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Laparoscopic Sleeve Gastrectomy

The Sleeve gastrectomy involves that the stomach is restricted by dividing it vertically and removing more than 85% of it. The stomach that remains is shaped like a thin banana. The nerves to the stomach and the outlet valve (pylorus) remain intact with the idea of preserving the functions of the stomach while reducing the volume. There is no intestinal bypass or malabsorption with this procedure, only stomach reduction. In case of high risk patients, the laparoscopic sleeve gastrectomy is used as a first stage to induce weight reduction allowing for the more demanding intestinal dissection (Duodenal switch or Bypass) to be performed under good conditions.
Since this operation does not involve any "rerouting" or reconnecting of the intestines, it is a simpler operation than the gastric bypass or the duodenal switch. Unlike the Gastric Banding procedure, the sleeve gastrectomy does not require the implantation of an artificial device inside the abdomen.
Advantage of the Laparoscopic Sleeve Gastrectomy

- The stomach is reduced in volume but tends to function normally so most food items can be consumed, albeit in small amounts.
- Eliminates the portion of the stomach that produces the hormones that stimulates hunger (Ghrelin).
- No dumping syndrome because the pylorus is preserved. 
- By avoiding the intestinal bypass, the chance of intestinal obstruction (blockage), anemia, osteoporosis, protein deficiency and vitamin deficiency are almost eliminated.
- Very effective as a first stage procedure for high BMI patients (BMI>60 kg/m2).
- Similar results appear as a single stage procedure for low BMI patients (BMI 35-45 kg/m2) with the gastric bypass.
- Excellent option for people with existing anemia, Crohn's disease and other conditions that make them too high risk for intestinal bypass procedures. 
Disadvantages of the Laparoscopic Sleeve Gatrectomy
- Soft calories such as ice cream, milk shakes, can be absorbed and may slow weight loss.
- This procedure does involve stomach stapling and therefore leaks may occur.
- Because the stomach is removed, it is not reversible. It can be converted to almost any other weight loss procedure. - Potential for weight regain, while this is true for all procedures.

On average, patients who undergo laparoscopic sleeve gastrectomy surgery experience a 75 to 85 % loss of excess weight during the first year. 
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