Sleeve gastrectomy is a form of restrictive bariatric (weight loss) surgery in which staples are used to create a banana shaped tube or a sleeve within the stomach itself. This specific type of surgery leaves about 15% of the stomach’s functionality. Therefore, less food can be ingested resulting in weight loss. The reduction of the size of the stomach through this surgical technique is irreversible and permanent. This procedure is also known as vertical sleeve gastrectomy. This is due to the fact that the sleeve created is a long vertical shaped tube. This tube is the least likely to expand and is actually resistant to high volumes of food.
The best candidates for sleeve gastrectomy are extremely obese patients with a body mass index (BMI) of 40 or higher. Sleeve gastrectomy surgery is sometimes performed as a two-step process. The actual stapling is the first step. If the patient loses a sufficient amount of weight, the second step becomes unnecessary. However, if the weight loss amount is insufficient, the second step becomes vital. This final step requires a diversion of part of the stomach directly into the small intestine via the pyloric valve and it is called a duodenal switch.
Many candidates for bariatric surgery do not want a foreign body implanted in them, such as the staples from a sleeve gastrectomy. Therefore, lap band surgery becomes a desirable option. Lap band surgery places a restrictive band around the stomach. This band can be adjusted and removed. However, patients who had undergone the sleeve gastrectomy procedure experienced weight loss in excess of 57%. Those who had undergone the lap band procedure experienced a weight loss of approximately 41%. Therefore, the statistics show that gastrectomy procedures show better results overall. Some statistics show that the second step (duodenal switch) of the sleeve gastrectomy surgery showed an 81-86% excess weight loss, which far exceeds that of any other procedure practiced today.
An interesting aspect of sleeve gastrectomy surgery has to do with the reduction of an appetite-reducing chemical known as Ghrelin. Many patients who have undergone sleeve gastrectomy surgery noticed a marked decrease in their appetites. However, in some cases there was a return of appetite after approximately three years from the date of the procedure. This indicates that Ghrelin had unexpectedly returned to pre-surgical levels. Studies have found that the actual removal of the portion of the stomach responsible for the production of Ghrelin had permanently and sufficiently reduced the appetite.
The undesired side effects of sleeve gastrectomy surgery include a syndrome called dumping. This is a process where the food in the stomach literally dumps into the small intestine at a much higher volume than is normal. This can cause several problems including the distension (stretching) of the small intestine and problems with blood glucose levels. The worst-case scenario is an actual perforation of the small intestine. Other side effects can be an infection at the site of the staples that can be remedied with specific antibiotics. Patients must be monitored closely following this type of bariatric procedure.
What is Sleeve Gastrectomy?
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