LAPAROSCOPIC SLEEVE GASTRECTOMY


Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by removal of a large portion of the stomach along with the greater curvature. The result is a sleeve or tube-like structure. The procedure permanently reduces the size of the stomach, although there could be some dilatation of the stomach later in life. It almost is always performed laparoscopically (i.e. keyhole surgery with a telescope).

It has become the fastest-growing weight-loss surgery in North America, Asia, Australia and New Zealand.

Currently, 77% of all bariatric operations in Australia are Sleeve Gastrectomies

The small stomach creates a sense of fullness early so that only a small amount of food can be taken in at any sitting.

When performed laparoscopically, most patients stay in hospital for 2 nights and are back at work within two weeks.

Laparoscopic Sleeve Gastrectomy

Advantages:

  • Technically straight-forward to perform
  • The smaller stomach still functions normally, so you can tolerate most foods, just in small amounts
  • The upper portion of the stomach that produces a hormone that stimulates appetite, Ghrelin, is removed
  • Less acid secretion, so less chance of an ulcer
  • Because the intestine is not bypassed, there is less chance of intestinal obstruction, anaemia, osteoporosis, or protein and vitamin deficiency long term.
  • For patients who are well motivated, this may be all the surgery that is needed to achieve weight-loss

Disadvantages

  • Not reversible, because part of the stomach is removed
  • The body still tolerates carb-rich and high-fat foods, which can slow weight loss
  • Weight loss may be more difficult or lessened without the intestinal bypass
  • Because stomach stapling is involved, a potential for leaks and other complications exists

Risks:

  • Leakage from staple line
  • Gastro-oesophageal reflux
  • Venous thrombo-embolism
  • Bleeding
  • Infection
  • Late formation of gallstones

However, the risk of internal hernia and leakage from a join are absent.

 

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