A laparoscopic sleeve gastrectomy is a bariatric procedure that involves removing approximately 85 percent of the stomach and shaping the remaining 15 percent into a sleeve, according to the University of Maryland Medical Center. The procedure limits the amount of food ingested at any given time, without altering or blocking normal absorption of vitamins and minerals. Laparoscopic sleeve gastrectomy may be used as a definite procedure or as a first stage operation prior to gastric bypass surgery.
Procedure
A minimally invasive procedure, laparoscopic sleeve gastrectomy involves making five or six small incisions in the stomach, according to the Obesity Action Coalition. The procedure is performed via a video camera, or laparoscope. The doctor places the laparoscope into one of the incisions to see inside the stomach on a video monitor located in the operating room. The surgeon then places thin surgical instruments through the remaining incisions. Next, the stomach is divided along its vertical length and the surgeon removes approximately 80 to 85 percent of the excess stomach. The remaining portions are stapled together to form a small pouch in the shape of a long vertical tube or a banana, according to the MedlinePlus.
Candidates
Laparoscopic sleeve gastrectomy is ideal for patients who are at high medical risk for gastric bypass surgery, due to severe heart or lung disease. It’s also performed over gastric bypass surgery if the patient has an excessively large liver or extensive scar tissue to the intestines, according to the Obesity Action Coalition. MedlinePlus states that laparoscopic sleeve gastrectomy candidates typically are obese and have not been able to loss weight through regular diet and exercise.
Mechanism and Advantages
Laparoscopic sleeve gastrectomy is a relative short procedure, taking approximately two hours to complete. The greatly reduced stomach limits the amount of food that can be eaten in one sitting, making people feel full quicker. Also, the Obesity Action Coalition states frequent feelings of hunger subside substantially post-surgery because the hunger-stimulating hormones located within the stomach have been removed. Lastly, since the stomach is the only organ altered, consumed food follows its normal course, allowing all vitamins and minerals to still be absorbed by the intestines.
Risks and Complications
Laparoscopic sleeve gastrectomy has the least major post-operative complications of all bariatric surgeries, with complications arising in about five to 10 percent of patients, according to the Obesity Action Coalition. A leak from the sleeve can develop with this procedure, resulting in an infection or abscess, deep vein thrombosis or pulmonary embolus. Another complication that may arise is narrowing of the sleeve.
Prognosis
The Obesity Action Coalition states that several studies have shown promising weight loss results up to three years post-surgery. According to the studies, high body mass index patients, or morbidly obese patients who underwent laparoscopic sleeve gastrectomy, lost about 40 to 50 percent of their excess weight in the first two years post-surgery. The Obesity Action Coalition reports this equates to approximately 125 pounds of weight loss per patient. Patients also significantly improved or resolved their chronic medical conditions associated with obesity such as diabetes, high cholesterol and sleep apnea.
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