Laparoscopic Sleeve Gastrectomy is a weight loss methodology in which the abdomen is reduced to about 15% of its initial size, by surgically removing a large segment of the belly along the greater curve.
This sleeve gastrectomy is an easier and simpler operation than the gastric bypass process as it does not involve the diverting of or reconnection of the intestines. This surgery also does not require the use of a banding tool to be embedded around a portion of the stomach, unlike the Lap-band. As far as the weight loss is concerned, it is generally faster with the sleeve than with the gastric band.The other advantages in the list are less food intolerance and lower surgical risk than with the gastric bypass while weight loss is similar.
The procedure of the surgery :
One will acquire general anaesthesia prior to this surgery. This is a medicine that keeps a patient asleep and pain-free for few hours or so.
The surgery is usually done using a tiny specialized video camera that is placed in the belly. This type of surgery is called laparoscopy and the camera is called a “laparoscope”, this allows the surgeon to view inside the belly during the operation with the help of the video monitor in the operative room.
Post these processes, the surgeon makes 2 to 5 small cuts called “incisions” in the abdomen through which the necessary instruments that are needed to perform the surgery are inserted.
A harmless gas is pushed into the belly to inflate it. The stomach wall thus gets lifted up from the small intestine and other organs giving the surgeon enough space to work. The surgeon removes most of the part of the stomach at least about 75% of the belly, hence creating a long vertical tube or banana-shaped stomach.No intestines are extracted or bypassed during this operation.
The leftover portions of the stomach are joined together using surgical staples. The tools are removed and then the cuts are stitched closed.
The surgery takes approximately 60 to 90 minutes.
This surgical procedure is primarily used as part of a staged access to weight loss. The patients who have a very high body mass index “BMI” or who are at risk for undergoing anaesthesia or suffers from heart problems may benefit from this staged approach. In patients who undergo “LSG” as a first stage procedure, the second stage i.e. gastric bypass is carried out 12 to 18 months later after the occurrence of significant weight loss and then the risk of anaesthesia is much lower as the liver also decreases in size. Though this approach involves two procedures yet it is safe and effective for selected patients.
The patients undergoing this surgery can expect to lose weight varying between 40% to 70% of their surplus body weight that they had earlier in the first year after operation.
Many obesity-related disorders improve after bariatric surgery. Diabetes, hypertension and other related diseases. Abnormal cholesterol levels get cured in more than 75% of patients undergoing “LSG”. Though wider study has not been done relating to this particular topic yet the weight loss that occurs after LSG results in drastic improvement in these medical conditions in the first year after surgery.
Authored By Dr G Parthasarathy - Surgical Gastroenterologist, Hyderabad