We recommend this procedure as the best restrictive procedure available due to the good results achieved and its physiological mechanism of action.
Since 2014 is the most performed procedure in the world, slightly above the Gastric Bypass.
Through 5 holes of 0.5 to 1 cm in the belly, we introduce the devices, camera, and endostaplers to perform the procedure without opening the abdomen, so there are no visible scars. This is to reduce the stomach size making a kind of tube or sleeve, which reduces the volume of intake. The specimen is removed through the umbilicus.
There are no long-term nutritional deficiencies if the quality of food is adequate.
It is indicated for patients with BMI between 35 and 45 and mild comorbidities (specially Diabetes), and good dietary accomplishment. LSG is almost as effective as GBP against Diabetes, but GBP is preferable when other comorbidities are present.
In patients with gastroesophageal reflux disease GERD (heartburn) and severe esophagitis we recommend the Gastric Bypass because it corrects the disease.
It can also be used as a first step procedure in patients with high surgical risk or with BMI> 55. After weight loss, comorbidities improvement, and less risk it can be added a malabsorptive procedure like Gastric Bypass, SADI or Duodenal Switch. Sometimes this second procedure is not necessary because both weight and comorbidities, and therefore cardiovascular risk, are improved enough.
Weight loss is higher during the first 6 months after surgery and more than 50% of the excess in the long term.
Usually there is no need of supplements in the long term because there is no malabsorption.
The Dietitian needs further control to teach the patient how to follow a healthy and balanced diet.