Sleeve Gastrectomy Surgery
Laparoscopic sleeve gastrectomy is commonly referred to as “the sleeve procedure,” “bariatric surgery sleeve gastrectomy” or “the sleeve.”
Bariatric sleeve gastrectomy surgery is performed by removing approximately 80 percent of the stomach. The remaining stomach is a tubular pouch that resembles a banana. This procedure works by several mechanisms.
First, the new stomach pouch holds a considerably smaller volume than the normal stomach, which helps to significantly reduce the amount of food (and thus calories) that can be consumed. The greater impact, however, seems to be the effect the surgery has on gut hormones that impact several factors including hunger, satiety and blood sugar control.
Short term studies show that sleeve gastrectomy surgery is as effective as gastric bypass surgery in terms of weight loss and improvement or remission of diabetes. There is also evidence that suggests the gastric sleeve, similar to gastric bypass, is effective in improving type 2 diabetes independent of weight loss. The complication rates of the sleeve fall between those of adjustable gastric band and gastric bypass surgery.
- Restricts the amount of food the stomach can hold.
- Induces rapid and significant weight loss that comparative studies find similar to that of gastric bypass surgery. Weight loss of >50% for 3-5+ year data, and weight loss comparable to that of the bypass with maintenance of >50%.
- Requires no foreign objects, and no bypass or re-routing of the food stream.
- Involves a relatively short hospital stay of approximately 2 days
- Causes favorable changes in gut hormones that suppress hunger, reduce appetite and improve satiety.
Am I A Candidate for Sleeve Gastrectomy Surgery?
Sleeve gastrectomy surgery is not right for everyone. Here are some of the things we will consider when evaluating your candidacy for sleeve surgery.
The surgical sleeve procedure is indicated for use in weight reduction for severely obese patients with a Body Mass Index (BMI) of at least 40 or a BMI of at least 35 with one or more severe co-morbid conditions, or those who are 100 lbs. or more over their estimated ideal weight.
Sleeve gastrectomy surgery may be right for you if:
- You are at least 18 years old.
- Your BMI is 40 or higher or you weigh at least twice your ideal weight or you weigh at least 100 pounds more than your ideal weight. (BMI is calculated by dividing body weight (lbs.) by height in inches squared (in²) and multiplying that amount by 703). BMI Calculator
- You have been overweight for more than 5 years.
- Your serious attempts to lose weight have had only short-term success.
- You do not have any other disease that may have caused your obesity.
- You are prepared to make substantial changes in your eating habits and lifestyle.
- You are willing to continue being monitored by the specialist who is treating you.
- You do not drink alcohol in excess.
- If you do not meet the BMI or weight criteria, you still may be considered for surgery if your BMI is at least 35 and you are suffering from serious health problems related to obesity.
- Is a permanent, non-reversible procedure.
- Has the potential for long-term vitamin deficiencies.
- Has a higher early complication rate than adjustable gastric banding.
While sleeve gastrectomy surgery is an effective treatment for morbid obesity, the pounds do not come off by themselves. Surgery is an aid to support you in achieving lasting results by limiting food intake, reducing appetite and slowing digestion. However, your motivation and commitment to adopt a new lifestyle are extremely important for long-term weight loss. You must be committed to new eating habits for the rest of your life. Exercise is an equally important component of a changed lifestyle.
- Gastric sleeve surgery is a permanent, non-reversible operation.
- You should use contraception if you are still in the childbearing age group. Weight loss can increase your fertility due to hormone changes.
- Overeating and eating too fast can cause discomfort and eventually an enlarged stomach. This is turn will decrease your ability to eat small portions and may result in weight gain.
- Due to the lower portion of the stomach being cut, stapled and removed, you are at risk for leakage along the staple line.
- The esophagus can also become tight and narrow, causing a stenosis or narrow opening.
- There is also a risk of developing an incisional hernia.
These complications can be treated with additional surgery.
Frequently Asked Questions About Sleeve Gastrectomy Surgery
Most of your stomach will be removed, leaving a small, banana-shaped stomach that helps restrict the amount of food you can eat at one time. This helps you feel fuller sooner and longer.
A typical hospital stay is 1–2 days after surgery. We will ask you to walk when you get home. Your surgeon will advise you about exercise programs, driving and going back to work.
In the months before surgery, we will ask you to try to eat healthier foods to lose weight and be in better shape for your surgery.
In the hospital right after surgery, and when you go home, your diet will be liquids only. You will follow a progressively staged nutrition plan that will slowly take you through different textures of foods from liquids to pureed to soft solids then eventually regular foods. This may take up to 4–6 weeks.
You will have an appointment about 1–2 weeks after gastrectomy sleeve surgery, then routine visits through the first year after. After that time, it is very important to see your surgeon every year.
You may expect to lose 77 percent of excess weight in the first 3 years after surgery. Long-term success depends on commitment to diet and lifestyle changes. Remember, surgery is not a quick fix. It is a tool to help you with your weight loss.
Yes, you will need to take vitamins for the rest of your life. Each person is different, but you must at minimum take multivitamins and calcium.
References: 1. Himpens J, et al. Annals Surg. 2010;252(2): 319-323. 2. DeMaria EJ, et al. Surg Obes Relat Dis. 2010;6:347-355.