Laparoscopic sleeve gastrectomy is a minimally invasive type of bariatric surgery used to reshape the stomach of obese patients. The patient undergoes a consultation to determine if he is a candidate for laparoscopic surgery. Prior to the surgery, the patient usually meets with the surgeon who answers any questions and provides pre-operative instructions. The surgeon might require blood tests and other diagnostic studies. Following the sleeve gastrectomy, which is generally completed in about an hour, the patient usually remains hospitalized for 24 to 48 hours.
The surgeon performs laparoscopic sleeve gastrectomy while the patient is under general anesthesia. Up to six dime-sized incisions are made in the belly through which the laparoscope and other surgical instruments enter the abdomen. Before the procedure begins, the surgeon usually inflates the abdomen slightly with a gas, lifting the skin and musculature away from internal organs. Using a high frequency sound wave scalpel, the surgeon separates the stomach from fatty and connective tissue while sealing minor blood vessels.
Once the surgeon has isolated the stomach, the process of longitudinal resection begins with the surgeon removing the large curved area, leaving a tubular structure, or sleeve, measuring approximately 0.4 inches (11 mm) in diameter. Using an endoscopic surgical instrument resembling an alligator clip, the surgeon applies multiple vertical rows of staples simultaneously to a section and then slices through the tissue. The doctor repeats this process until the entire stomach has been reduced. He might also apply clips, sutures or a fibrous adhesive to the closed incision on the remaining portion of the stomach as reinforcement. Depending on the initial size of the organ, laparoscopic sleeve gastrectomy may remove up to 85 percent of the stomach.
After a laparoscopic sleeve gastrectomy procedure, the patient is monitored in a recovery area before being admitted to a room. The physician usually prescribes pain medication, usually administered through a preprogrammed pump, for post-operative discomfort.
Patients are usually walking within a day of surgery. The following day, patients begin a protein-supplemented liquid diet, which typically continues for the first three weeks after surgery. Individuals generally resume normal activities within three weeks. Since the procedure is less invasive and causes less trauma than other bariatric procedures, patients generally recover in a shorter period of time.
Complications of a laparoscopic sleeve gastrectomy might include nausea, vomiting, and dehydration. Patients can develop an infection which would cause them to develop a fever, swelling or unusual drainage. Within 30 days, some people experience more serious consequences, which include internal bleeding or leakage from the stomach surgical site or development of a hernia. The surgical procedure or post-op immobility can also produce blood clots that culminate in pulmonary embolism.
