The objective of the operation is to resect the fundus, the portion of the stomach that is the prime source of hunger hormones, as well as to decrease the functioning part of the stomach.
Laparoscopic sleeve gastrectomy completely divides the stomach into two pieces. The resected stomach is placed in a specimen bag and then extracted through the trocar site. The remaining portion of your stomach would be the size and shape of a banana. The port sites are then closed with non-absorbable sutures to prevent port site hernia.
Laparoscopic Gastric Sleeve is becoming more popular whether as a primary, staged, or revisional operation. Laparoscopic sleeve gastrectomy is now an established stand-alone bariatric procedure worldwide.
Laparoscopic Sleeve Gastrectomy Surgery Technique
Although there are minor variations of the LSG procedure, in general 75–80% of the greater curvature is excised, leaving a narrow stomach tube. 5 small incisions are created on abdominal wall (Fig. 1).
A point on the greater curve, on the antrum, is chosen as the starting point. This has previously been described as ranging from 2 to 10 cm from the pylorus. The lesser sac is entered by opening the gastrocolic ligament. The short gastric vessels and the greater curvature ligaments (gastrosplenic and gastrocolic) are then divided with ultrasonic dissection to the left crus. A laparoscopic stapler which is FDA approved is introduced and is fired consecutively along the length of the proposed size of stomach. (Fig. 2).
At this point, about 75%–80% of the stomach has been separated (Fig. 3).
The specimen (Fig. 4) is removed by enlarging one of the 12-mm ports. A drain is then placed alongside the staple line to test and identify the leaks if any.
