Skip to main content

Advertisement

Log in

Laparoscopic Vertical Sleeve Gastrectomy for Morbid Obesity. The Future Procedure of Choice?

  • Review Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

I report the general experience of performing sleeve gastrectomy defined as “a partial gastrectomy that results in removal of most of the stomach,” as a first-stage procedure for morbidly and super-obese people. I also explore its potential as a single procedure evaluating its advantages and disadvantages. This procedure is designed to reduce the size of the stomach and its distention, whereby the patient feels full sooner and their appetite is decreased. Some posit-increased satiety results from the decreased ghrelin, secreted by the fundus, which is resected during this procedure. The advantages of sleeve gastrectomy are as follows: the stomach is reduced without loss of function, pyloric preservation prevents dumping, it requires only 1 day in the hospital, it provides an effective first-stage procedure for super-obese patients, it is useful in patients with disorders such as anemia or Crohn's disease, which preclude intestinal bypass, it can be performed laparoscopically, even in patients who weigh over 500 lbs, no band adjustment is required, it does not result in malabsorption, and it provides a good educational teaching base for doctors lacking experience in the treatment of gastric ulcers. The disadvantages include the risk of stapling complications and its irreversibility.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. E Lin N Gletsu K Fugate D McClusky LH Gu JL Zhu et al. (2004) ArticleTitleThe effects of gastric surgery on systemic ghrelin levels in the morbidly obese Arch Surg 139 780–4 Occurrence Handle15249413 Occurrence Handle10.1001/archsurg.139.7.780

    Article  PubMed  Google Scholar 

  2. F Broglio PV Koetsveld A Benso C Gottero F Prodam M Papotti et al. (2002) ArticleTitleGhrelin secretion is inhibited by either somatostatin or cortistatin in humans J Clin Endocrinol Metab 87 4829–32 Occurrence Handle12364482 Occurrence Handle10.1210/jc.2002-020956 Occurrence Handle1:CAS:528:DC%2BD38XnvFCrt70%3D

    Article  PubMed  CAS  Google Scholar 

  3. H Norrelund TK Hansen H Orskov H Hosoda M Kojima K Kangawa et al. (2002) ArticleTitleGhrelin immunoreactivity in human plasma is suppressed by somatostatin Clin Endocrinol (Oxf) 57 539–46 Occurrence Handle10.1046/j.1365-2265.2002.01649.x Occurrence Handle1:CAS:528:DC%2BD38XotlGgtrw%3D

    Article  CAS  Google Scholar 

  4. A Ikezaki H Hosoda K Ito S Iwama N Miura H Matsuoka et al. (2002) ArticleTitleFasting plasma ghrelin levels are negatively correlated with insulin resistance and PAI-1, but not with leptin, in obese children and adolescents Diabetes 51 IssueID12 3408–11 Occurrence Handle12453893 Occurrence Handle10.2337/diabetes.51.12.3408 Occurrence Handle1:CAS:528:DC%2BD38Xptl2ntbc%3D

    Article  PubMed  CAS  Google Scholar 

  5. EV Polyzogopoulou F Kalfarentzos AG Vagenakis TK Alexandrides (2003) ArticleTitleRestoration of euglycemia and normal acute insulin response to glucose in obese subjects with type 2 diabetes following bariatric surgery Diabetes 52 1098–103 Occurrence Handle12716738 Occurrence Handle10.2337/diabetes.52.5.1098 Occurrence Handle1:CAS:528:DC%2BD3sXjsFGhtLk%3D

    Article  PubMed  CAS  Google Scholar 

  6. E Lin N Gletsu K Fugate D McClusky LH Gu JL Zhu et al. (2003) ArticleTitleInsulin-associated downregulation of ghrelin expression in the morbidly obese and type-2 diabetes (DM) J Am Coll Surg 197 IssueIDsuppl 3 S9

    Google Scholar 

  7. FB Langer MA Reza Hoda A Bohdjalian FX Felberbauer J Zacherl E Wenzl et al. (2005) ArticleTitleSleeve gastrectomy and gastric banding: effects on plasma ghrelin levels Obes Surg 15 IssueID7 1024–9 Occurrence Handle16105401 Occurrence Handle10.1381/0960892054621125 Occurrence Handle1:STN:280:DC%2BD2MvjvFerug%3D%3D

