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Gastric Sleeve
Surgical Procedure
About The Gastric Sleeve
Gastric Sleeve Surgery,
also known as Gastric Sleeve Resection or Vertical Sleeve
Gastrectomy (VSG), is a restrictive type of weight loss surgery that
permanently reduces the size of the stomach. It promotes weight loss
by limiting food intake and lessening the sensation of hunger; it
does not involve intestinal rerouting or food malabsorption.
The gastric sleeve procedure has been gaining attention in recent
years as an effective bariatric option, yet it is not a completely
new type of surgery. It has been performed by bariatric surgeons for
quite some time, but usually as the first part of a two-stage
operation.
Originally, the gastric sleeve surgery was designed to be
followed up by a second procedure, either gastric bypass or duodenal
switch surgery, at a later date. The purpose of the two-stage
approach is to make weight loss surgery safer for high-risk
patients, particularly individuals with a high body mass index (BMI
greater than 50 to 60) and/or with health conditions that make them
unacceptable candidates for a single, combined restrictive and
malabsorptive surgery.
In recent years, many bariatric surgeons have begun to perform
gastric sleeve surgery as a stand-alone weight loss procedure. With
this new approach, the stomach pouch is usually made smaller than in
duodenal switch patients. While long term results are not yet
available, short term weight loss results have been primarily
favorable, especially in low BMI patients (BMI 35 to 45).
During The Procedure
During gastric sleeve surgery, the bariatric surgeon removes
approximately 60 to 80% of the stomach along the greater curvature,
leaving only a small tube, or “sleeve” for the new stomach pouch
that extends from the natural stomach opening to the natural stomach
outlet (pyloric valve). The procedure helps to limit eating by
reducing the overall size of the stomach and control hunger by
removing the part of the stomach that produces the
hunger-stimulating hormone Ghrelin.
The cutaway part of the stomach is removed from the body and not
left in place as with gastric bypass surgery, therefore the stomach
reduction is permanent and the gastric sleeve procedure is not
reversible. Overall, it is a less complicated operation than either
gastric bypass or duodenal switch surgery, since the pyloric valve
and small intestine are left intact. Also, the gastric sleeve does
not involve implanting a medical device into the body in order to
restrict eating as with adjustable gastric banding surgery.
Expected Weight Loss
Patients who undergo the gastric sleeve procedure as a first stage
procedure are typically expected to lose approximately 30 to 50% of
their excess body weight during the following six to twelve months
before continuing with the second surgery. This initial weight loss
will make it safer to proceed with the second-stage of the process,
either gastric bypass or
duodenal switch surgery, which involves rerouting the small
intestine. The timing of the second procedure will depend on the
rate of weight loss following the gastric sleeve surgery.
Advantages of Gastric Sleeve Weight Loss Surgery
- Promotes weight loss by restricting amount of food that can
be eaten at any one time
- Reduces hunger since it removes the part of the stomach that
produces the hunger stimulating hormone ghrelin
- Digestion occurs normally as the digestive system is not
altered
- Does not cause malabsorption or nutritional deficiencies as
it does not involve rerouting or bypassing the small intestine
- Less chance of developing ulcers than with gastric bypass
surgery
- Dumping syndrome not likely to occur as the stomach outlet
(pyloric valve) remains intact, unlike gastric bypass surgery
- Less complicated procedure than gastric bypass or duodenal
switch surgery
- Can usually be performed laparoscopically on extremely obese
patients
- Does not require a gastric band being implanted into the
body
- Does not require adjustments or fills as with a
LAP-BAND or REALIZE
Band
- Safer than a combined restrictive/malabsorptive weight loss
surgery for patients who have many health problems
- May be converted to gastric bypass or duodenal switch if
necessary for additional weight loss
- Expected excess weight loss for stand-alone procedure is 60
to 70% at two years
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