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Gastric Sleeve

Gastric sleeve surgery is one of the newer types of bariatric surgery and is referred to by many different terms such as: gastric sleeve resection, sleeve gastrectomy, vertical sleeve gastrectomy, tube gastrectomy, and laparoscopic sleeve gastrectomy.

The Gastric Sleeve Procedure

With the gastric sleeve procedure, about 85 percent of the stomach is sectioned off and removed along the greater curvature to create a smaller stomach that looks like a long, narrow tube or sleeve. Not only does the smaller stomach hold less food, but also reduces hunger since the area of the stomach that produces ghrelin, the hunger-stimulating hormone, is removed.

The gastric sleeve procedure can usually be performed laparoscopically, and can even be preformed on super obese patients with a BMI greater than 50. Laparoscopic surgery is a minimally invasive surgical technique that allows the surgeon to operate through several small incisions rather than open surgery. This procedure usually results in a shorter hospital stay, quicker recovery, smaller scars, and less pain than you would experience 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, called a laparoscope, through the incisions. The stomach is sectioned off along the greater curvature to create a smaller, tube-shaped or sleeved-shaped stomach. Then, the new stomach area is sealed closed with surgical staples and the cutaway stomach portion is removed from the body.

In some cases, gastric sleeve surgery could be followed by a gastric bypass surgery or duodenal switch surgery after a person has lost a significant amount of weight. Called a "staged" approach to weight loss surgery, this makes the second procedure less risky than it would have been had it been the first and only procedure. The timing of the second surgery varies according to the degree of weight loss. It usually occurs within 6 to 18 months after the initial surgery.

Advantages of Gastric Sleeve Surgery

Patients can typically expect to lose approximately 30 to 60% of their excess body weight within 12 months of the procedure. It is less invasive than gastric bypass and does not result in altering or cutting the intestines. Other advantages include: there is no dumping syndrome associated with gastric sleeve, there is no foreign device in the body, unlike a LAP-BAND®, and malabsorption is not an issue as it is in the case of gastric bypass surgery. The patient does not need too many nutritional supplements compared to ones who have a gastric bypass. The gastric sleeve procedure is believed to be less risky for high BMI patients and better for patients with prior surgery or complex medical conditions. After the surgery most food items can be consumed, although in small quantities. Other types of weight loss surgery, if required, can still be performed following a gastric sleeve procedure.

Risks of the Gastric Sleeve Surgery

Any surgical procedure carries certain risks including the possibility of adverse reaction to anesthesia and medications. As it is a purely restrictive weight loss procedure, inadequate weight loss or weight regain is more likely than with a procedure involving intestinal bypass. With time, the new smaller stomach pouch may stretch and leaks or bleeding may occur along the stomach stapling edge. Although the gastric sleeve helps control hunger and limits the amount of food that can be eaten at any one time, weight loss will not occur without a healthy, low-calorie diet and regular exercise. If performed as the first part of a two-stage process, a second malabsorptive weight loss surgery such as the duodenal switch will need to be performed at a later time. The surgery is not reversible as a portion of the stomach is permanently removed and some insurance companies may not cover procedure. All surgery and anesthesia involves some level of risk including bleeding, blood clots, infection, pneumonia, or complications.