Gastric Sleeve Surgery
Gastric Sleeve Surgery is one of the newest types of bariatric surgery in the treatment of severe obesity. The relative safety and numerous advantages of gastric sleeve surgery compared to other bariatric procedures has made it an increasingly popular option with both bariatric surgeons and patients seeking surgical treatment for obesity.
The procedure is a restrictive type of weight loss surgery that surgically reduces the size of the stomach to limit food intake and lessen the sensation of hunger. The procedure does not involve cutting, rerouting, or bypassing any portion of the small intestine like gastric bypass, nor does it require a medical implant or periodic adjustments as with gastric banding.
Gastric Sleeve is an excellent choice for most bariatric candidates because it provides high levels of expected weight loss and low surgical risks. It also provides easy dietary recommendations post-surgery, something enviable for other bariatric surgeries. Overall, the gastric sleeve procedure is the ideal procedure for many patients.
Approach to Weight Loss
Gastric Sleeve Surgery works in two distinct ways, first is the reduction of the stomach’s capacity, also known as a restriction. This smaller stomach will make patients feel fuller faster after eating, signal your brain to stop eating.
Secondly, the ghrelin production will be reduced, which causes hormones that cause hunger to diminish. This lower amount of desire will also contribute to lower caloric intake, and thus, weight loss.
About the surgical procedure
Gastric Sleeve surgery is performed laparoscopically, with 4 to 6 laparoscopic instruments inserted into the abdomen to allow the surgeon to maneuver. Then the trocar is placed in the abdomen, whose purpose is to cut the stomach and staple the stomach closed.
The bougie is inserted endoscopically, to allow an outline for the surgeon to cut the stomach. The bougie size, which is often prominently advertised on many provider’s websites, just says how big the stomach will be after surgery.
After the discarded stomach is removed (via through the laparoscopic holes), the surgeon performs a leak test to make sure the stomach is properly sealed off. The surgeon will then stitch up the 4 to 6 holes in the abdomen. You’ll then be ready to recover in our hospital.
It has only been in recent years that bariatric surgeons have begun to perform gastric sleeve surgery as a stand-alone weight loss procedure. With this new approach, the stomach pouch is usually made smaller than in duodenal switch patients. While long term results are not yet available, short term weight loss results have been primarily favorable, especially in low BMI patients (BMI 35 to 45).
- Promotes weight loss by restricting amount of food that can be eaten at any one time
- Reduces hunger since it removes the part of the stomach that produces the hunger stimulating hormone ghrelin
- Digestion occurs normally as the digestive system is not altered
- Does not cause malabsorption or nutritional deficiencies as it does not involve rerouting or bypassing the small intestine
- Less chance of developing ulcers than with gastric bypass surgery
- Dumping syndrome not likely to occur as the stomach outlet (pyloric valve) remains intact, unlike gastric bypass surgery
- Less complicated procedure than gastric bypass or duodenal switch surgery
- Can usually be performed laparoscopically on extremely obese patients
- Does not require a gastric band being implanted into the body
- Does not require adjustments or fills as with a LAP-BAND or REALIZE Band
- Safer than a combined restrictive/malabsorptive weight loss surgery for patients who have many health problems
- May be converted to gastric bypass or duodenal switch if necessary for additional weight loss
- Expected excess weight loss for stand-alone procedure is 60 to 70% at two years
In studies to date, the gastric sleeve surgery has been shown to be a safe and effective alternative to the other common options of gastric bypass and gastric banding. The operation encompasses many of the benefits of these two procedures with few of the disadvantages.