Gastric Sleeve

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Overview

The Gastric Sleeve surgery is one of the newer types of bariatric weight loss surgery, and helps patients achieve weight loss by permanently removing a portion of the stomach to restrict the amount of food patients can take in. The procedure was originally intended as the first part of a two-step surgical procedure for patients with a BMI of 55 and above and too risky for Gastric Bypass surgery. However, surgeons soon realized that patients did well after having the Gastric Sleeve surgery, noting that they lost about 60 to 100 percent of excess weight over a 12 to 24 month period. Also, most patients did not require getting the Gastric Bypass surgery after getting the Gastric Sleeve procedure done. Today, with proven results and widespread use, the popular Gastric Sleeve surgery is used as a standalone procedure for those struggling to lose weight, and keep it off.

How Does the Gastric Sleeve Work?

With the Gastric Sleeve surgery, the patient’s stomach is reduced to about 80 percent of its original size so that the stomach takes the shape of a tube, or “sleeve”. The outer curvature portion of the stomach, along with the hunger hormone, Ghrelin, is removed laparoscopically and stapled shut, leaving the stomach about the width of your index finger. The smaller, remaining portion of the stomach ensures lower food absorption, which causes weight loss by restricting the amount of food the patient can take in. The patient feels satisfied after eating and the removal of Ghrelin helps the patient’s satisfaction last longer.

The Surgical Procedure

Surgery begins with the administration of general anesthesia, and the entire surgery is performed while the patient is asleep. The Gastric Sleeve is always performed laparoscopically. The surgeon creates 4 or 5 small incisions in the abdomen, and tiny surgical tools and a small camera is inserted in the incisions to carry out the procedure. The stomach is removed through one of the incisions, and the stomach is stapled shut with 3 layers of staples. Then, a leak test is performed to ensure no stomach leakage. The stomach nerves and the pylorus are not affected or altered, and the stomach’s function is well-maintained. Surgical risks are generally low, and the entire procedure is performed within an hour.

Advantages

The Gastric Sleeve is always performed laparoscopically, and has fewer surgical risks and complications than other bariatric weight loss surgeries, like the Gastric Bypass. Additionally, there is no need for adjustments and constant follow-up care, like the Lap-Band, which requires saline fills to readjust the band for continued weight loss. Patients never have a foreign object left inside of them, and there is no real risk of nutrient or vitamin deficiencies to the body. Patients do not suffer from dumping syndrome, and the chance of ulcers, intestinal obstruction, osteoporosis, and anemia is drastically minimized. It is also a great option for patients with Crohn’s disease which makes them high-risk for Gastric Bypass. The Gastric Sleeve is also the only bariatric weight loss surgery that removes the hunger hormone, Ghrelin.

Disadvantages

The biggest hesitation patients feel before getting the Gastric Sleeve surgery is that it is irreversible. It is also a restrictive weight loss procedure and does not combine malabsorption, which speeds up weight loss. Lastly, if patients do not keep track of their food intake, then the sleeve has potential to stretch over time.

Recovery and Results after the Procedure

After surgery, the patient recovers for 2 to 3 days and depending on their profession, can mostly return to normal activity within a week. Most patients are walking around about an hour after their surgery. Even though the Gastric Sleeve is relatively new, the results are consistent in that patients lose around 60 to 100 percent of their excess body weight over a 12 to 24 month period. Comorbidities associated with high BMIs such as type 2 diabetes, sleep apnea, high cholesterol, high blood pressure, and degenerative joint disease are partially or entirely resolved with successful weight loss.

Diet and Lifestyle after the Gastric Sleeve

Patients have to retrain themselves to eat differently and treat their stomach as their weight loss tool. A liquid diet is prescribed for two weeks after surgery, with the first week consisting of only clear liquids. Then, patients ease into solid foods by a week of full liquids, and then soft foods. Once the patient retrains their stomach to accept solid foods, lifestyle changes such as regular exercise and diet modification should be part of the permanent aftercare. 

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Procedure Details