Laparoscopic Sleeve Gastrectomy

The Bariatric Surgery Program at UT Southwestern Medical Center has been on the leading edge of weight-loss surgery for more than two decades.

We offer the laparoscopic sleeve gastrectomy as a minimally invasive bariatric option for treating obesity and related health complications.

Achieving Weight Loss Through Metabolic Changes

Gastric sleeve procedures involve removing 90 percent of the stomach, leaving a much smaller, tube-shaped stomach known as the “sleeve.” Reduced from about the size of a football to the size of a small banana, the newly created stomach limits the amount of food a patient can ingest at a time.
 
The procedure removes the fundus, the part of the stomach that produces ghrelin, a hormone that stimulates hunger and promotes fat storage. This effectively changes the body’s metabolism.

Considered to be less risky than gastric bypass surgery, sleeve gastrectomy can be an excellent option for patients who want weight loss comparable to the bypass but who may not have as much risk tolerance. The laparoscopic sleeve gastrectomy generally takes about half as long as the gastric bypass procedure.

What to Expect with a Laparoscopic Sleeve Gastrectomy

People considering a laparoscopic sleeve gastrectomy are encouraged to speak with others who have undergone the same procedure to better understand the benefits and long-term lifestyle changes that must be made. Patients are also encouraged to attend a monthly support group both before and after surgery.

Preparing for the Surgery

Prior to the procedure, patients will:

• Meet with our bariatric specialists to discuss pre- and post-operative details
• Meet with a psychologist for an evaluation and testing to prepare for the diet and the exercise requirements that are essential to successful weight-loss management
• Be required for two weeks before surgery to drink only high-protein shakes and eat one sensible meal daily
• Be on a liquid diet the day before surgery, drinking only high-protein shakes and zero-calorie beverages
• Be encouraged to exercise in the weeks leading up to the procedure

It’s essential to carefully follow diet and exercise guidelines before surgery and to prepare for a regimented diet after surgery. Our registered dietitians work with patients to develop individual meal plans and fitness goals before and after surgery.

About the surgery

A bariatric surgeon performs laparoscopic sleeve gastrectomy by making five or six small abdominal incisions and inserting a tiny camera and long instruments through the incisions. The surgeon then removes 90 percent of the stomach. The surgeon does not remove or bypass any of the intestines.

The procedure typically takes one to two hours – a short operative time that can be important for patients with severe cardiac or pulmonary conditions.

Recovery
Patients who undergo a laparoscopic sleeve gastrectomy typically spend one or two nights in the hospital after the procedure. Depending on their condition and medical history, most people can return to work within two to three weeks.

Life After Surgery

Post-operative diet
As with all types of bariatric surgery, patients must immediately follow a special diet for the rest of their lives after undergoing a laparoscopic sleeve gastrectomy.

It generally takes six weeks after the procedure to “retrain” the stomach to eat. The first two weeks consist of consuming only liquids. During a six-week transition period, foods are gradually reintroduced to the altered “new” stomach and remaining gastrointestinal system. Our bariatric surgery team supervises this process.

Post-operative exercise
As soon as the bariatric surgeon says it’s time, patients can begin a rigorous exercise program to help them lose weight and avoid regaining it. Research shows that exercise helps patients lose more weight more quickly while increasing their aerobic fitness.

We recommend 150 minutes of moderate physical activity, such as brisk walking, or 75 minutes of vigorous physical activity, such as jogging or swimming laps, per week.

Post-Operative Care
All bariatric surgery patients are required to have regular follow-up appointments. These visits ensure that weight loss occurs in a healthy, consistent manner. They also help prevent minor complications from turning into major ones. The bariatric surgery team will also regularly monitor patients’ vitamin and mineral levels.

Patients who have undergone a laparoscopic sleeve gastrectomy typically visit a registered dietitian, a bariatric advanced practice provider, or a bariatric surgeon every three months for the first post-operative year, twice the second post-operative year, and then annually.

Weight Loss Success Stories

• Patricia England lost more than 120 pounds after a sleeve gastrectomy. Read her success story.
• John (Chris) Davis lost 80 pounds 6 months after a sleeve gastrectomy. Read his success story.