Sleeve Gastrectomy (Gastric Sleeve) is a surgical weight loss procedure which can be an alternative to gastric banding. As pictured (left), the procedure involves removing part of your stomach which results in you eating a smaller amount of food.
Unlike the gastric bypass, the procedure does not involve any re-routing of the intestinal tract, which can result in complications with malabsorption and malnutrition.
Popularity regarding the Gastric Sleeve is growing due to its effectiveness with weight loss in patients who are very overweight (BMI >45).
A Gastric Sleeve is often also recommended as an option to individuals with logistical limits to attending regular follow-up visits for band adjustments, or for those preferring to undergo a permanent (and irreversible) procedure and not be obligated to ongoing maintenance following surgery.
Advantages of a Gastric Sleeve
- Volume of the stomach is reduced while all intestinal connections are maintained
- Limited concerns regarding nutritional deficiencies following surgery
- Does not result in complications like "dumping syndrome" and malabsorption (as with gastric bypass)
- This procedure means no further surgery is needed to complete the process
Advantages of Gastric Sleeve Compared to Gastric Banding
This procedure does have several advantages over gastric banding and other surgical procedures. For example:
- Less chance of wound infection
- Unlike gastric banding surgeries, there are no foreign objects left in the body during the procedure. Gastric banding does have risks of band slipping, eroding or becoming infected
- Unlike gastric bypass or duodenal switch, all nutrients are absorbed and very little chance exists of malabsorption issues. There is no bypass of the small intestines with the gastric sleeve
- No implantation of a foreign object in your body
- Does not require follow up visits for adjustments
- Most foods are well tolerated and do not get stuck, as they sometimes do with the gastric band procedure
- The stomach capacity makes it difficult to overeat high calorie liquids or soft foods
- The hormone which stimulates hunger, Ghrelin, is removed thereby decreasing appetite
General Positives Regarding the Gastric Sleeve
- Procedure can be done "keyhole" laparoscopically (minimally invasive) in almost all patients
- Procedure is considered safer for high risk or morbidly obese patients (BMI>45)
- Weight loss is initially quite rapid and early results overall appear to be very good
- An alternative option for those who live in remote areas or travel extensively (a one-step process with no follow up procedures)
Risks of The Gastric Sleeve
There are several risks and complications of gastric sleeve surgery:
- The operation requires stapling inside the stomach. There is always a chance the staples won't hold, resulting in a leak. Leaking stomach acids frequently lead to infection of surrounding tissues and other serious problems that may require another operation or a drainage tube. This risk is usually less than a 1% chance.
- Gastrooesophageal acid reflux can occur. Stomach acids flow back up the oesophagus and irritate the tube's lining
- As with any surgical procedure, there is a risk of blood clots
- Weight may be regained over time, because the stomach can stretch.
In the Gastric Sleeve procedure roughly three quarters of the stomach is surgically removed leaving a slender tube-like stomach that maintains its direct connection with the oesophagus and small intestine. The portion of the stomach that is surgically removed is discarded, drastically reducing the volume of the stomach, which results in early satiety and fullness when eating a meal, therefore consuming a smaller portion of food. The residual stomach capacity is about 200 mls - this means a portion about the size of a generous entree should be possible.