Laparoscopic Vertical Sleeve Gastrectomy
Laparoscopic vertical sleeve gastrectomy procedure is a relatively new procedure in the U.S. The Vanderbilt Center for Surgical Weight Loss has experienced great success with this procedure. Our patients have lost the weight they expected while staying healthy. In late 2012, this procedure became an option for Medicare patients following government approval.
The sleeve gastrectomy is performed laparoscopically through small incisions. Sophisticated instruments and a small camera are inserted through these incisions to conduct the operation. The use of small incisions creates less tissue damage, fewer complications, and an earlier discharge from the hospital.
In this procedure, most of the stomach is removed and a ‘vertical sleeve’ or tube is fashioned from the remaining stomach. The food goes through the stomach into the small intestine in a normal fashion. Because the stomach is so much smaller, it takes less food to fill you up, and you eat less. The food does not bypass any of the intestines so there is no malabsorption created by the sleeve gastrectomy. The production of the “appetite hormone” ghrelin is reduced since it is made by the stomach. The reduction of this hormone reduces hunger and contributes to the success of the procedure.
Advantages of the Sleeve Gastrectomy
The procedure is a satiety-inducing procedure because it reduces the “appetite hormone” ghrelin, and there is no bypassing of the small intestine therefore the risk of malnutrition is low. Long term the sleeve gastrectomy has less risk of bowel obstruction and stomach ulcers. Weight loss after the sleeve gastrectomy is similar to the weight loss after the gastric bypass.
Disadvantages of the Sleeve Gastrectomy
The procedure removes part of the stomach, is not reversible and is considered experimental by most insurance companies; therefore, it is typically not covered. United Healthcare and Blue Cross Federal now cover the procedure.