Bariatric Surgery - Sleeve Gastrectomy

Sleeve Gastrectomy

The sleeve gastrectomy is a purely restrictive operation. In this procedure, the surgeon creates a narrow tube from the stomach and removes the remainder. The surgeon uses metal staples which are similar to stitches, and then cuts through the stomach.

The new stomach tube, or pouch, is about a quarter of the size of the original stomach. Unlike a gastric bypass, where food enters into a small pouch and then passes straight into the small bowel, the route which food takes following a sleeve gastrectomy is the same, as it took before surgery.


The sleeve gastrectomy can be performed as a single operation. Most people will lose between 30-50% of their excess body weight. Weight loss is generally quite fast, as with the bypass procedure, however because patients have a larger stomach capacity, and the intestines are not bypassed, most people do not lose as much weight as with the gastric bypass.


Schematic diagram showing sleeve gastrectomy.


Often the procedure will be used as the first stage of a 2-stage procedure, if the surgeon feels it is too risky to proceed straight to a gastric bypass. If this is the case, the patient will have the sleeve gastrectomy first, and then after some weight loss has occurred (usually about 9–18 months after the first surgery), the second operation can be performed.


Expectations of weight loss
Most people lose weight quite quickly over the first year following a sleeve gastrectomy. Most people lose between 30–50% of their excess body weight, although this can vary and some may lose even more.

Adherence to dietary advice will result in greater weight loss and better weight maintenance. The dietitian will discuss with the patient what changes he/ she would need to make to their eating patterns in order to have the best weight loss results.


Advantages
  • Surgery can be offered to patients who are at a high risk for progressing straight to the gastric bypass.
  • The amount of food patients can eat is restricted.
  • People are likely to feel fuller quicker and stay fuller for longer.
  • Weight loss starts staight away, from the day of surgery.
  • Weight loss tends to be faster than following the gastric band.
  • Patients can lose on average 30–50% of their excess body weight.
  • As with the gastric band, the patient's intestines remain intact, so food is digested and absorbed as normal.
  • The surgery can then be followed by conversion to the gastric bypass or duodenal switch resulting in further weight loss.


Disadvantages
  • The surgery itself has more risks than the gastric band, because it is a longer procedure and the stomach is cut.
  • Patients may not lose as much weight as following the gastric bypass operation, and they may be at more risk of regaining weight.
  • Patient's hair may thin. This is temporary while losing weight at a rapid rate.
  • Patients may develop gallstones due to rapid weight loss. It may be necessary for patients to undergo a further operation to remove their gallbladder, although this is fairly rare.
  • Most of the stomach is removed. This is a permanent and non-reversible operation.
  • Nausea and vomiting may occur (feeling and being sick). Especially in the first few days after surgery, vomiting is also common if patients eat too quickly, or eat too much.
  • Patients will need to take a tablet daily to reduce stomach acidity (e.g. omeprazole/ lansoprazole/ pantoprazole).


You will have better results if you follow dietary changes and have self control.

Source: NHS Choices.

http://healthitis.blogspot.com