    Article  PubMed  CAS  Google Scholar 

  8. M Gagner T Rogula (2003) ArticleTitleLaparoscopic reoperative sleeve gastrectomy for poor weight loss after biliopancreatic diversion with duodenal switch Obes Surg 13 IssueID4 649–54 Occurrence Handle12935370 Occurrence Handle10.1381/096089203322190907

    Article  PubMed  Google Scholar 

  9. JP Regan WB INabnet M Gagner A Pomp (2003) ArticleTitleEarly experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient Obes Surg 13 IssueID6 861–4 Occurrence Handle14738671 Occurrence Handle10.1381/096089203322618669 Occurrence Handle1:STN:280:DC%2BD2c%2FjvF2rtw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  10. H Noshiro S Shimizu E Nagai K Ohuchida M Tanaka (2003) ArticleTitleLaparoscopy-assisted distal gastrectomy for early gastric cancer. Is it beneficial for patients of heavier weight? Ann Surg 238 IssueID5 680–5 Occurrence Handle14578729 Occurrence Handle10.1097/01.sla.0000094302.51616.2a

    Article  PubMed  Google Scholar 

  11. RI Abdel-Moneim (1985) ArticleTitleThe hazards of surgery in the obese Int Surg 70 101–3 Occurrence Handle4055270 Occurrence Handle1:STN:280:BimD3s3nvVE%3D

    PubMed  CAS  Google Scholar 

  12. S Shimizu H Noshiro E Nagai A Uchiyama M Tanaka (2003) ArticleTitleLaparoscopic gastric surgery in a Japanese institution: analysis of the initial 100 procedures J Am Coll Surg 197 IssueID3 372–8 Occurrence Handle12946791 Occurrence Handle10.1016/S1072-7515(03)00419-8

    Article  PubMed  Google Scholar 

  13. K Yasuda M Inomata N Shiraishi K Izumi K Ishikawa S Kitano (2004) ArticleTitleLaparoscopy-assisted distal gastrectomy for early gastric cancer in obese and nonobese patients Surg Endosc 18 IssueID8 1253–6 Occurrence Handle15457385 Occurrence Handle10.1007/s00464-003-9310-7 Occurrence Handle1:STN:280:DC%2BD2cvovV2hsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  14. RA Weiner I Pomhoff M Schramm S Weiner R Blanco-Engert (2004) ArticleTitleNew advances in laparoscopic treatment of morbid obesity Surg Technol Int 13 79–90 Occurrence Handle15744679

    PubMed  Google Scholar 

  15. PS Powers A Rosemurgy F Boyd A Perez (1997) ArticleTitleOutcome of gastric restriction procedures: weight, psychiatric diagnoses, and satisfaction Obes Surg 7 IssueID6 471–7 Occurrence Handle9730503 Occurrence Handle10.1381/096089297765555197 Occurrence Handle1:STN:280:DyaK1czpvVaksw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  16. MS Parikh R Shen M Weiner N Siegel CJ Ren (2005) ArticleTitleLaparoscopic bariatric surgery in super-obese patients (BMI > 50) is safe and effective: a review of 332 patients Obes Surg 15 IssueID6 858–63 Occurrence Handle15978159 Occurrence Handle10.1381/0960892054222632

    Article  PubMed  Google Scholar 

  17. D Cottam FG Qureshi SG Mattar S Sharma S Holover G Bonomani et al. (2006) ArticleTitleLaparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity Surg Endosc 20 IssueID6 859–63 Occurrence Handle16738970 Occurrence Handle10.1007/s00464-005-0134-5 Occurrence Handle1:STN:280:DC%2BD28zisVegtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  18. P Mognol D Chosidow JP Marmuse (2005) ArticleTitleLaparoscopic sleeve gastrectomy as an initial bariatric operation for high-risk patients: initial results in 10 patients Obes Surg 15 IssueID7 1030–3 Occurrence Handle16105402 Occurrence Handle10.1381/0960892054621242

