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Laparoscopic sleeve gastrectomy

Description

Laparoscopic sleeve gastrectomy involves 5 small incisions. The stomach is dissected from its attachments. A rubber tube (‘bougie’) is then passed down the swallowing pipe into the stomach. The stomach is then stapled off against this bougie to ensure the sleeve is sized/calibrated correctly. The stapled off stomach is then removed, permanently, through one of the keyhole wounds. Lots of local anaesthetic is placed in the wounds and the abdominal cavity. Most patients wake up with very little pain or nausea. Over 90% of patients are well enough to go home on day 1. Up to 1 in 20 patients will have significant nausea the next day, and need to stay in hospital an extra night until this settles.

Indications

BMI > 40, or BMI > 35 with weight related comorbidities. Patients with pre-existing severe reflux or super high BMIs (needing massive weight loss) should not usually have a sleeve gastrectomy. Please discuss the relative merits of the available weight loss surgery procedures with Dr Dodd.

Risks

Bleeding (1% of cases) from the sleeve staple line. This is very rare but can be severe enough to require a return to the operating theatre. Leak (1% of cases) from the sleeve staple line is a rare but potentially serious event. This can require return to theatre, conversion to Roux-en-Y gastric bypass, drains, ICU stay and a prolonged stay in hospital. Leaks can happen weeks after surgery. Symptoms of leak include new onset severe pain, fever, chills and rigors (violent body shakes). If you have any of these symptoms after surgery, please contact Dr Ben Dodd urgently. Late complications: These include sleeve torsion (twisting), stricture (narrowing), hiatus hernia and reflux. These can be severe enough to require revisional surgery.

Related Information

Obesity