What Is a Laparoscopic Sleeve Gastrectomy?



Sleeve Gastrectomy is a bariatric surgery targeted at helping a patient achieve weight loss. This option is usually recommended for patients who may be required to achieve substantial weight loss due to health reasons but have not been able to, despite making changes to their dietary and lifestyle habits such as exercising. 


During laparoscopic sleeve gastrectomy, the stomach is stapled and divided vertically. This procedure requires specially designed surgical staplers, using the keyhole or laparoscopic method. By doing this, about 2/3 of 60% of the stomach will be removed. 


The remainder of the stomach is now in the shape of a long narrow tube resembling a shirt sleeve. The reduced size of the stomach restricts the amount of food the stomach can hold at a time and thus reducing the appetite of the patient, helping them reduce the calorie intake and achieve long term weight loss.


Why Should I Consider a Sleeve Gastrectomy?


Laparoscopic Sleeve Gastrectomy, Sleeve Gastrectomy, Weight Loss Surgeries


Sleeve gastrectomy is used to treat severe obesity. The procedure helps an individual lose excess weight, thereby reducing the risk of contracting weight-related health problems that can be life-threatening, such as heart disease, high cholesterol, type-2 diabetes, stroke and cancer.


A doctor usually recommends the procedure after attempts to lose weight through exercising and diet are unsuccessful.


Not all patients can qualify for sleeve gastrectomy. This procedure is only an option if:


  • The individual’s BMI (Body Mass Index) is 40 or above.
  • The individual’s BMI is between 35 and 39.9, and they display signs of severe weight-related health problems such as type 2 diabetes, high blood pressure or severe sleep apnea. 
  • The individual’s BMI is between 30 and 34. However, they have serious weight-related health problems that can be life-threatening, and your doctor advises immediate attention. 


The patient must also be prepared to make permanent changes to their lifestyle to ensure sustainable weight loss. Such lifestyle changes may include:


  • Long-term follow-up sessions with your doctor
  • Following a nutrition plan
  • Adopting an active lifestyle such as regular exercises
  • Monitoring of medical condition progress


The result of Laparoscopic Sleeve Gastrectomy is very good, with about 60% of one’s excess weight being lost over one or two years. More importantly, this can be maintained for at least five to ten years with close follow-ups with a doctor. Complications from the surgery are also considerably lower compared to traditional open Sleeve Gastrectomy surgeries.


How Does a Sleeve Gastrectomy Work?

The details of a sleeve gastrectomy will depend on the patient’s condition after the doctor’s assessment. Sleeve Gastrectomy can be done with traditional open incisions in the abdomen or laparoscopically, which involve smaller incisions made in the upper abdomen.


Regardless of the type of procedure, open or laparoscopic, the patient will be given general anaesthesia and will not be conscious during the surgery. 


To perform a sleeve gastrectomy, our doctor will need to create a “pocket” by wrapping the top part of the stomach vertically around the lower oesophagus while the more significant curved part of the stomach is removed. This creates a small stomach, resembling a sleeve which is where the name Sleeve Gastrectomy is derived from.   


Laparoscopic sleeve gastrectomy is usually the preferred option as the procedure is minimally invasive and has reduced risk compared to open surgery. Moreover, compared to traditional Sleeve Gastrectomy, Laparoscopic Sleeve Gastrectomy has a faster recovery time, significantly less pain, and minimal scarring.


The surgery may usually take up to 2 hours, and after the surgery, you will be required to stay in the hospital for observation for signs of complication.


What Are the Side Effects of Sleeve Gastrectomy?


Like any other surgery, a Sleeve gastrectomy carries some level of risks that can be short and long term. The risks associated with a sleeve gastrectomy can include bleeding from the surgical site, allergic reaction to the anaesthesia, leakage from the stomach, and infection from the wound. 


However, complications from sleeve gastrectomy are rarely life-threatening. 


Severe complications from a sleeve gastrectomy may lead to the following conditions such as:


  • Nausea and vomiting
  • Hypoglycemia (Low blood sugar)
  • Gastrointestinal obstruction
  • Hernia
  • Gastroesophageal reflux disease (GERD) and
  • Malnutrition


When conducted laparoscopically, the risk of complication from sleeve gastrectomy is also reduced as the surgery adopts a less invasive method and allows faster recovery time. 


What Should I Expect After a Sleeve Gastrectomy?


Sleeve gastrectomy helps you with lifelong changes in your diet and lifestyle. For the first week after the surgery, you may be placed on a liquid diet and another two weeks of eating soft and pureed foods. 


