Laparoscopic Sleeve Gastrectomy

The Laparoscopic Sleeve Gastrectomy procedure generates weight loss by restricting the amount of food (and therefore calories) that can be eaten by removing 2/3 or more of the stomach without bypassing the intestines or causing any gastrointestinal malabsorption.  It is a purely restrictive operation.  It is currently indicated as an alternative to the Laparoscopic Adjustable Gastric Band procedure and as a safe option for higher weight individuals.

This procedure generates weight loss solely through gastric restriction (reduced stomach volume).  The stomach is restricted by stapling and dividing it vertically and removing more than 2/3 of it.  This part of the procedure is not reversible.  The stomach that remains is shaped like a very slim banana and measures from 1-5 ounces.  The nerves to the stomach and the outlet valve (pylorus) remain intact with the idea of preserving the functions of the stomach while drastically reducing the volume.  Note that there is no intestinal bypass with this procedure, only stomach reduction.  The lack of an intestinal bypass avoids potentially costly, long-term complications such as marginal ulcers, vitamin deficiencies and intestinal obstructions.  The Laparoscopic Sleeve Gastrectomy is believed to have an advantage over the Adjustable Gastric Band due to removal of the part of the stomach that produces the hormone [Ghrelin] that controls the desire to eat. The removed section of the stomach is actually the portion that “stretches” the most.  The long vertical tube shaped stomach that remains is the portion least likely to expand over time and it creates significant resistance to volumes of food.  Remember, resistance is greatest the smaller the diameter and the longer the channel.  Not only is appetite reduced, but very small amounts of food generate early and lasting satiety [fullness]).