The Gastric Sleeve is performed laparoscopically, using special instruments that allow the surgeon to operate through 6-8 very small abdominal incisions. In this procedure a large portion of the stomach is removed, leaving a small tube shaped pouch. The capacity of the new stomach pouch is 3 to 4 ounces.

The Gastric Sleeve is a restrictive procedure, meaning patients lose weight by limiting the amount of food they take in. There is no re-routing of the intestines and no change in the ability to absorb calories and nutrients such as iron, vitamin B-12, and calcium. Patients report a drastic decrease in hunger and an early feeling of “fullness” when they eat. The mechanism for weight loss is a decrease in calorie intake.

The operative complication rates are comparable to that of laparoscopic gastric bypass and include gastric leak, bleeding, infection, and blood clots that can lead to pulmonary embolism. Long term complications that may require reoperation are less frequent than those for RYGB and gastric band. Risks of nutritional deficiency are very low. Because there is no implant, as with the adjustable gastric band, there is no risk of mechanical failure, and the need for frequent follow-up adjustment visits is eliminated.

Current evidence shows that the excess body weight loss at 12 months is 45% to 64%, with significant resolution of obesity related illnesses. Long term data (5 years or more) is not yet available. There is still much research to be done but the most exciting is the effect the gastric sleeve has on obese patients suffering with Type 2 Diabetes.

In June 2007, the ASMBS released a statement regarding the laparoscopic sleeve gastrectomy. Click here to read the statement.