Here’s What You Need To Know About A Sleeve Gastrectomy

Performing a sleeve gastrectomy procedure is an artform. As a bariatric and minimally invasive surgeon, Dr. Sepehr Lalezari, believes the procedures he performs is as much about the lives that are positively affected as it is about the weight loss or surgery itself. Dr. Lalezari completed a bariatric and minimally invasive surgery fellowship (specialty training) at Johns Hopkins Medicine in Baltimore, MD, and is now practicing at his advanced bariatric and minimally invasive general surgery practice in Los Angeles,  Lalezari Surgical.

At Johns Hopkins, he learned the most cutting-edge procedures such as single-site surgery, robotic and endoscopic surgery truly incision-less surgery, he called it. Training at JHU was an honor and has put him in a unique position when starting a private practice.

Born in Iran, Dr. Lalezari moved to California with his family at age 4. With the help of a highly influential primary school teacher, he overcame early difficulty with learning the English language to become a high achiever, eventually graduating magna cum laude, and two years early from UCLA with a Bachelor of Science in neuroscience.

For his clinical training, Dr. Lalezari trained throughout the United States, including Florida, New York, California, and at Minnesota’s prestigious Mayo Clinic. Although he studied neuroscience as an undergrad, he steered his career toward bariatrics and minimally invasive surgery after seeing the long-term effects that his care could provide, as well as the long-term relationships he could develop with patients similar to that of his primary care doctor growing up who first inspired him to pursue a career in medicine. “With bariatric surgery, I love the relationships you develop with the patients,” he said. “They’re looking for a way out of their current situation, they’ve been fighting their entire lives, and you help them meet their goals. In the end, they’re so happy. The relationships that develop with patients over time is why I got into medicine in the first place.”

In surgery, his success is now measured in the magnitude by which his patients’ lives are changed.

Haute Beauty interviewed Dr. Sepehr Lalezari and discussed his expertise on performing gastric sleeve procedures.

Sleeve GastrectomyPhoto Credit: Courtesy of Shutterstock

HB: What is a gastric sleeve for weight loss?

Gastric sleeve or sleeve gastrectomy is a bariatric operation where 9/10ths of the stomach is removed through small incisions. Usually, it involves the use of a 5mm camera and several 5mm instruments to perform the operation.

HB: How is a gastric sleeve performed?

Five small incisions are created to perform the operation. The stomach has a very rich blood supply. The blood supply to the lateral aspect of the stomach is cut using advanced energy devices that seal and cut the tissues at the same time. Once the blood supply to the lateral aspect of the stomach which is to be removed is cut a stapling device is used to staple and cut the portion of the stomach to be removed. Usually, a buttress material is used on the staple line to help prevent complications. If a hiatal hernia is present it is fixed at the time of the operation to help resolve acid reflux. The detached portion of the stomach is then removed through a 12mm incision.  The area is inspected for any leaks in the staple line. This completes the operation.

HB: How long does a sleeve gastrectomy procedure take?

It usually takes about 45 minutes on average. This will usually depend on the size of the patient. The higher the BMI the more difficult the operation and will increase the time needed to perform the operation safely. Another factor is the presence and size of a hiatal hernia.

HB: How effective is the gastric sleeve for weight loss?

Typical weight loss associated with sleeve gastrectomy is 60-70% excess body weight loss.

HB: How rapid is weight loss after surgery?

Weight loss is the most rapid right after surgery and tends to slow down at about 6 months.

sleeve gastrectomyPhoto Credit: Courtesy of Shutterstock

HB: When is maximum weight loss typically seen after bariatric surgery?

Maximum weight loss is usually seen at about 1 year after surgery. Most patients tend to have a decrease in the rate of weight loss at this time but that is not to say that people cannot still lose weight after 1 year. This aspect is really dependent on the patient and their personal goals.