What Is a Lap Sleeve Gastrectomy?

A lap sleeve gastrectomy is a type of weight-control surgery that removes part of the stomach. The procedure is used for those who are morbidly obese and have not responded to more conservative treatments, such as diet and exercise, to lose weight and improve their health. Morbid obesity is defined as twice normal weight, or at least 100 pounds over normal weight.

Laparoscopy

• The "lap" in lap sleeve gastrectomy indicates that the surgical procedure is performed by laparoscopy. According to Dr. Dennis C. Smith of the Advanced Obesity Surgery Center in Biloxi, Miss., instead of a long, open-abdominal incision to reach the stomach, the surgeon usually makes about five tiny incisions around the abdomen and then inserts special micro-tools and instruments through these incisions. A tube is inserted to inflate the abdomen with gas so that the abdominal wall rises, allowing the surgeon better access and visibility. Because the liver lies in front of part of the stomach, surgical retractors lift the liver out of the way. A scope with a light and tiny video camera allows the surgeon to watch a video screen and see inside the abdomen during the procedure.

The Sleeve

• "Sleeve" refers to the appearance of the stomach after the surgeon removes 75 percent to 85 percent of it, leaving an organ with a long, tube-like shape. The surgeon creates the sleeve with a special double stapler after loosening the stomach from surrounding tissue. Starting at the bottom of the stomach, the surgeon uses the stapler to "bite" the stomach into two parts. The tool creates a double row of staples that splits in the middle, separating the sleeve from the portion of the stomach that is removed.

Gastrectomy

• "Gastrectomy" refers to removal of the stomach. After the stomach is separated, the removed portion is pulled through one of the abdominal incisions.

  The pyloric valve, a band of muscle, separates the stomach from the pylorus (the first part of the small intestine). The valve tightens to prevent the stomach from emptying too quickly. One advantage to the lap sleeve gastrectomy is that the pyloric valve is not removed, and this prevents the "dumping" syndrome (nausea, vomiting, bloating and diarrhea) that patients who have other types of bariatic surgery experience shortly after eating.

Function

• Once the stomach is smaller, you feel full very quickly when you eat. Additionally, according to Mount Sinai Hospital Bariatric Surgery Center, the part of the stomach removed (the fundus) produces the hormone ghrelin, which triggers hunger. With less of this hormone, you feel less hunger. Because the remaining stomach functions normally, you can eat any type of food in small amounts. This procedure does not bypass any part of the small intestine, so you won't have to worry about vitamin and protein deficiencies that result from inadequate absorption after having other types of weight-loss surgeries.

Weight Loss

• While weight loss varies from person to person, according to Medline Plus, most people lose 50 percent to 60 percent of their excess weight within the first year after surgery.