Vertical Sleeve Gastrectomy / Gastric Sleeve

How It Works:

gastric sleeve / sleeve gastrectomy

The gastric sleeve, or vertical sleeve gastrectomy, is a restrictive weight loss surgery that permanently removes approximately 75-80% of the stomach. The laparoscopic approach to making the sleeve — long and tubular, resembling a “banana shape” – allows each working section of the stomach to remain intact with the outlet being the patient’s own pyloric sphincter. No part of the intestine is modified or bypassed.

The design of the sleeve also benefits the patient by removing the fundus of the stomach, which produces much of the “appetite hormone” ghrelin. As a result, patients receive additional help with suppressing their hunger or appetite.

The vertical sleeve gastrectomy had been used for decades in conjunction with another malabsorptive procedure known as the duodenal switch. Bariatric surgeons began omitting the portion of this procedure in the early 2000s, studying the sleeve as a standalone approach. The five-year data demonstrated very favorable outcomes in weight loss, reduced post-op complications and mortality, and saw favorable resolution of patients’ co-morbidities.

This makes the gastric sleeve a strong choice for balancing benefits and risks in comparison to combination weight loss surgery options such as the gastric bypass.

The sleeve is currently the most popular weight loss surgery in the United States.

Video Courtesy of Ethicon

 

Results of the Gastric Sleeve:

Excess weight loss in the average patient ranges from 50 to 75%, and almost all patients will see an improvement or elimination of type II diabetes, high cholesterol, high blood pressure and sleep apnea.

While the gastric sleeve offers more modest weight loss rates versus the gastric bypass, longer-term excess body weight loss and maintenance is almost the same.

Amelia’s Gastric Sleeve Story

Benefits of the Gastric Sleeve:

  • Because of its simplicity, the gastric sleeve has a lower incidence of long-term complications and mortality compared to gastric bypass surgery
  • Excess weight loss results are exceptional
  • Obesity-related disease improvement and resolution rates are excellent
  • No implant in the abdomen as with gastric banding
  • It can be performed laparoscopically, which means less pain, less blood, generally fewer initial complications and a shorter overnight hospital stay
  • Fewer surgical attachment points for the sleeve (only one) means lower risk of leaks versus the gastric bypass (five attachment points)
  • Over the course of time, the sleeve requires less maintenance compared to the gastric band, as the sleeve is a permanent change to the structure of the stomach

Considerations and Risks of the Gastric Sleeve:

  • The sleeve procedure is still major surgery and comes with a degree of surgical risk which may be exacerbated by a patient’s poor health due to obesity
  • If the staple line begins to leak, the result could be bleeding or infection in the abdomen which requires emergency care and surgery
  • The gastric sleeve is permanent but can be revised
  • The gastric sleeve is not reversible or adjustable
  • Initially, post-op, the vertical sleeve gastrectomy brings more risk than the adjustable gastric band due to the surgical separation of the stomach
  • The band is handled as an outpatient procedure, allowing the patient to go home the same day, whereas the sleeve usually requires one overnight stay in the hospital.

After Gastric Sleeve Surgery

Typical hospital recovery time after sleeve surgery requires an overnight stay, a day shorter than the gastric bypass and longer than gastric banding (an outpatient procedure). Once home, patients will practice appropriate wound care and limit strenuous activities according to their postoperative guidelines. Most patients return to work within 2-3 weeks and normal activities can be resumed within 6 weeks, with surgeon approval.

Gastric sleeve patients will take a multi-vitamin supplement for the rest of their lives but are at a much reduced risk of malnutrition versus gastric bypass patients. Patients will follow a diet and exercise program that combines moderation and nutritional balance.

Our program’s approach is to re-educate the patient in order to adapt to the new post-surgery lifestyle. Things such as food budgeting, exercise, vitamins, portion control, speed at which one eats, and behavior modifications such as refraining from drinking while eating is exactly the same regardless which procedure is chosen. However, according to some studies, the benefit comparison suggests that your weight loss, and subsequent resolutions of co-morbid conditions, is achieved faster with the sleeve than band.

Getting Started

Learn more about the gastric sleeve procedure by scheduling a consultation with our office. The more you know about this procedure, the greater the likelihood of your success over the long-term. We strive to offer the information and support that you need to make informed decisions and we look forward to helping you in your journey to a new life with the gastric sleeve.

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