    Article  PubMed  Google Scholar 

  19. Frezza EE, Herbert H, Wachtel MS. Combined laparoscopic gastric banding and stomach reduction (GBSR). Initial Success and Import of Risk Factors. JSLS. Submitted for publication

  20. L Milone V Strong M Gagner (2005) ArticleTitleLaparoscopic sleeve gastrectomy in superior to endoscopic intragastric balloon as a first stage procedure for super-obese patients (BMI > or = 50) Obes Surg 15 IssueID5 612–7 Occurrence Handle15946449 Occurrence Handle10.1381/0960892053923833

    Article  PubMed  Google Scholar 

  21. A Baltasar C Serra N Perez R Bou M Bengochea L Ferri (2005) ArticleTitleLaparoscopic sleeve gastrectomy: a multi-purpose bariatric operation Obes Surg 15 IssueID8 1124–8 Occurrence Handle16197783 Occurrence Handle10.1381/0960892055002248

    Article  PubMed  Google Scholar 

  22. Lee CM, Feng JJ, Cirangle PT, Jossart GH. Laparoscopic vertical sleeve gastrectomy for morbid obesity in 216 patients: report of two-year results. Presented at SAGES, Dallas, Texas, April 28, 2006

  23. S Moon Han WW Kim JH Oh (2005) ArticleTitleResults of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients Obes Surg 15 IssueID10 1469–75 Occurrence Handle16354529 Occurrence Handle10.1381/096089205774859227

    Article  PubMed  Google Scholar 

  24. FB Langer A Bohdjalian FX Felbergbauer E Fleischmann MA Reza Hoda B Ludvik (2006) ArticleTitleDoes gastric dilatation limit the success of sleeve gastrectomy as a sole operation for morbid obesity? Obes Surg 16 IssueID2 166–71 Occurrence Handle16469218 Occurrence Handle10.1381/096089206775565276

    Article  PubMed  Google Scholar 

  25. G Almogy PF Crookes GJ Anthone (2004) ArticleTitleLongitudinal gastrectomy as a treatment for the high-risk super-obese patient Obes Surg 14 IssueID4 492–7 Occurrence Handle15130224 Occurrence Handle10.1381/096089204323013479

    Article  PubMed  Google Scholar 

  26. NV Christou D Look AP McLean (2005) ArticleTitlePre and post-prandial plasma ghrelin levels do not correlate with satiety or failure to achieve a successful outcome after Roux-en-Y gastric bypass Obes Surg 15 IssueID7 1017–23 Occurrence Handle16105400 Occurrence Handle10.1381/0960892054621071

    Article  PubMed  Google Scholar 

  27. Frezza EE, Wachtel MS, Chiriva-Internati. The multiple faces of glucagon-like peptide 1-obesity, appetite, and stress: what is next? a review. Dig Dis Sci; 2007 Feb. (Epub)

  28. EE Frezza (2004) ArticleTitleAre we closer in finding the treatment for type II diabetes mellitus in morbid obesity – are the incretins the key to success? Obes Surg 14 IssueID7 999–1005 Occurrence Handle15329192 Occurrence Handle10.1381/0960892041719699

    Article  PubMed  Google Scholar 

  29. JJ Meier B Gallwitz WE Schmidt MA Nauck (2002) ArticleTitleGlucagon-like peptide 1 as a regulator of food intake and body weight: therapeutic perspectives Eur J Pharmacol 440 269–79 Occurrence Handle12007541 Occurrence Handle10.1016/S0014-2999(02)01434-6 Occurrence Handle1:CAS:528:DC%2BD38XjsVSktbo%3D

    Article  PubMed  CAS  Google Scholar 

  30. EC Consten M Gagner A Pomp WB Inabnet (2004) ArticleTitleDecreased bleeding after laparoscopic sleeve gastrectomy with or without duodenal switch for morbid obesity using a stapled buttressed absorbable polymer membrane Obes Surg 14 IssueID10 1360–6 Occurrence Handle15603652 Occurrence Handle10.1381/0960892042583905

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Frezza, E. Laparoscopic Vertical Sleeve Gastrectomy for Morbid Obesity. The Future Procedure of Choice?. Surg Today 37, 275–281 (2007). https://doi.org/10.1007/s00595-006-3407-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-006-3407-2

Key words

Navigation