The Laparoscopic Sleeve Gastrectomy procedure may also be called the ( Sleeve Gastrectomy, Vertical Gastrectomy, Greater Curvature Gastrectomy, partial Gastrectomy )  It generates weight loss by restricting the amount of food ( and therefore calories ) that can be eaten by removing 80% or more of the stomach without bypassing the intestines or causing any gastrointestinal malabsorption.  It is a purely restrictive operation.

 

This procedure generates weight loss solely through gastric restriction (reduced stomach volume).  The stomach is restricted by stapling and dividing it vertically and removing more than 80% of it.  This part of the procedure is not reversible.  The stomach that remains is shaped like a very slim banana and measures from 1-5 ounces (30-150 cc).  The nerves to the stomach and outlet valve (pylorus) remain intact with the idea of preserving the functions of the stomach while drastically reducing the volume.  By comparison, in a Roux-en-Y gastric bypass, the stomach is divided, not removed, and the pylorus is excluded.  The Roux-en-Y gastric bypass stomach can be reconnected (reversed) if necessary.  There is no intestinal bypass with the Sleeve Gastrectomy, only stomach reduction.  The lack of an intestinal bypass avoids potentially long term complications such as marginal ulcers, vitamin deficiencies and intestinal obstructions.

 

The portion of the stomach which is removed is responsible for secreting Ghrelin, which is one of the hormones that are responsible for appetite and hunger.  By removing this portion of the stomach rather than leaving it in-place, the level of Ghrelin is reduced to near zero, actually causing a reduction of appetite.

 

The removed section of the stomach is actually the portion that “stretches” the most.   The long vertical tube shaped stomach that remains is the portion least likely to expand over time and it creates significant resistance to volumes of food.  Not only is appetite reduced, but very small amounts of food generate early and lasting satiety.

 

Alternative to a Rou-en-Y Gastric Bypass

There is no intestinal bypass, risk of malabsorptive complications such as vitamin deficiency and protein deficiency is minimal.

• There is no risk of marginal ulcer which occurs in over 2-5% of Roux-en-Y Gastric Bypass patients
• The pylorus is preserved so dumping syndrome does not occur or is minimal.
• There is no intestinal obstruction since there is no intestinal bypass
• It is relatively easy to modify to an alternative procedure should weight loss be inadequate or weight regain occur.