Laparoscopic Sleeve Gastrectomy Overview
If you're very overweight, obesity surgery may be a choice for you. Obesity surgery is also called bariatric surgery. Your healthcare provider may advise it if you have a body mass index (BMI) higher than 40 or higher than 35 with certain other obesity-related conditions, such as sleep apnea or diabetes. A BMI higher than 40 typically means that you're about 100 pounds overweight. One of the 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 5 small cuts in your belly. They will use a thin long scope with a tiny camera at the end to do the surgery. Tools pushed through the incisions will be used to remove about 80% of your stomach. Your surgeon will do the procedure while viewing the 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'll have a much smaller stomach, you'll fill up quickly at mealtimes and eat less.
The fundus secretes a hormone called ghrelin. This hormone may be partly responsible for making you feel hungry. So, removing it may also help you lose weight afterward by decreasing your hunger.
LSG surgery takes about 2 hours. Most people stay in the hospital for about 2 days after surgery.
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 second, more extensive type of weight-loss surgery at a later date. The risks with some forms of bariatric surgery are much higher for people with a BMI of more than 60.
If you're 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 weight-loss surgeries.
If you have a BMI of about 40 to 50, your healthcare provider may advise LSG. That's because it's less likely to cause side effects than other forms of weight-loss surgery. Side effects can include stomach ulcers or poor food absorption.
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:
Stomach juices leaking from where the stomach was removed
- Risk of vitamin and iron deficiency
- Higher risk of surgical problems than gastric band surgery
- Risk of hiatal hernia caused by the stomach pushing up against the diaphragm
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
Poor wound healing
Heart issues, such as a heart attack
Lung problems, such as pneumonia
To help protect against gastrointestinal problems and weight regain, continue to have careful follow-up with your provider 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. These changes need to be kept for the long term.
Be sure to discuss any type of weight-loss surgery carefully with your healthcare provider. Before surgery you'll need to have a complete physical exam to make sure you are healthy enough to have the procedure. You should also get nutritional and mental health counseling to make sure you're prepared for what to expect after surgery.