Losing weight is not an easy task, particularly when patients are diagnosed with morbid obesity, according to their Body Mass Index (BMI). After unsuccessful attempts at losing weight through diet, exercise, pre-packed-meals or pharmacotherapy, which are the most common medically supervised weight loss methods, surgery may represent the only resource. Laparoscopic sleeve gastrectomy is one of the surgical methods to lose weight that is included in the category of bariatric surgery.
The surgery is particularly indicated for people with very high BMI, high BMI who also suffer from comorbidities, or who have a complex surgical history. Since it is an invasive procedure, physicians only consider it in cases when there is high medical risk for bypass or for patients who prefer to have a more permanent surgery, but that does not involve a device being placed inside their body, as is the case with gastric band procedures.
Laparoscopic Sleeve Gastrectomy Procedure
During a laparoscopic sleeve gastrectomy, the surgeon removes up to 90% of the stomach, reducing its size and capacity to enhance weight loss. The stomach is vertically divided into two parts, creating a small pouch shaped like a banana or a sleeve. After stapling the stomach, the surgeon removes the excess. The laparoscopic sleeve gastrectomy is a restrictive operation, since it limits the food intake, but it does not alter the normal function of the digestive system.
The procedure is called “laparoscopic” since it is performed without the need for open surgery. The surgeon makes five to six small incisions in the abdomen that are used to pass surgical instruments, including a laparoscope camera. By doing so, surgeons increase visibility, while the laparoscopic method involves less pain, scarring and recovery time. Most of the weight loss surgeries can be performed either through laparoscopy or open surgery, but the latter involves a higher risk of infections and adhesions, since the internal scarring can cause additional complications.
Laparoscopic Sleeve Gastrectomy Efficacy
Among the greatest benefits associated with a laparoscopic sleeve gastrectomy is the fact that the normal function of the stomach, nerves or other aspects of the digestive system are not affected. Since the food ingested continues to follow its normal route, the development of dumping syndrome is less likely. In addition, compared to other methods, there is also a lower risk of ulcers and patients do not need to visit the hospital as often.
Studies on the efficacy of the surgery revealed that it is effectively able to reduce hunger as part of stomach responsible for producing stimulating hormones is removed, while patients also feel full faster and with smaller amounts of food, since the stomach is reduced. The study “Long-term Weight and Metabolic Effects of Laparoscopic Sleeve Gastrectomy Calibrated with a 50-Fr Bougie,” published on July 2015, emphasized the importance of a preoperative correct selection of candidates and a close postoperative follow-up.
Laparoscopic Sleeve Gastrectomy Disadvantages and Risks
One of the most important features about recovery and efficacy of laparoscopic sleeve gastrectomy is postoperative follow-up. In order to accomplish successful weight loss, adopting a healthy diet and partaking in exercise as well as following the physician’s indications is critically important. Laparoscopic sleeve gastrectomy has a lower risk of complications than a gastric bypass, but higher than a laparoscopic adjustable band.
Main complications that can occur during the procedure include bleeding, infection, injuries to the other organs, or the surgery may need to convert the procedure to an open procedure. In addition, following the surgery, there is also the risk of leak from the staple line, which is a problem that tend to occur in less than one percent of the cases.