Gastric Sleeve

Gastric Sleeve Surgery

Dr. Gagner was the first surgeon to pioneer the use of laparoscopic Sleeve Gastrectomy (LSG), also known as gastric sleeve surgery, as a first-step in weight-loss interventions in high-risk patients. Since Dr. Gagner began performing this procedure in 2000, LSG has become a popular option for both patients with high risk due to co-morbidities and weight, and patients with low BMI as an alternative to gastric banding.

What is Laparoscopic Sleeve Gastrectomy?

Laparoscopic Sleeve Gastrectomy is a procedure that is performed using a laparoscope, or small camera, that is inserted the abdomen. Long surgical instruments used to carry out the surgery are also inserted through a series of small incisions. The LSG procedure is generally less invasive and carries fewer risks than other weight-loss surgeries, which is why it is often used as a first step in surgical weight-loss treatments.

The LSG procedure involves reducing the stomach volume by permanently removing 60-85% of the stomach pouch, leaving the remaining section in a sleeve-like shape, hence the expression “gastric sleeve.” Thus, weight-loss is obtained through gastric reduction, restricting the amount of food needed to feel full.

LSG works with the body’s normal satiety mechanism, causing patients to naturally eat less and feel good about it. Gastric sleeve surgery can also restrict appetite by reducing hunger-related hormone production in the stomach, which further contributes to weight loss.

As the intestines are not altered in any way, digestion and absorption are not affected, and eating habits do not have to be radically altered. The LSG procedure has been shown to reduce excess body weight by anywhere from 55 to 75% within one year.

On average, the surgery takes less than an hour to complete; patients are discharged 1-2 days post-op, and return to work after 2-4 weeks.



  • Preserves gastric emptying by leaving the pyloric valve intact
  • Preserves all mineral absorption (calcium, iron)
  • Can be easily revised if there is weight regain
  • Less dumping syndrome and hypoglycemia


  • Permanent removal of left side of stomach
  • Lifelong need for Vit. B12 supplement


  • Leakage, 1-2% in collective series
  • Bleeding, less than 1% in collective series
  • Narrowing of gastric sleeve, less than 1% in collective series