Laparoscopic Sleeve Gastrectomy

The laparoscopic sleeve gastrectomy is a newer procedure involving the resection or removal of most of the outer portion of the stomach, leaving a narrow tube or sleeve-shaped stomach. It was originally used in conjunction with an additional weight-loss surgery in extremely obese patients, but more recently, it has been shown to be very successful as a primary procedure. It causes weight loss by decreasing stomach size and limiting the amount of food one can eat (restriction). Additionally, the production of a hunger hormone (Ghrelin) is significantly reduced which decreases appetite.

 

Advantages:

• Patients typically see significant and rapid weight loss, often 50-70% excess weight loss in the long-term.
• It is less drastic than the gastric bypass as there is no rearrangement of the GI tract.
• There is no use of prosthetic devices (i.e. gastric band).
• There is often significant improvement of many weight-related medical problems.
• It can be safer for patients who require anticoagulation, regular NSAID pain medication or high-dose psychiatric medications.
• Very low mortality rate -- approximately 0.2%.

Disadvantages:

• Leaks from staple lines may result in infection or death.
• Staple line strictures may lead to obstruction and vomiting.
• Some patients develop reflux or heartburn symptoms.
• There is a lack of long-term data, though short and mid-term data demonstrate very good results and low complication rates.