Obesity has emerged as one of the most pressing health problems of the 21st century, contributing to a wide range of chronic illnesses such as diabetes, hypertension, cardiovascular disease, sleep apnea, and certain types of cancer. When diet, exercise, and medical therapies fail to achieve sustainable weight loss, bariatric surgery becomes a viable and effective option. Among the different surgical techniques, Laparoscopic Sleeve Gastrectomy (LSG) has gained immense popularity worldwide due to its simplicity, effectiveness, and safety profile.

What is Laparoscopic Sleeve Gastrectomy?

Laparoscopic Sleeve Gastrectomy is a minimally invasive bariatric surgery designed to help patients lose significant weight by reducing the size of the stomach. During this procedure, approximately 75–80% of the stomach is surgically removed, leaving behind a narrow, tube-like structure resembling a sleeve or banana. The newly created stomach has a much smaller capacity, which restricts food intake and induces early satiety. Additionally, the surgery alters gut hormones, especially ghrelin (the “hunger hormone”), thereby reducing appetite and contributing to long-term weight loss.

How the Surgery is Performed

The surgery is performed under general anesthesia using laparoscopic techniques, which involve small incisions instead of a large open cut. The main steps include:

Creating Access to the Abdomen
After insufflating the abdomen with carbon dioxide to create working space, the surgeon inserts trocars (hollow tubes) through small incisions in the abdominal wall. A laparoscope with a high-definition camera provides magnified images of the operative field.

Mobilization of the Stomach
The greater curvature of the stomach is carefully dissected from surrounding attachments, including the blood vessels and fatty tissues.

Resection of the Stomach
Using a surgical stapler, the surgeon removes around 75–80% of the stomach along the greater curvature, starting from near the pylorus up to the esophagogastric junction.

Creation of the Sleeve
The remaining portion of the stomach is shaped into a tubular “sleeve,” which holds a much smaller volume of food. The staple line is reinforced to reduce the risk of leaks and bleeding.

Completion of Surgery
The resected portion of the stomach is extracted through one of the small incisions, and the incisions are closed. The entire procedure typically takes 60 to 90 minutes.

Mechanism of Weight Loss

The effectiveness of LSG is attributed to two primary mechanisms:

Restriction: The reduced stomach size limits the amount of food that can be consumed at one time, leading to calorie reduction.

Hormonal Changes: By removing the fundus of the stomach, which produces ghrelin, hunger signals are significantly reduced, resulting in decreased appetite and improved metabolic control.

Unlike gastric bypass, LSG does not involve rerouting of the intestines, which means nutrient absorption is not significantly altered, reducing the risk of malabsorption syndromes.

Benefits of Laparoscopic Sleeve Gastrectomy

Effective Weight Loss
Patients typically lose 50–70% of their excess body weight within 12–18 months after surgery.

Improvement in Obesity-Related Conditions
Many patients experience remarkable improvement or complete remission of conditions such as type 2 diabetes, hypertension, dyslipidemia, and obstructive sleep apnea.

Minimally Invasive Approach
Since the procedure is performed laparoscopically, patients benefit from smaller incisions, less pain, faster recovery, and shorter hospital stays.

No Foreign Body or Intestinal Bypass
Unlike gastric banding, no foreign device is placed in the body, and unlike gastric bypass, no intestinal rerouting occurs. This reduces the risk of long-term complications such as band slippage or nutritional deficiencies.

Better Quality of Life
With sustained weight loss, patients often experience improved mobility, self-esteem, and mental health.

Risks and Complications

Like any surgical procedure, LSG carries potential risks. Early complications include bleeding, leakage from the staple line, infection, and deep vein thrombosis. Long-term complications may include gastroesophageal reflux disease (GERD), vitamin deficiencies, or insufficient weight loss in some cases. Strict adherence to postoperative dietary and lifestyle guidelines is essential to minimize risks and maximize outcomes.

Postoperative Care and Lifestyle Changes

After surgery, patients typically stay in the hospital for 2–3 days. A liquid diet is recommended initially, gradually progressing to pureed foods, soft foods, and eventually a balanced solid diet. Long-term success depends on:

Eating smaller, nutrient-dense meals.

Avoiding high-calorie, sugary foods.

Committing to regular physical activity.

Taking prescribed vitamin and mineral supplements.

Attending follow-up visits for monitoring progress.

Psychological support and counseling are often recommended to help patients adapt to lifestyle changes and maintain long-term success.

Conclusion

Laparoscopic Sleeve Gastrectomy has become one of the most widely performed bariatric surgeries across the globe. It offers significant and sustainable weight loss, improves obesity-related comorbidities, and enhances quality of life with relatively fewer complications compared to other bariatric procedures. However, it is not a quick fix; rather, it is a tool that requires lifelong commitment to healthy eating, regular exercise, and medical follow-up. For individuals struggling with morbid obesity, LSG provides a new beginning—a chance to reclaim health, mobility, and confidence.