Sleeve gastrectomy preserves all the important structural elements of the stomach, such as the antrum, pylorus and the nerves that control stomach function. It leaves your stomach much smaller, but close to the normal stomach in terms of its function.
During this procedure, a thin vertical sleeve of stomach is created using a stapling device, and the rest of the stomach is removed. The sleeve is about the size of a banana. This procedure limits the amount of food you can eat and helps you feel full sooner. It allows for normal digestion and absorption. Food consumed passes through the digestive tract in the usual order, allowing it to be fully absorbed in the body.
The sleeve gastrectomy is a restrictive procedure, meaning it helps feel full on less food. Studies suggest that it may also change hormone levels in the body to help with weight loss. Researchers continue to study these changes on the hormone levels in the body following this surgery.
Advantages of the Procedure
Sleeve gastrectomy is typically performed using a minimally- invasive laparoscopic technique. This usually results in a shorter hospital stay, faster recovery, smaller scars, and less pain than open surgical procedures.
Sleeve gastrectomy patients often resolve co-morbid conditions 12 to 24 months the procedure; they have experienced resolution rates for type 2 diabetes, high blood pressure, high cholesterol, and obstructive sleep apnea that were similar to resolution rates for other restrictive procedures such as lap banding (gastric banding).
Risks of the Procedure
The sleeve gastrectomy includes dividing, stapling and removing the excess stomach. This surgery is not reversible.
Staple Line Leaks
The longer staple line on the stomach can add increased risk for gastric contents to leak out of the stomach into the abdominal area. If this complication is not quickly identified and treated, it can be fatal.
Studies have demonstrated superiority of sleeve gastrectomy over adjustable lap banding (gastric banding) in terms of weight loss, co-morbidity reduction, or diabetes remission.
Other studies have demonstrated superiority of gastric bypass over the sleeve gastrectomy with regards to weight loss, co-morbidity reduction, or diabetes remission.*
Sleeve gastrectomy patients do not suffer adverse effects from eating sugars (dumping syndrome), but this does require more discipline in food choices. Foods like soda, ice cream, cake and cookies slide through the new “sleeve” easily, but obviously these choices will not lead to the desired goal of significant weight-loss.
- Minor wound or skin infection/scarring, deformity, loose skin
- Vomiting or nausea/inability to eat certain foods/improper eating
- Inflammation of the esophagus (esophagitis), acid reflux (heartburn)
- Problems with the outlet of the stomach (narrowing or stretching)
- Anemia, metabolic deficiency (iron, vitamins, minerals), temporary hair loss
- Development of gallstones or gallbladder disease
- Stomach or outlet ulcers (peptic ulcer)
- Staple-line disruption, weight gain, failure to lose satisfactory weight
Early on after surgery, patients may experience a worsening of their reflux symptoms. This may improve as weight loss progresses.