Gastric sleeve surgery is one of the restrictive bariatric surgery options. It does not involve the malabsorption component of bypassing part of the intestine. Thus, as with the gastric band procedure, it does not carry the risk of vitamin deficiency associated with the gastric bypass and duodenal switch surgeries owing to their malabsorption components. The gastric sleeve surgery is therefore a viable option for patient’s with Crohn’s disease, anemia and some other medical conditions that may disqualify them from gastric bypass surgery.
Gastric Sleeve Surgery (Sleeve Gastrectomy)
Gastric Sleeve Surgery: PATIENT Criteria
The gastric sleeve surgery is indicated for people with a BMI of 40 or more where diet, exercise and other medical interventions have been unsuccessful. The gastric sleeve surgery also may be approved for people with a BMI of 35 or more with a medical condition such as Diabetes Type 2. You will undergo an extensive screening process to evaluate your psychological status (screening for the presence of depression, sexual abuse, eating disorders, etc). A failed bariatric psych evaluation will not disqualify you from the gastric sleeve surgery, but it may postpone it.
The bariatric surgeon also will review your medical history and look for risk factors that could make the gastric sleeve surgery unsafe for you. You will undergo lab work and a physical exam.
If you are a smoker, you will be required to stop smoking one month prior to the gastric sleeve surgery so as to reduce risks. You will be required to be smoke-free for at least one month after the gastric sleeve surgery, as well to promote healing. Read: How Safe Is Bariatric Surgery.
Gastric Sleeve Surgery: How it Works
Gastric sleeve can be performed laparoscopically. This bariatric surgery removes approximately 85% of the stomach, including the portion that produces the hunger stimulating hormone grehlin. The remaining 15% of the stomach is a long tube resembling a sleeve, from which the surgery’s name is derived. This sleeve continues to function normally, so there are no food restrictions as with the gastric bypass.
While there is no need for adjustments after the gastric sleeve surgery (as there are with the gastric band), you should be aware that the gastric sleeve is NOT reversible and is therefore a lifetime decision. Be sure to check with your bariatric surgeon as to what the remaining capacity of your sleeve will be. It ranges from 60cc to 150cc.
Gastric sleeve also can be used as the first step procedure in cases where gastric bypass or duodenal switch are too risky before a significant amount of weight loss, such as in patients with an initial BMI of 50+. In this case, the second bariatric surgery — gastric bypass or duodenal switch — is done somewhere between 6 to 18 months after the gastric sleeve.
GASTRIC SLEEVE SURGERY: Cost
At the time of this writing, gastric sleeve surgery costs approximately $15,000. Be sure to check its inclusion and the medical criteria for which your health plan will provide coverage. Medical loans are available for the gastric sleeve surgery.
GASTRIC SLEEVE SURGERY: recovery time
Recuperation time for the gastric sleeve surgery is 6 weeks. It is not uncommon to spend a night or two in the hospital after this surgery. You will be required to follow a liquid bariatric diet for the first week post-op, followed by two weeks of pureed food. After that you may eat solids again, generally-speaking, but it will take the full six weeks for the stomach to heal along the staple line. While the gastric sleeve has a low rate of complications, a possible problem is leakage or bleeding from the staple line.
GASTRIC SLEEVE SURGERY: results
Weight loss from the gastric sleeve surgery is that, on average, 30% to 50% of excess body weight will be lost within the first year. Read: Success Habits of Weight-Loss Surgery.
With regard to permanent weight loss, gastric sleeve data is restricted to 2 year and 6 year post-op studies, as it is a relatively newer procedure. The gastric sleeve surgery does show comparable results to other bariatric procedures. The 6 year success rate for the gastric sleeve shows that greater than 50% of the excess body weight remains lost. Be aware that overeating will cause the stomach (sleeve) to stretch, which will cause weight gain.
Living larger than ever,
My Bariatric Life
Photo: Dr. Vishal Mehta