Sleeve Gastrectomy

More commonly known as the gastric sleeve, laparoscopic vertical sleeve gastrectomy (LVSG) is currently the most popular bariatric surgery. Similar to the duodenal switch (DS), the hormonally active portion of the stomach is removed, with the remaining tubular segment restricting oral intake. However, in contrast to both the gastric bypass (RYGB) and the DS, there is no intestinal rerouting; hence, no malabsorptive component.

For reasons not yet fully known, the resolution of medical problems appears to be weight loss independent, albeit at a slower rate than with the RYGB or DS. The removed portion contains the hunger hormone Ghrelin, leading to earlier satiety. It is, therefore, considered to be a restrictive-anorectic operation. Sleeve gastrectomy offers many of the benefits of the more established stapled procedures, while simultaneously avoiding the need for frequent adjustments or the litany of downstream complications associated with embedded foreign bodies as in the gastric band operation.

The Procedure

1. The stomach is freed from organs around it. 
2. Surgical staplers are used to remove 80% of the stomach, making it much smaller. The removed part is thought to be the hormonally active component.

How it Works

The new stomach holds less food and liquid helping reduce the amount of food (and calories) that are consumed. By removing the portion of the stomach that produces most of the “hunger hormone”, the surgery has an effect on the metabolism. It decreases hunger, increases fullness, and allows the body to reach and maintain a healthy weight as well as blood sugar control. The simple nature of the operation makes it very safe without the potential complications from
surgery on the small intestine.

Advantages

1. Technically simple and shorter surgery time
2. Can be performed in certain patients with high risk medical conditions
3. May be performed as the first step for patients with severe obesity
4. May be used as a bridge to gastric bypass or other malabsorptive procedures
5. Effective weight loss and improvement of obesity related conditions

Disadvantages

1. Non-reversible procedure
2. May worsen or cause new onset reflux and heart burn
3. Less impact on metabolism compared to malabsorptive procedures

To get more information, We recommend that you watch our free online bariatric surgery seminar as well as the the relevant modules on EMMI, a patient education program. www.my-emmi.com/SelfReg/UNIVERSITYBARIATRICS