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Gastric Sleeve Surgery

Gastric sleeve is a surgery that involves only the stomach. It does not involve surgery on the intestine. A large, rounded portion of the stomach is removed, leaving a slender section of stomach that looks like a sleeve, or a banana. After a sleeve gastrectomy, patients feel full after eating much less.

Gastric sleeve leaves the openings of the stomach intact, so digestion can continue as normal unlike gastric bypass. This procedure is also helpful for patients who want to lose weight but have health conditions that make more aggressive procedures less safe. This procedure is irreversible, but it can be converted to other weight loss procedures in the future if necessary.

In gastric sleeve surgery, also called vertical sleeve gastrectomy, a surgeon removes most of your stomach, leaving only a banana-shaped section that is closed with staples. Like gastric band surgery, this surgery reduces the amount of food that can fit in your stomach, making you feel full sooner. Taking out part of your stomach may also affect gut hormones or other factors such as gut bacteria that may affect appetite and metabolism. This type of surgery cannot be reversed because some of the stomach is permanently removed.

Advantages of Gastric Sleeve

  • No disconnecting or rerouting of small intestine
  • Weight loss similar to gastric bypass
  • No implanted device and no adjustments
  • Safer than gastric bypass

Gastric Sleeve Risks

  • Long-term results not known conclusively
  • Severely obese patients may need a second operation with a conversion to bypass

Procedure of Gastric Sleeve Surgery

This procedure works by several mechanisms. First, the new stomach pouch holds a considerably smaller volume than the normal stomach and helps to significantly reduce the amount of food (and thus calories) that can be consumed. The greater impact, however, seems to be the effect the surgery has on gut hormones that impact a number of factors including hunger, satiety, and blood sugar control.

Short term studies show that the sleeve is as effective as the roux-en-Y gastric bypass in terms of weight loss and improvement or remission of diabetes. There is also evidence that suggest the sleeve, similar to the gastric bypass, is effective in improving type 2 diabetes independent of the weight loss. The complication rates of the sleeve fall between those of the adjustable gastric band and the roux-en-y gastric bypass.

Advantages

  1. Restricts the amount of food the stomach can hold
  2. Induces rapid and significant weight loss that comparative studies find similar to that of the Roux-en-Y gastric bypass. Weight loss of >50% for 3-5+ year data, and weight loss comparable to that of the bypass with maintenance of >50%
  3. Requires no foreign objects (AGB), and no bypass or re-routing of the food stream (RYGB)
  4. Involves a relatively short hospital stay of approximately 2 days
  5. Causes favorable changes in gut hormones that suppress hunger, reduce appetite and improve satiety

Health benefits of Gastric Sleeve Surgery

Gastric sleeve results in complete “resolution” (cure, as long as weight loss is maintained) of many obesity-related health problems, including those listed below:

  • Diabetes
  • Sleep apnea
  • Hypertension
  • Asthma
  • Cholesterol problems
  • and at least 10 other conditions

Patients who aren’t cured usually experience a noticeable improvement.

Note that patients who have a strict follow-up schedule with their surgeon at 3-, 6-, and 12-months post-op see greater improvements in or remission of their diabetes, high blood pressure (hypertension), and high cholesterol than patients who skip these visits.

Gastric sleeve weight loss also improves joint health. For every pound of weight lost, there is a 4 pound reduction in pressure on the knee. This improves mobility and reduces pain in the knees.

Further, 88,000 weight loss surgery participants were involved in data collection for cancer research. Results state that patients who undergo weight loss surgery have 33% less risk of developing cancer.

Risk rates were even further reduced for obesity-related cancers, including:

  • Colon cancer
  • Postmenopausal breast cancer
  • Endometrial cancer
  • Pancreatic cancer



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