Laparoscopic Sleeve Gastrectomy

Sleeve gastrectomy is a purely restrictive procedure. It can be used as a primary weight loss operation or as a first-stage operation in a 2-stage approach in patients who are extremely obese and may carry significant risks to undergo a one step definitive surgical approach.

The sleeve gastrectomy is an operation in which the left side of the stomach is surgically removed. This results in a new stomach which is roughly the size and shape of a banana. Since this operation does not involve any "rerouting" or reconnecting of the intestines, it is a simpler operation than the gastric bypass or the duodenal switch.

Unlike the Lap-Band® procedure, the sleeve

Laparoscopic Sleeve Gastrectomy
© Medical Imagery

gastrectomy does not require the implantation of an artificial device inside the abdomen. It works as the Lap-Band® procedure but with the additional advantage of the avoidance of some of the complications and side-effects associated with the Lap-Band® procedure. What are the advantages of the "Sleeve?"

It does not require disconnecting or reconnecting the intestines
It is a technically simpler operation than the gastric bypass or the duodenal switch
It may be a safer operation for some patients with a BMI more than 60.
It may be used as the first stage of a 2-stage operation.

What is a 2-Stage Operation?
Certain patients may have a body shape that makes their surgery more technically difficult. For example, patients with a BMI over 60 -- particularly those who carry their weight in their belly area -- may be at increased risk for bariatric surgery. If you fall into this category, you may benefit from a 2-Stage bariatric surgery.

In the staged approach, a multi-step operation like the gastric bypass or the duodenal switch is broken down into 2 simpler and safer operations. In the first stage, a sleeve gastrectomy is performed. This allows losing 80 to 100 pounds or more, which will make the second part of the operation substantially safer.

The second stage operation is usually performed 8 to 12 months after the first. The "sleeve" stomach is converted into a formal gastric bypass or duodenal switch. This will permit additional weight loss and will provide a much more permanent result than sleeve gastrectomy alone.

Both stages of the surgery can be performed laparoscopically, giving the advantage of shorter recovery, shorter incisions, fewer incision-related problems and less pain.