Laparoscopic/Robotic sleeve gastrectomy which is also known as vertical sleeve gastrectomy is a procedure in which about 70 to 80% of the stomach is removed leaving a narrow gastric tube or “sleeve” through which food passes. The removed part of the stomach includes fundus, this upper outer part is important as it releases hormone Ghrelin. This hormone is termed as ‘hunger hormone’ because it stimulates appetite, increases food intake and promotes fat storage. No intestines are removed or bypassed during Sleeve Gastrectomy so that malabsorption is minimal. Due to this small stomach tube, the amount of food ingested is restricted and a person can take small amount of food at a time thereby the amount of calories consumed is restricted which results in weight loss.

Having said that, it is not only the restriction that causes the weight loss but many a metabolic change also occur due to rapid transit of the food in the intestines, releasing intestinal hormones that cause these effects. Thus, Sleeve Gastrectomy is no longer considered purely a restrictive surgery but also a metabolic surgery.

Though, Sleeve Gastrectomy was originally used as a first step procedure for a more definitive gastric bypass in super obese, it is now also used as a single stage procedure with excellent results across the globe. In patients with Reflux Disease and Diabetes the results may be inferior to the Gastric Bypass but the excess weight loss of both the procedures may be comparable in a select subgroup of patients.

It is a simple procedure and the patients may be able to leave the hospital in one day or even the same day in selected cases.

1. Stomach pouch

2. Stomach that is removed (Ghrelin cell production)

3. Intestines remain intact