Sleeve gastrectomy is the newest and most permanent weight loss surgery performed at the Bariatric Center. The procedure involves detaching a portion of the stomach, leaving only a small banana-shaped “sleeve” of stomach sealed with staples and a liquid adhesive. The procedure reduces the stomach’s capacity by approximately 85 percent, so patients cannot eat as much as they could prior to surgery. The removed portion of the stomach is responsible for secreting a  hormone called grehlin. This hormone is responsible for hunger - an appetite stimulant. Immeditely after surgery, sleeve gastrectomy patients feel less hungry and meals are smaller  in portion, because of the smaller restricted stomach.

• Rapid initial weight loss similar to the weight loss achieved with gastric bypass
• Minimally invasive approach is possible
• Minimal risk of vitamin and protein deficiencies due to malabsorption, because digestive tract is not rerouted
• Permanent procedure – no adjustments are necessary
• Safer procedure compared to gastric bypass
  

Disadvantages of Sleeve Gastrectomy

• Cutting and stapling of the stomach is required
• Higher risk of complications during surgery than adjustable banding procedure
• Non-adjustable
• Cannot be reversed, but can be modified with another procedure if desired weight loss is not achieved or stomach stretches
• 1-2 day(s) overnight stay in the hospital, depending on your health risk

How Does Sleeve Gastrectomy Treat Obesity?

A sleeve gastrectomy staples and detaches a portion of the stomach, leaving the remaining stomach with approximately 15 percent of its former capacity. This reduction causes patients to feel fuller faster, eat less and thereby, lose weight.
Sleeve gastrectomy is not the same as “stomach stapling” procedures performed 20 – 30 years ago. It differs in three key ways:

• Rather than simply stapling off a portion of the stomach, the excess portion is completely removed.
  
  
• While the remaining stomach “sleeve” may stretch to expand in time, the portion of the stomach most likely to stretch is the portion that is removed.
  
  
• The risk of infection or complications is reduced.

Expected Weight Loss

The amount of weight a person can expect to lose after a sleeve gastrectomy depends on several factors. There is no guaranteed amount of weight loss, but the average weight loss in recent clinical studies is approximately 70 to 75 percent of the patient’s excess weight within two to three years of the surgery.

The effectiveness of the sleeve gastrectomy depends on the success of the surgical procedure and the ability of the patient to change his or her diet and level of physical activity.

The team at the Bariatric Center has committed to providing long-term care for patients. After surgery, sleeve gastrectomy patients must maintain scheduled follow-up visits. Patients may be required to have four or more visits during the first year following the surgery, which include reviewing the patient’s progress and discussing any concerns or problems that may arise.

Following sleeve gastrectomy, patients are encouraged to eat balanced diets and avoid problematic eating patterns that may have been typical in their pre-surgery lifestyles, such as social or emotional eating. The stomach will hold between one and five ounces, so patients feel fuller faster and longer. Most patients follow a liquid diet immediately following surgery and gradually begin eating solids and reducing calorie intake.

At the appropriate time, patients are also encouraged to increase their physical activity level, which is very important to weight loss, good health and improved quality of life.


Risks and Complications

Risks and complications, including death, are associated with all major surgical procedures. Although the laparoscopic technique used for sleeve gastrectomy is considered minimally invasive and is associated with reduced complications during the operation, it is still a surgical procedure. Severe obesity increases the risks of some complications.

It is extremely important that you discuss the possible benefits and all the potential risks and complications of weight loss surgery with your surgeon.