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Operations

Laparoscopic Sleeve Gastrectomy (Tube Gastrectomy)

Laparoscopic Sleeve Gastrectomy

This is our restrictive procedure, where the stomach volume is reduced by stapling it along its entire length.  The final result is a 70mL to 100mL stomach tube.  The reduction in stomach volume enforces a restriction in the amount of food able to be ingested at any one time.  This is equivalent to the size of a desert plate.  This procedure is done laparoscopically, via keyhole surgery, and is performed through five incisions measuring 5mm to 15mm.  The length of the hospital stay averages five days. 

Advantages of Laparoscopic Sleeve Gastrectomy:

  1. Simply reduces the amount of food, not the type of food
  2. Normal stomach emptying therefore no vomiting
  3. No malabsorption
  4. No adjustments required post operatively compared to the Gastric banding
  5. Ideal for patients in remote areas

Disadvantages of Laparoscopic Sleeve Gastrectomy:

  1. Possible long-term weight regain if the tube stretches
  2. Relatively new operation, therefore, long term results are not defined
  3. An additional procedure may be necessary later if sufficient weight loss is not obtained

In properly chosen patients, these purely restrictive operations have long term success rate of approximately 60% - 70%, meaning patients lose at least 60% of their excess weight and maintain the weight loss for at least five years.

The more conservative of the combined procedures, such as the roux-en-y gastric bypass, have long term success rates of approximating 80% and the average weight loss is 60% - 70%.  The duodenal switch results in the greatest weight loss, with most patients losing 70% - 90% weight over two years.  These procedures are not discussed in detail here, however, if it is considered appropriate, more information will be made available.

The Minimizer Ring

  • The Minimizer Ring is a silastic ring that can be placed around the stomach at the time of a sleeve gastrectomy.
  • The Minimizer Ring is designed to help prevent the stomach from stretching that can occur over time after a sleeve gastrectomy. This may help prevent long-term weight regain over time.
  • The ring has been used for several years with a gastric bypass and at this time we are gathering evidence as to how effective it is with a sleeve gastrectomy. You may be asked to voluntarily participate in a research study to help determine how effective the ring is at preventing the stomach from stretching over time.
  • The Minimizer ring is not the gastric band/lap band and works quite differently.
  • The ring has a good safety profile but if you would like to have the ring removed or require it to be removed for any reason, this can be done so quite easily. Dr Chandraratna will only leave the ring in place if it fits around the stomach loosely and this reduces the risk of complications.
  • We offer the Minimizer Ring to all of our patients who have a sleeve gastrectomy.
  • There is no additional cost for for the ring for patients who have private health insurance covering the surgery. (For uninsured patients, there is an additional cost).
Minimizer Ring
 
Lambung
 

Decision to Proceed with Bariatric Surgery

As healthcare providers, we will only proceed with surgery if we believe that you have made an informed decision. You should have an understanding of your obesity and the procedure involved. Also, you should also have realistic expectations of what the procedure can accomplish and are be aware of the risks involved.

We are committed to doing everything necessary to get the best possible results for you.  Also, a large commitment is required from you to achieve your goals, which means that you will have a responsibility to modifying your lifestyle, eating and exercise habits.

Your decision to proceed should only be made after careful consideration and discussion with your family. This decision could ultimately change your life in a very powerful and positive way.  However, you must be committed to work for this change.

Find out more about Tube Gastrectomy with the following links.

Laparoscopic Sleeve Gastrectomy Video Laparoscopic Sleeve Gastrectomy Laparoscopic Sleeve Gastrectomy
Comprehensive Medical Assessment
Diet/ Nutrition
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