

MORE ON THE LAPAROSCOPIC SLEEVE GASTRECTOMY

Laparoscopic Sleeve Gastrectomy - Information Sheet (600 KB)

Preliminary Sleeve Gastrectomy Study Results (327 KB)

WATCH THE VIDEO ABOUT THIS PROCEDURE

Phil Lockie discusses the advantages, disadvantages and process of Laparoscopic Sleeve Gastrectomy.

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