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| Laparoscopic Sleeve Gastrectomy |
The Sleeve gastrectomy involves that the stomach is restricted by dividing it vertically and removing more than 70 percent of it. The stomach that remains is shaped like a thin banana. The nerves to the stomach and the outlet valve (pylorus) remain intact with the idea of preserving the functions of the stomach while reducing the volume. Note that there is no intestinal bypass or malabsorption with this procedure, only stomach reduction. In case of high risk patients, the laparoscopic sleeve gastrectomy is used as a first stage to induce weight reduction allowing for the more demanding intestinal dissection (Duodenal switch or Bypass) to be performed under good conditions.
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Since this operation does not involve any "rerouting" or reconnecting of the intestines, it is a simpler operation than the gastric bypass or the duodenal switch. Unlike the Gastric Banding procedure, the Sleeve gastrectomy does not require the implantation of an artificial device inside the abdomen. For certain patients, in particular those with a body mass index greater than 60, the Sleeve gastrectomy may be the first part of a 2-stage operation. The 2-stage operation may have substantial advantages for specific individuals. |
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| Advantage of the Laparoscopic Sleeve Gastrectomy |
The stomach is reduced in volume but tends to function normally so most food items can be consumed, albeit in small amounts.
Eliminates the portion of the stomach that produces the hormones that stimulates hunger (Ghrelin).
No dumping syndrome because the pylorus is preserved. Minimizes the chance of an ulcer occurring.
By avoiding the intestinal bypass, the chance of intestinal obstruction (blockage), anemia, osteoporosis, protein deficiency and vitamin deficiency are almost eliminated.
Very effective as a first stage procedure for high BMI patients (BMI>60 kg/m2).
Similar results appear as a single stage procedure for low BMI patients (BMI 35-45 kg/m2) with the gastric bypass.
Appealing option for people with existing anemia, Crohn's disease and numerous other conditions that make them too high risk for intestinal bypass procedures. Can be done laparoscopically in patients weighing over 220 kgs (500 pounds). |
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| Disadvantages of the Laparoscopic Sleeve Gatrectomy |
Potential for inadequate weight loss or weight regain. While this is true for all procedures, it is theoretically more possible with procedures that do not have an intestinal bypass.
Soft calories such as ice cream, milk shakes, etc can be absorbed and may slow weight loss.
This procedure does involve stomach stapling and therefore leaks may occur.
Because the stomach is removed, it is not reversible. It can be converted to almost any other weight loss procedure.
On average, patients who undergo laparoscopic Sleeve Gastrectomy surgery experience a 60 to 80 % loss of excess weight.
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