You will likely be able to consume solid food in small portions after that. This food plan is crucial to ensure that your staple lines heal well after the procedure to keep the sleeve in place.


When you can resume eating solid foods, you will be able to eat all foods, but in much smaller quantities. You will feel full and satisfied more quickly after consuming a small portion of food, as the volume of food the pouch can hold is significantly reduced. 


Your stomach may be full after eating as little as half a cup of solid food, and this food keeps you satiated for the next few hours. This reduces the amount of food that you can eat at a time. You will also consume food more slowly. 


Simultaneously, as sleeve gastrectomy resects your fundus, the main part of your stomach which produces ghrelin, known as the ‘hunger hormone’, decreased levels of ghrelin lead to a reduced appetite and greater satiety. This also helps you lose weight quickly without having to make an intentional effort, unlike dieting. 


This means you can still consume most of your favourite foods without having to worry about dumping syndrome, in which you will experience abdominal discomfort and other symptoms. You may take some time getting used to these changes, and they should be permanent. This is what ensures rapid and reliable weight loss.


Your doctor or nutritionist may advise you to take multivitamins and Vitamin B tablets daily and help you make healthy food choices. You may be advised to start an exercise routine as soon as you obtain the green light from your surgeon. 


Regular exercise works hand-in-hand with a healthy diet to ensure sustained weight loss and prevent weight regain. Unlike certain types of bariatric surgery, ongoing adjustments do not need to be made. However, regular follow-up with your surgeon or dietician is necessary to ensure the pace of weight loss is appropriate and your intake contains adequate nutrition.


What Are the Benefits of Choosing Laparoscopic Sleeve Gastrectomy Over Traditional Sleeve Gastrectomy?


Laparoscopic sleeve gastrectomy is a safe and effective procedure where patients can expect to lose around 60 to 80 percent of their excess body weight and sustain it in the long term.


Furthermore, studies have shown that laparoscopic sleeve gastrectomy causes many obesity-related diseases to resolve or improve following surgery, leading to improvement in an individual’s quality of life.


Successful and Sustained Weight Loss With a Sleeve Gastrectomy


Laparoscopic sleeve gastrectomy helps patients to lose weight more rapidly over a significantly shorter time. In many cases, rapid weight loss occurs in the first six months after the procedure and around 70 per cent of their excess weight within one year after the surgery. Studies have found that 60 percent of this excess weight loss is maintained in the next five years.


How a Sleeve Gastrectomy Can Improve or Resolve Obesity-Related Diseases


Not only does laparoscopic sleeve gastrectomy help you in weight loss that is significant and sustained, but this surgery has also been proven to improve or resolve multiple comorbidities linked to obesity. 


Studies have shown that more than 75 percent of patients undergoing laparoscopic sleeve gastrectomy will have significant improvement or resolution in many major conditions such as Type II Diabetes, hyperlipidemia, hypertension, obstructive sleep apnea, high cholesterol and gastroesophageal reflux disease. 


Within one year, patients report 80 per cent resolution for Type II Diabetes, 75 per cent for hyperlipidemia, 83 per cent for hypertension, and 91 per cent for gastroesophageal reflux disease. The effect is especially notable in Type II Diabetics, who experience incredible improvement in diabetes control with weight loss, and the majority of patients with Type II diabetes go into long term remission. This is a result of the weight loss achieved through bariatric surgery.


High rate of satisfaction and improvement in quality of life


Following laparoscopic sleeve gastrectomy, patients benefit from this surgery and lead longer healthier lives. 


Within three months after laparoscopic sleeve gastrectomy, patients report greater satisfaction due to improved health, better self-image and increased social activity due to weight loss. Ninety-three per cent of patients have experienced an enhanced quality of life due to weight loss and better management of obesity-related conditions such as Type II Diabetes and hypertension.


A Sleeve Gastrectomy Has an Extremely Low Risk of Complications 


It is noteworthy that laparoscopic sleeve gastrectomy is a simple procedure as it does not involve rerouting or reconnection of your intestines. Thus this procedure has a very low rate of complications and quick recovery times. 


The surgical risks with a laparoscopic sleeve gastrectomy are highly uncommon and affect less than one per cent of all patients undergoing the procedure. There is also less risk of developing vitamin or mineral deficiencies as the food you eat will follow a normal digestive route with no change in your gastrointestinal tract.


Laparoscopic sleeve gastrectomy is also virtually scarless as your surgeon makes several small incisions instead of a large one. As opposed to traditional open surgery, laparoscopic sleeve gastrectomy causes you to experience less pain, less risk of wound infection, shorter hospital stay and a faster recovery and return to normal activities.


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