Sleeve Gastrectomy (Gastric Sleeve) is a surgical weight loss procedure that presents as an alternative to gastric banding. Unlike the gastric bypass, the procedure does not involve any re-routing of the intestinal tract, which can result in malabsorption and malnutrition complications.
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 who are limited logistically from attending regular follow-up visits for band adjustments or those who would prefer to undergo a permanent (irreversible) procedure and not be obligated to indefinite maintenance issues following surgery.
Advantages of a Gastric Sleeve
- Volume of the stomach is reduced yet all intestinal connections are maintained
- Limited concerns regarding nutritional deficiencies following surgery
- Does not result in dumping syndrome (as with gastric bypass)
- Single stage process means no further surgery is needed to complete the procedure
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, no foreign objects are left in the body during the procedure. With gastric banding, the band may slip, erode or become infected.
- Unlike gastric bypass or duodenal switch, there is no bypass of the small intestines with the gastric sleeve, so all nutrients are absorbed and very little chance exists of absorption issues.
- Does not require implantation of a foreign 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 band
- Difficult to overeat high calorie liquids or soft foods because of limited stomach capacity
- Hunger stimulating hormone Ghrelin is removed, which decreases appetite
General Positives Regarding the Gastric Sleeve
- Procedure can be done laparoscopically (minimally invasive) in almost all patients
- Considered a safer procedure 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
Risks of The Gastric Sleeve
here are several risks and complications of gastric sleeve surgery:
- Leaking of the sleeve. The operation requires stapling inside the stomach, and there is always a chance that the staples won't hold, resulting in a leak. The leaking stomach acids frequently lead to infection of surrounding tissues and other serious problems that may require another operation or a drainage tube. This is usually less than a 1% risk.
- Gastro-oesophageal acid reflux
- 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 tubular 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. The residual stomach capacity is about 200 mls so a generous entree should be possible.