Laparoscopic Sleeve Gastrectomy Overview
If you are severely overweight, obesity surgery may be a choice for you. Obesity surgery
is also called bariatric surgery. Your healthcare provider may recommend it if you
have a body mass index (BMI) higher than 40. A BMI of greater than 40 typically means
that you are about 100 pounds overweight. One of the newer choices for bariatric surgery
is called laparoscopic sleeve gastrectomy (LSG).
The LSG procedure
LSG surgery is done in a hospital under general anesthesia. Your surgeon will make
about five small cuts in your belly. He or she will do the surgery using a thin, long,
telescope with a tiny camera at the end. Instruments pushed through the incisions
will be used to remove about 80% of your stomach. Your surgeon will do the procedure
using images on a TV screen in the operating room.
This surgery takes out the part of your stomach that curves outward, called the fundus.
After the fundus is taken out, your surgeon will close the rest of your stomach into
a tube shape that looks like a banana or the sleeve of your shirt, hence the name
"sleeve gastrectomy." Because you will have a much smaller stomach, you will fill
up quickly at mealtimes and eat less.
The fundus contains most of the area of your stomach that secretes a hormone called
ghrelin. Because ghrelin may be partly responsible for making you feel hungry, taking
out this part of your stomach may also help you lose weight afterward by decreasing
LSG surgery takes about 2 hours. Most people stay in the hospital for about 2 days
Reasons to consider LSG surgery
Here are some reasons why LSG may be right for you:
If you have a BMI of more than 60, LSG may be used as a first surgery to help you
lose enough weight so you can then safely have a more extensive type of weight-loss
surgery such as a gastric bypass or duodenal switch with biliopancreatic diversion.
The risks with some forms of bariatric surgery are much higher for people with a
BMI over 60.
If you are older or have other risk factors for surgery like heart, lung, or liver
problems, LSG may be a safer choice for you than other longer and more complicated
If you have a BMI of about 40 to 50, your healthcare provider may recommend LSG as
the primary weight-loss surgery. That's because it's less likely to cause side effects.
These include stomach ulcers or poor food absorption than other forms of weight-loss
Weight-loss benefits of LSG
In the first 2 years after LSG, most people will lose between 40% and 50% of their
body weight. If your BMI before surgery is 60 or more, you may lose about 125 pounds.
Studies also show that if you have obesity-related problems like diabetes, high blood
pressure, sleep apnea, or high cholesterol, you have about a 75% chance that these
conditions will also improve.
Risks of LSG surgery
Any surgery done under general anesthesia carries some risk for heart and brain damage,
but these risks are low. LSG is a shorter procedure than other types of gastric bypass
surgery. With LSG surgery you have a 5% to 10% risk for a complication such as:
Leaking of stomach juices from where the stomach has been removed
Blood clot that forms in your leg and travels to your lungs and heart
Narrowing of the inside diameter of the new stomach
Nutrients poorly absorbed
To help protect against GI problems and weight regain, you should continue to have
careful follow-up past the third year after surgery.
Weight loss after LSG slows down after a few years, and your stomach may stretch and
grow. For any bariatric surgery to succeed, you must make important lifestyle changes
that include both better nutrition and regular exercise.
Be sure to discuss any type of weight-loss surgery carefully with your healthcare
provider. Before surgery you will need to have a complete physical exam to make sure
you are healthy enough to have the procedure. You should also receive nutritional
and mental health counseling to make sure you are prepared for what to expect after