Saturday, February 9, 2013
Gastric Sleeve - Sleeve Gastrectomy
Gastric Sleeve - Sleeve Gastrectomy
What is the gastric sleeve?
The gastric sleeve is a restrictive type of bariatric surgery that assists with weight loss by
reducing the size of the stomach to help you eat less food and feel full faster.
The gastric sleeve works by:
Limiting food intake
Controlling hunger sensations
To accomplish this, about 75 - 85% of the stomach is cut away and removed from the
The gastric sleeve procedure does not involve cutting or rerouting any portion of the
small intestine and it does not bypass the pylorus, the normal stomach opening between
the stomach and small intestine, as does gastric bypass; neither does it require a medical
implant or need adjustments as with gastric banding.
Food continues to move through the digestive tract in the usual manner, allowing for
normal digestion and absorption. The smaller stomach holds less food and appetite
decreases (1) due to the reduction in the level of the hunger stimulating hormone ghrelin.
Other names that are commonly used for the gastric sleeve procedure are Sleeve
Gastrectomy (SG), Vertical Sleeve Gastrectomy (VSG), and Gastric Sleeve Resection.
The Gastric Sleeve Procedure
With gastric sleeve surgery, the stomach is sectioned off and removed along the greater
curvature to create a new smaller, tube-shaped stomach, while keeping both ends of the
The gastric sleeve procedure can usually be performed laparoscopically, even on super
obese patients (BMI greater than 50). Laparoscopic surgery is a minimally invasive
surgical technique that allows the surgeon to operate through several small incisions
rather than one large incision (open surgery). It usually results in a shorter hospital stay,
quicker recovery, smaller scars, and less pain than with open surgery.
To perform laparoscopic gastric sleeve surgery, the surgeon makes several small
incisions in the abdomen and then inserts tiny surgical instruments and a viewing tube
with a small camera (laparoscope) through the incisions to the surgical area. The
stomach is sectioned off; then, the new stomach area is sealed closed with surgical
staples and the cutaway portion of the stomach is removed from the body.
GASTRIC SLEEVE SURGERY ILLUSTRATION
Gastric Sleeve Timetable
The following timetable lists the average times for surgery and recovery, although actual
experiences can vary from patient to patient.
Operating Time: 1-3 hours
Hospital Stay: 2-3 days
Return to Normal Activities: 2 weeks
Time for Full Recovery: 3 weeks
Gastric Sleeve as a Stand-Alone or Two-Staged Bariatric Procedure
The gastric sleeve procedure can be performed as a stand-alone bariatric procedure or
as the first step of a two-staged procedure, such as gastric bypass surgery or the
duodenal switch procedure. The purpose of a staged procedure is to make surgery safer
for high-risk patients who may not be acceptable candidates for a single, combined
restrictive-malabsorptive weight loss surgery.
The second stage of surgery is not always required, but is an option if additional weight
loss is necessary. The second stage is the malabsorptive portion of surgery, which
involves cutting the small intestine and bypassing a section to reduce the amount of
food absorbed into the body through the digestive tract.
The malabsorptive portion of the surgery will be performed after a period of time
determined by the bariatric surgeon, usually 6 to 18 months after the gastric sleeve
surgery. The time between surgeries allows the body to recover as well as provide time
for partial weight loss to occur in order to make additional surgery safer for high-risk
Gastric Sleeve Advantages
What are the advantages of the gastric sleeve?
The gastric sleeve offers many advantages as a type of weight loss surgery. If you are
considering weight loss surgery, you may find that the gastric sleeve procedure is the
right approach to help you achieve significant weight loss and greatly improve your
health and quality of life.
Advantages and Benefits
Supports safe and successful weight reduction
Limits food ingestion to help you eat less
Reduces hunger sensations and helps you feel full faster
Digestion occurs naturally and does not cause malabsorption as the digestive tract is
Does not cause dumping syndrome, as it uses the natural stomach outlet (pyloric
Does not cause food to get stuck entering stomach or require many food restrictions
Safer and less complex procedure as it does not involve cutting and altering the
Does not involve implanting a medical device (gastric band) into the body
Does not require periodic adjustments, as with gastric banding
Can usually be performed laparoscopically, even on super obese patients
Option for patients with health problems or medical issues that disqualify them from
other types of weight loss surgery
May be used as part of a staged procedure and converted to duodenal switch or gastric
bypass for additional weight loss if necessary
Revision option for adjustable gastric band patients
Weight Loss Results
Gastric sleeve weight loss surgery can help people who are affected by severe obesity to
safely and effectively lose weight. Studies have shown that the percentage of excess
weight loss ranges from 33 to 85%, with an average of 60%
Health and Quality of Life Benefits
The gastric sleeve procedure has been shown to lead to improvements in medical
comorbidities and an improved quality of life.(1)
Studies have demonstrated that the gastric sleeve can eliminate, resolve, or improve
many health conditions associated with obesity, including type 2 diabetes mellitus,
hypertension, hyperlipidemia, sleep apnea, degenerative joint disease/joint pain, and
gastroesophageal reflux disease (GERD).
Why should you consider the gastric sleeve procedure?
If you are considering a surgical treatment for obesity, discuss the gastric sleeve
procedure with your doctor. The advantages of the gastric sleeve surgery may help you
decide that this approach is the best type of weight loss surgery for you based on your
personal preferences and personal health situation.
Consider the following benefits of gastric sleeve weight loss surgery:
No medical implant (such as gastric banding)
No intestinal bypass (such as gastric bypass)
Safest for high-risk patients (those with a very high BMI or medical issues)
Shown safe and effective, especially for patients with BMI 30-55
The decision to have any type of weight loss surgery requires careful consideration and
discussion with your doctor. If you are obese and have exhausted all other treatment
options, then a surgical solution may be the next step. Talk to a bariatric surgeon and
find out if the gastric sleeve weight loss surgery is an appropriate treatment approach