Reducing stomach volume by the use of a gastric sleeve (laparoscopic longitudinal gastrectomy)

Laparoscopic longitudinal gastrectomy (gastric sleeve) is an effective and safe surgical intervention for losing excess weight: it limits the amount of food that can be consumed, without bypassing the intestine and avoiding the malabsorption process. The procedure removes about 85% of the stomach — precisely the part that stretches the most when we eat — and the rest is transformed into a gastric tube of 60–120 ml, which keeps its function.

Gastric sleeve at a glance

• Type of procedure: restrictive, laparoscopic — resection of part of the stomach
• How much is removed: about 85% of the stomach; a gastric tube of 60–120 ml remains
• Duration: between 1 and 3 hours
• Hospitalisation: about 2–3 days
• Time off work: about 2 weeks; total recovery 3–4 weeks
• No implant and no later adjustments — a one-time procedure

What is laparoscopic longitudinal gastrectomy?

It is a restrictive intervention, increasingly popular worldwide, performed with very advanced laparoscopic techniques. It consists of the resection of part of the stomach, creating a gastric tube with a volume of about 60–120 ml: the stomach is transformed into a tube that keeps its function.

After the intervention, small amounts of swallowed food produce an extreme feeling of satiety, due to the drastic reduction of the stomach’s holding capacity. During the operation, the excess volume of the stomach is removed — not remodelled — which also eliminates the area that produces the hormone responsible for stimulating hunger, explaining the reduced appetite after surgery.

Who is the gastric sleeve recommended for?

• obese patients with a higher degree of risk, due to major associated pathology
• those who want to minimise the risks of surgical intervention for losing excess weight
• patients of older age — longitudinal gastrectomy is an optimal choice in these cases
• people who want to lose weight through a minimally invasive intervention and wish to avoid a long-term implant or the regular, frequent doctor visits such an implant would require

How does the operation work?

The intervention is performed laparoscopically, through small incisions, under general anaesthesia. About 85% of the stomach is resected — the removed section being essentially the part responsible for storing food — and the rest forms the 60–120 ml gastric tube. The intervention lasts between 1 and 3 hours.

What are the advantages of the gastric sleeve?

• after the volume reduction, the stomach continues to work normally: most foods can be consumed, but in small amounts
• the absorption of vitamins and minerals is not affected — no need to supplement them in the diet
• eliminates the risks of intestinal blockages, anaemia and osteoporosis
• minimises the risk of ulcers
• a one-time procedure, with no later adjustments
• avoids the complications caused by introducing a foreign body into the organism — the risks of erosion, slipping or infection are eliminated
• improves obesity-related diseases, such as type 2 diabetes or hypertension
• benefits from modern medical technology, which makes it easy to apply even in very complex medical cases

What is the recovery like, stage by stage?

• Hospitalisation: about 2–3 days after the operation.
• First month: a light, semi-solid post-operative diet.
• Long term: a solid, low-calorie diet enriched with proteins.
• Time off work: about 2 weeks.
• Total recovery time: approximately 3–4 weeks.

Following the procedure, patients’ quality of life improves considerably, daily living being made easier by the substantial weight loss. The rapid, considerable weight reduction and the very low risk of complications make this bariatric intervention a very good choice for those who need a change.

For optimal monitoring of the weight-loss process, good collaboration between patient and doctor is needed. The goal is a gradual loss of the excess kilograms — weight loss is a gradual process, and losing weight too fast can create major health risks.

What if the result is not enough?

Depending on the results obtained, laparoscopic longitudinal gastrectomy can remain the definitive operation. In case of insufficient weight loss, the operation can later be combined with another bariatric intervention — for example gastric bypass — a decision made together with the doctor, after evaluating the progress.

Frequently asked questions

Will I be able to eat normally after surgery?

Yes — most foods remain allowed, but in small amounts. Satiety appears quickly, and appetite decreases thanks to the removal of the area that produces the hunger hormone.

Do I need vitamin supplements?

No — unlike the bypass, the sleeve does not affect the absorption of vitamins and minerals, so supplementing them in the diet is not necessary. The doctor will nevertheless establish which tests and check-ups are useful.

Sleeve or gastric bypass?

The bypass offers the greatest weight loss but involves an intestinal diversion and long-term supplements; the sleeve keeps the normal digestive path and nutrient absorption, being preferred for higher-risk or older patients. See all bariatric procedures.

Is the operation reversible?

No — the resected portion of the stomach is removed permanently. This is also its advantage: there is no implant, no adjustments are needed, and the effect on the hunger hormone is permanent.