Bariatric Procedures

Laparoscopic Vertical Sleeve Gastrectomy A once-in-a-generation procedure
Laparoscopic Vertical Sleeve Gastrectomy

Every few decades, a procedure comes along that fundamentally alters our approach to treatment of a chronic condition. Laparoscopic Vertical Sleeve Gastrectomy is the success story of our generation, the culmination of 60 years of innovation and research. As one of the most effective bariatric procedures ever performed, Sleeve Gastrectomy is also the safest and the most physiologic procedure ever envisioned. Today, Sleeve Gastrectomy accounts for over 80% of the nearly 300,000 bariatric procedures performed in the United States annually.

Laparoscopic Vertical Sleeve Gastrectomy involved removing (gastrectomy) 75% of the stomach, leaving behind a sleeve or banana shaped stomach. The procedure is performed through 5 small abdominal incisions. Using modern laparoscopic staplers, the stomach is simultaneously divided and sealed in a precise manner. It takes only one hour to complete, with a one-stay in the hospital and a one-week recovery at home.

How does Sleeve Gastrectomy work?

How does Sleeve Gastrectomy work?

Sleeve Gastrectomy offers a variety of tools that help reduce and maintain weight. The primary tool is the mechanical tool of a narrow stomach with 4 oz. in capacity, which helps reduce portion size and calorie intake. The secondary tools, which are equally important, are the result of changes in metabolic digestive hormones. Because the procedure involves removal of the portion of the stomach that normally secretes the hunger hormone Ghrelin, it causes permanent reduction in hunger. In addition, because delivery of nutrients to small intestines is speedier, intestinal hormones Peptide YY and GLP-1 are increased. This results in increased satisfaction with food, normalization of blood sugar, and resolution of Diabetes.

When patients use the potent tools provided by the procedure appropriately, they experience sustainable weight loss of over 100 lbs. and complete resolution or significant improvement of health disorders like Diabetes, hypertension, sleep apnea, etc. They consistently report improved quality of life, and as an added bonus, receive the ultimate gift of longevity.

Dr. Zaré has been involved with Sleeve Gastrectomy since 2001, when the procedure was under study at a Georgetown University affiliate hospital. As a pioneer and an early adopter, he has been able to refine the procedure and offer the current version with results consistently superior to nationally reported data. Patients can expect a short hospital stay and a swift return to daily activities within a matter of days. Sleeve Gastrectomy is Dr. Zaré’s bariatric procedure of choice.

How does Sleeve Gastrectomy compare to other procedures?

Beginning in 1960’s, surgeons began performing bariatric surgery as an alternative to dieting to help individuals lose weight. The early procedures such as Gastric Bypass, Vertical Banded Gastroplasty, Biliopancreatic Diversion, and Duodenal switch showed us that by performing surgery on the digestive system, we can produce weight loss and improve metabolic disorders like Diabetes. They also showed that the majority of patients losing weight with bariatric surgery were able to maintain their lower weight long term. Some of the early procedures were associated with unwanted adverse effects such as malabsorption, resulting in iron-deficiency anemia, dumping syndrome, anastomotic problems, internal hernias, etc. Others like Vertical Banded Gastroplasty and Gastric Banding were associated with foreign body reactions like slippage, erosion, and infection. However, the knowledge gained from the early procedures paved the way for Laparoscopic Vertical Sleeve Gastrectomy, the most refined bariatric procedure to date.

  • Gastrectomy
  • Sleeve Gastrectomy
  • Gastric Bypass
  • Offers restriction

  • Yes

  • Yes

  • Durability of restriction

  • Maintained by pylorus

  • May be lost

  • Reduces appetite

  • Yes

  • Yes

  • Resolves Diabetes

  • Yes

  • Yes

  • Malabsorption

  • No

  • Yes

  • Multivitamin supplements

  • 1 daily

  • 2 daily

  • Calcium supplements

  • None

  • 3 daily

  • Vitamin B12 supplements

  • 1 weekly

  • 1 weekly

  • Iron supplements

  • None

  • Often required

  • Absorption of medications

  • Normal

  • Often reduced

  • Increased risk of peptic ulcer

  • No

  • Yes

  • Aspirin and NSAlDs

  • Allowed in moderation

  • Not allowed

  • Increased risk of internal hernia

  • No

  • Yes

  • Dumping syndrome

  • No

  • Common

  • Acid reflux

  • May not improve

  • Improved

  • Gastric remnant complications

  • No

  • Yes

  • Likelihood of weight regain

  • 10-15%

  • 10-15%

  • Duration of procedure

  • 1 hour

  • 2.5 hours

  • Hospital stay

  • 1 night

  • 2 nights

  • Recovery

  • 1 week

  • 1 week