What is a
"Sleeve Gastrectomy"?
The Sleeve Gastrectomy
is an operation in which the left side of the
stomach is surgically removed. This results in a
new stomach which is roughly the size and shape
of a banana. Since this operation does not
involve any "rerouting" or reconnecting the
intestines, it is a simpler operation than the
gastric bypass or the duodenal switch. Unlike
the Lap-Band® procedure, the sleeve Gastrectomy
does not require the implantation of an
artificial device inside the abdomen
avoiding the need for fills.
Because the new stomach continues to function
normally there are far fewer restrictions on the
foods which patients can consume after surgery,
however the quantity of food eaten will be
considerably reduced. This is seen by many
patients as being one of the great advantages of
the sleeve Gastrectomy, as is the fact that the
removal of the majority of the stomach also
results in the virtual elimination of hormones
produced within the stomach which stimulate
hunger.
For patients with a body mass index greater than
60, the sleeve gastrectomy may be the first part
of a two-stage operation. Some patients have a
body shape that can make a bariatric surgery
more technically difficult – particularly those
patients who carry their weight in their belly.
If you fall into this category, you may benefit
from a two-stage bariatric surgery. In the
staged approach, a multi-step operation like the
gastric bypass is broken down into two simpler
and safer operations. In the first stage, a
sleeve gastrectomy is performed. This allows a
patient to lose 80 to 100 pounds or more, making
the second part of the operation substantially
safer.
Low BMI individuals who should
consider this procedure include:
-
Those who are
concerned about the potential long term side
effects of an intestinal bypass such as
intestinal obstruction, ulcers, anemia,
osteoporosis, protein deficiency and vitamin
deficiency.
-
Those who are
considering a Lap-Band® but are concerned
about a foreign body inside the abdomen.
-
Those who have
medical problems that prevent them from
having weight loss surgery such as anemia,
crohn's disease, extensive prior surgery,
and other complex medical conditions.
-
People who need
to take anti-inflammatory medications may
also want to consider this. Usually, these
medications need to be avoided after a
gastric bypass because the risk of ulcer is
higher.
What advantages does it have?
-
It does not
require disconnecting or reconnecting the
intestines
-
It is a
technically simpler operation than the
gastric bypass or the duodenal switch.
-
There is no
foreign body inside your body
-
It does not
need adjustments or fills
-
It may be a
safer operation for patients with a body
mass index (BMI) more than 60. It may be
used as the first stage of a 2-stage
operation.
Risks and Complications
As with any surgery, there can be complications.
This list can include:
- Deep vein
thrombophlebitis 0.5%
- Non-fatal
pulmonary embolus 0.5%
- Pneumonia
0.2%
- Acute
respiratory distress syndrome 0.25%
-
Splenectomy 0.5%
- Gastric
leak and fistula 1.0%
-
Postoperative bleeding 0.5%
- Small
bowel obstruction 0.0%
- Death
0.25%
Patients with Lap-Band®
complications
If you are a patient with a previous Lap-Band®
procedure and you're experiencing problems such
as reflux, esophagitis, band erosion, band
slippage, port site infection you may be a
candidate for "revision" surgery. This means
removing the Lap-band® System and performing a
VSG (Gastric Sleeve) procedure. Patients in this
category are very concerned about regaining
their already lost weight and they will greatly
benefit with the gastric sleeve procedure. At
this point the Gastric Sleeve will not only let
them maintain their weight, but will let them
continue losing more weight.
It might also be a good option if patients have
a problem with their lap band requiring
revision, have already lost a lot of weight and
don't want a full bypass. The weight loss seems
to be a little better and more rapid than the
lap band (60 - 70% EWL) over two years. However
there is still no long term data to support this
claim.
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