Laparoscopic Sleeve Gastrectomy

Sleeve gastrectomy is a restrictive form of bariatric surgery that shrinks the stomach to approximately 15% of its original size. It is commonly performed on severely obese patients who are not healthy enough to undergo a successful gastric bypass, biliopancreatic diversion or similar major surgery. The procedure enables rapid weight loss with fewer complications than the more conventional weight loss surgeries, but its effectiveness loses stride because there is no intestinal bypass.

The actual sleeve gastrectomy procedure is quite simple. The surgeon’s tools enter through a small incision and staple the stomach down into a long tube which is of a greatly reduced volume. Once the “sleeve” is examined to ensure quality and no leakage or bleeding, the excess stomach tissue is then excised. This direct removal has a secondary bariatric effect of reducing the secretion of the hormone Ghrelin, responsible for inducing hunger. One of the few parts of the body to produce and secrete Ghrelin is the stomach lining, most of which is removed in surgery.

Laparoscopic Sleeve Gastrectomy - Dr Arif Ahmad

Risks and Complications of Sleeve Gastrectomy

As with any surgery, there are inherent risks to under going sleeve gastrectomy. First and foremost is the risk of infection; even though the size of the incisions used for this procedure is very small, there is always a possibility that bacteria will infiltrate the body.

Specific to sleeve gastrectomy, as well as most bariatric surgeries, is the risk of leakage and bleeding. The stapling and removal of stomach tissue generally fares well while it heals within the body, but issues can arrive if the surgeon isn’t precise with his suturing or poorly reexamines the new stomach before concluding the surgery. Also, due to the huge change in the size of the stomach, the patient may over ingest so severely that food attempting to enter the reduced cavity exacerbates these conditions before it is regurgitated.

Additionally, the narrow size of the stomach may be vulnerable to large chunks of poorly masticated (chewed) food getting stuck. Finally, because this is a relatively new procedure there are many novel issues that more popular forms do not endure, relating to insurance and ability to find a suitable doctor.

Advantages and Disadvantages of Sleeve Gastrectomy

The following is a list to summarize the pros and cons to sleeve gastrectomy in comparison to other bariatric techniques:

Advantages:

Disadvantages:

• • No malabsorptive complications or related deficiencies
  • No risk of ulcer
  • Gastric dumping syndrome is largely avoided
  • Normally laproscopic, reducing recovery time
  • Removes gland that secretes Ghrelin, hunger hormone
  • No foreign bodies (bands, tubes etc) permanently inside body
  • No “tightening” needed for further weight loss
  • Considered investigational or experimental by insurance companies
  • Relatively few doctors perform this surgery
  • Weight regain more likely
  • Irreversible