How Does The Gastric Sleeve Work?

The vertical sleeve gastrectomy is a restrictive form of weight loss surgery in which approximately 85% of the stomach is removed leaving a cylindrical or sleeve shaped stomach with a capacity ranging from about 60 to 150 cc, depending upon the surgeon performing the procedure. Unlike many other forms of bariatric surgery, the outlet valve and the nerves to the stomach remain intact and, while the stomach is drastically reduced in size, its function is preserved. Again, unlike other forms of surgery such as the Roux en Y gastric bypass, the sleeve gastrectomy is not reversible.

Because the new stomach continues to function normally there are far fewer restrictions on the foods which patients can consume after surgery, albeit that 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.

Perhaps the greatest advantage of the gastric sleeve lies in the fact that it does not involve any bypass of the intestinal tract and patients do not therefore suffer the complications of intestinal bypass such as intestinal obstruction, anemia, osteoporosis, vitamin deficiency and protein deficiency. It also makes it a suitable form of surgery for patients who are already suffering from anemia, Crohn's disease and a variety of other conditions that would place them at high risk for surgery involving intestinal bypass.

Who Should Consider Gastric Sleeve Surgery

• This kind of surgery is best for any person who is unable to have regular follow up visits that the gastric banding procedures need such as the Realize Band surgery and the Lap Band surgery.
• A person scared of the long-term effects of intestinal bypass such as: anemia, intestinal obstruction and protein deficiency.
• People who don’t want foreign objects in their stomach like you see with the Lap Band surgery.
• People who are unable to do conventional weight loss surgery because of a serious medical condition like anemia and Chrohn’s disease, or a person who has had a number of surgeries.
• People who are using anti-inflammatory medicines and most avoid the gastric bypass surgery.

Laparoscopic Sleeve Gastrectomy Surgery

• The remaining stomach looks like a sleeve (or hose or tube) and holds about 15 percent as much food as the original stomach.
• The surgeon will remove the larger, rounded part of the stomach from the body. (This is the only gastric surgery in which part of the  stomach is taken out of the body.)
• Unlike gastric bypass, which changes stomach openings, sleeve gastrectomy leaves the openings intact.
• It may be a safer and more effective option than gastric bypass for patients with very high BMI, those with medical problems like anemia, Crohn’s disease, osteoporosis, extensive prior surgeries and other complex medical conditions.

Advantages of The Gastric Sleeve Procedure

• Sleeve gastrectomy may be safer than gastric bypass for patients who have a number of health risks.
• It lowers the risk of ulcers compared to gastric bypass.
• The surgery cuts away the part of the stomach that produces grehlin, a stomach hormone that stimulates hunger.
• Though the stomach is smaller, the openings are left intact, so digestion can go on as normal.
• The body is free of foreign objects like the Lap Band®.

Gastric Sleeve Surgery Risks

• Sleeve gastrectomy is more common in Europe, but most American health insurance carriers still consider it an investigational procedure and do not cover the cost.
• Anytime you have anesthesia or surgery, there is a risk of blood clots, other complications or death.
• Do not smoke. Smoking would put you at high risk for infection, blood clots, slow healing and other life-threatening complications.
• Complications can occur with the stapling, such as leaks or bleeding.
• You may need malabsorptive surgery – intestinal bypass or duodenal switch – in addition to your sleeve gastrectomy in order to lose all the weight you need and want to lose.
• The smaller portion of the stomach may stretch.
• Foods that you eat now may cause discomfort, nausea or vomiting after your surgery.
• Gastric surgery puts you at higher than normal risk of developing gallstones and gallbladder disease.
• You will not lose weight or maintain your weight loss unless you eat a healthy diet and exercise regularly. This is the reason we stress long-term follow-up with our center and your doctor.

Facts about the gastric sleeve or sleeve gastrectomy:

Alternative names: vertical sleeve gastrectomy, sleeve gastrectomy, greater curvature gastrectomy, parietal gastrectomy, gastric reduction and vertical gastroplasty.

Surgery for high BMI patients. For patients with a particularly high body mass index (typically 50+) many forms of weight loss surgery are either difficult to perform or present increased risk. As a result, a vertical sleeve gastrectomy (or increasingly a laparoscopic sleeve gastrectomy) is sometimes performed as the first of a two-part weight loss solution to provide an initial drop in weight which then makes other bariatric follow up possible at a reduced level of risk.

Surgery for low BMI patients. For obese patients with a relatively low body mass index the vertical sleeve gastrectomy can also prove a good choice, especially where existing conditions (such as anemia or Crohn's disease) prevent them from having other forms of bariatric surgery. In addition, patients may choose this form of surgery if they are concerned about the long-term affects of bypass surgery or object to having a 'foreign' body implanted into their body, as is the case with lap band surgery.