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Piotr Gorecki, MD, chief of bariatric surgery at NYM, uses laparoscopic surgical instruments that separate and seal the stomach, leaving a small, banana-shaped stomach behind.

New York Methodist Hospital's (NYM) repertoire of minimally invasive bariatric (weight-loss) procedures recently expanded to include laparoscopic sleeve gastrectomy (LSG), an advanced surgical technique designed to help morbidly obese patients lose weight. The procedure is one of the many services offered by NYM's Comprehensive Weight Management Program.

Other common bariatric procedures performed at NYM are gastric bypass surgery and lap band surgery, and both are still excellent options for bariatric surgery candidates, depending upon a patient's individual needs. With gastric bypass, the upper portion of the digestive tract is detached from the stomach and then reattached to the lower portion, "bypassing" a large area in which the digestive process normally begins. With lap band surgery, an inflatable silicone device is placed around the top portion of the stomach to decrease the time it takes to feel full while eating. LSG incorporates elements of both of these surgical techniques.

"As with gastric bypass, LSG permanently decreases the size of the area where the body stores undigested food," said Piotr Gorecki, MD, chief of bariatric surgery at NYM, "and like lap band surgery, a sleeve gastrectomy does not alter the path of the digestive system or intestinal tract. This 'happy medium' makes a sleeve gastrectomy an attractive option for some surgical weight loss candidates."

During a laparoscopic sleeve gastrectomy, the surgeon makes small incisions to gain access to the patient's abdominal cavity. Thin tubes called trocars, which serve as passageways for the surgical instruments, are passed through the incisions. The surgeon examines the abdominal cavity using a laparoscope or video camera, and then carefully removes a large portion of the stomach with laparoscopic surgical instruments that separate and seal the stomach, leaving a small, banana-shaped stomach behind. This "sleeve" will typically hold about one-tenth of the amount that the stomach was able to hold before, greatly reducing the amount of food that the patient can consume before he or she feels full.

All surgical weight reduction procedures are intended for morbidly obese patients who either have a body-mass index (BMI) above 40 (in general, at least 80 to 100 pounds over their ideal body weight) or a BMI over 35 (less overweight) along with type II diabetes, hypertension, sleep apnea, or another serious health issue due to obesity.

"A real additional benefit of a sleeve gastrectomy," said Dr. Gorecki, "is that, unlike lap band surgery, LSG does not require intense, frequent follow up and adjustments. Medical conditions that may be greatly improved or even reversed as a result of a bariatric procedure include heart disease, type II diabetes, high blood pressure, high cholesterol, and urinary incontinence.

"Ultimately," continued Dr. Gorecki, "the addition of LSG broadens the spectrum of the services that we can offer to patients considering weight-loss surgery, and allows us to tailor the surgery to a patient's specific needs. Bariatric surgery remains the only effective treatment for inducing and maintaining significant weight loss in morbidly obese patients, and with excellent outcomes and high patient satisfaction, we're pleased to offer LSG at NYM."