Gastric sleeve surgery (sleeve gastrectomy) is one of the newer forms of bariatric surgery but has quickly been gaining popularity over the recent years. Also known as vertical sleeve gastrectomy, vertical gastroplasty or sleeve gastroplasty, this procedure is another option for those looking to help with their morbid obesity through gastric bypass surgery. The gastric sleeve is a restrictive procedure meaning that it achieves weight loss results by restricting the amount of food that your body is physically able to take in. There is no malabsorption involved with this procedure but can be followed up with a malabsorptive procedure afterwards if the patient wishes.
How Does Gastric Sleeve Surgery Work?
Gastric sleeve surgery involves permanently removing a large portion of the stomach, anywhere from 60% to 85% of the total stomach. The portion left behind is a slim tube or “sleeve” that will serve as your new stomach. This stomach is already connected naturally to the stomach inlet and outlet which means that no rerouting of the intestines is needed.
What differentiates a gastric sleeve procedure from other weight loss surgeries is the nerves to the stomach and the outlet valve (pylorus) of the stomach remain intact to preserve the functions of the stomach while at the same time, reducing the volume it is able to hold. There is no bypass of the intestines with the gastric sleeve, only stomach capacity reduction. A sleeve gastrectomy also works because it removes the part of the stomach that produces Ghrelin, which is a hormone that stimulates appetite. This helps to noticeably reduce without completely eliminating a person appetite.
Advantages of the Gastric Sleeve
The primary features of gastric sleeve surgery are reducing the size of the stomach up to 85%, to restrict food intake while also reducing the hormones that create the craving for food due to the removal of the excess stomach portion. This reduces the production of the Ghrelin hormone which in turn reduces the hunger sensation.
The advantage of gastric sleeve surgery include:
- 30 to 60% extra weight loss within the first 12 months of the procedure
- Less invasive than gastric bypass
- No cutting or, disconnection or alteration of the intestines
- No risk of “dumping syndrome” typically associated with gastric bypass
- No need for implementation of foreign devices in to the body such as a gastric band
- Less restrictive post-surgery diet
- Procedure may be followed by gastric bypass or duodenal switch for even better results for super obese patients (those with a BMI > 70)
- Can be performed laparoscopically on extremely obese patients
Disadvantages of the Gastric Sleeve
As with any medical procedure of this nature, there is always the potential for adverse affects. The biggest potential drawback for some people with this procedure is that is irreversible and thus you must really understand all of the implications before proceeding with gastric sleeve surgery.
In addition the following potential drawbacks should be taken in to consideration:
- Since the gastric sleeve is a restrictive weight loss procedure and not malabsorptive, inadequate weight loss or weight regain is more likely to occur than would in a procedure involving intestinal bypass
- The newly created pouch has the potential to stretch over time
Weight Loss only really noticeable with total change in diet combined with exercise
- Additional surgery may be required for follow-up procedures to combine methods
- Leakage may occur at the site of stapling
- Still no knowledge of long term results due to short history of procedure
Insurance may not cover due to the short history of the procedure making the cost potentially prohibitive for many people.
The cost for gastric sleeve surgery is similar to other major weight loss surgery options. It can be an expensive procedure that you would need to talk to your insurance company about whether or not it would be covered.
Read more about the factors that influence the cost of gastric sleeve surgery.
Success Rates & Results
While this procedure is still in the early stages compared with other weight loss surgery procedures, some of the initial findings are pointing to this procedure showing some very good success rates in both weight loss and the alleviation of comorbidities related to that excess weight.
Read more here about the success of gastric sleeve and the results seen so far.
There are potential complications related to gastric sleeve surgery just as there are with all form of bariatric surgery. Understanding what those potential risks are and being prepared will help you should any of these complications arise after your surgery.
Read more about gastric sleeve complications and risks.
What Can I Eat After My Surgery?
There will be a drastic change in your diet after your surgery and the amount of food you can physically eat. You will need to ease in to your new diet and retrain your body to the new, smaller amount of food you will be eating from that day on.
Read more about what makes up a gastric sleeve diet and how what you choose to eat will decide the eventual outcome of your sleeve gastrectomy.
How Do I Know if This is the Right Surgery for Me?
There are positives and negatives to the gastric sleeve and that is why working with your doctor to determine the best option for you is critical. In the meantime you can compare the similarities and differences between some of the major weight loss surgeries with our weight loss surgery comparison infographic.
Finding the Right Doctor
If you are looking for a doctor in your area that can consult with you about gastric sleeve surgery you can either browse our directory of bariatric surgeons in your area and contact them directly or contact us for assistance in finding the right weight loss specialist to meet your needs. We recommend reaching out to multiple doctors in order to find one that you are comfortable with before making your decision.