The Sleeve Gastrectomy Procedure

The Laparoscopic Sleeve Gastrectomy

The Laparoscopic Sleeve Gastrectomy is an operation that can be done either as a stand-alone procedure, or as part of a staged operation for high-risk patients. The weight loss is projected to be in the range of 55 to 60% of the excess body weight, which is better than or comparable to that of other Laparoscopic Bariatric Procedures. However, this procedure doesn’t have the foreign body problems such as erosion or slippage that can occur with the gastric band. There are no connections between the stomach and the small intestine or the small bowel and another portion of small bowel, so the risks of complications are decreased.

Weight Loss Mechanism

In the Sleeve Gastrectomy procedure, the stomach is reduced to about 100-120 cc in volume, which results in weight loss. As a result, patients feel satisfied with less food, and they lose weight because they eat less. The portion of the stomach that is removed produces about 90% of the Ghrelin released in the body. Recent studies show Ghrelin to be the most potent hunger producing hormone. Without Ghrelin production, insatiable hunger is no longer a problem. Patients eat less but are satisfied. This reduction in caloric intake combined with exercise and food choice changes, results in weight loss that can be maintained.

Preservation of Pyloric Valve

Very importantly, the Sleeve Gastrectomy preserves the pylorus, the valve that regulates emptying of the stomach. This acts as "natures band" and allows food to hold up in the stomach naturally, making the person feel satisfied while the food trickles out. Coupled with the fact that there is no rearrangement of the bowel, it also means dumping and marginal ulcers are not a problem. The normal satiety mechanism is preserved and enhanced.