How
Does The Gastric Sleeve Work?
The vertical sleeve gastrectomy is a
restrictive form of weight loss surgery in which approximately 85% of the
stomach is removed leaving a cylindrical or sleeve shaped stomach with a
capacity ranging from about 60 to 150 cc, depending upon the surgeon performing
the procedure. Unlike many other forms of bariatric surgery, the
outlet valve and the nerves to the stomach remain intact and, while the stomach
is drastically reduced in size, its function is preserved. Again, unlike other
forms of surgery such as the Roux en Y gastric bypass, the sleeve gastrectomy
is not reversible.
Because the new stomach continues to function
normally there are far fewer restrictions on the foods which patients can
consume after surgery, albeit that the quantity of food eaten will be
considerably reduced. This is seen by many patients as being one of the great
advantages of the sleeve gastrectomy, as is the fact that the removal of the
majority of the stomach also results in the virtual elimination of hormones produced within the stomach which
stimulate hunger.
Perhaps the greatest advantage of the gastric sleeve lies in the fact that it
does not involve any bypass of the intestinal tract and patients do not
therefore suffer the complications of intestinal bypass such as intestinal
obstruction, anemia, osteoporosis, vitamin deficiency and protein deficiency.
It also makes it a suitable form of surgery for patients who are already
suffering from anemia, Crohn's disease and a variety of other conditions that
would place them at high risk for surgery involving intestinal bypass.
Facts
about the gastric sleeve or sleeve gastrectomy:
Alternative names: vertical sleeve gastrectomy, sleeve gastrectomy, greater
curvature gastrectomy, parietal gastrectomy, gastric reduction and vertical
gastroplasty.
Surgery for high BMI patients. For patients with a
particularly high body mass index (typically 50+) many forms of weight loss
surgery are either difficult to perform or present increased risk. As a result,
a vertical sleeve gastrectomy (or increasingly a laparoscopic sleeve
gastrectomy) is sometimes performed as the first of a two-part weight loss
solution to provide an initial drop in weight which then makes other bariatric
follow up possible at a reduced level of risk.
Surgery for low BMI patients. For
obese patients with a relatively low body mass index the vertical sleeve
gastrectomy can also prove a good choice, especially where existing conditions
(such as anemia or Crohn's disease) prevent them from having other forms of
bariatric surgery. In addition, patients may choose this form of surgery if
they are concerned about the long-term affects of bypass surgery or object to
having a 'foreign' body implanted into their body, as is the case with lap band
surgery.
Who
Should Consider Gastric Sleeve Surgery
- This
kind of surgery is best for any person who is unable to have regular
follow up visits that the gastric banding procedures need such as the
Realize Band surgery and the Lap Band surgery.
- A person scared of the long-term
effects of intestinal bypass such as: anemia, intestinal obstruction and
protein deficiency.
- People who don’t want foreign
objects in their stomach like you see with the Lap Band surgery.
- People who are unable to do
conventional weight loss surgery because of a serious medical condition
like anemia and Chrohn’s disease, or a person who has had a number of
surgeries.
- People who are using
anti-inflammatory medicines and most avoid the gastric bypass surgery.
- Laparoscopic Sleeve
Gastrectomy Surgery
During sleeve gastrectomy, the surgeon will remove the larger,
rounded part of the stomach.
- The
remaining stomach looks like a sleeve (or hose or tube) and holds about 15
percent as much food as the original stomach.
- The surgeon will remove the larger, rounded part of the
stomach from the body. (This is the only gastric surgery in which part of
the stomach is taken out of the body.)
- Unlike gastric bypass, which
changes stomach openings, sleeve gastrectomy leaves the openings intact.
- It may be a safer and more
effective option than gastric bypass for patients with very high BMI,
those with medical problems like anemia, Crohn’s disease,
osteoporosis, extensive prior surgeries and other complex medical
conditions.
Advantages of The Gastric
Sleeve Procedure
- Sleeve
gastrectomy may be safer than gastric bypass for patients who
have a number of health risks.
- It
lowers the risk of ulcers compared to gastric bypass.
- The
surgery cuts away the part of the stomach that produces grehlin, a stomach
hormone that stimulates hunger.
- Though
the stomach is smaller, the openings are left intact, so digestion can go
on as normal.
- The
body is free of foreign objects like the Lap Band®.
Gastric Sleeve Surgery
Risks
- Anytime
you have anesthesia or surgery, there is a risk of blood clots, other
complications or death.
- Do
not smoke. Smoking would put you at high risk for infection, blood clots,
slow healing and other life-threatening complications.
- Complications
can occur with the stapling, such as leaks or bleeding.
- You
may need malabsorptive surgery – intestinal bypass or duodenal switch – in
addition to your sleeve gastrectomy in order to lose all the weight you
need and want to lose.
- The
smaller portion of the stomach may stretch.
- Foods
that you eat now may cause discomfort, nausea or vomiting after your
surgery.
- Gastric
surgery puts you at higher than normal risk of developing gallstones and
gallbladder disease.
- You
will not lose weight or maintain your weight loss unless you eat a healthy
diet and exercise regularly. This is the reason they stress long-term
follow-up with your doctor.
