Sleeve Gastrectomy
Sleeve Gastrectomy
What Is A Sleeve Gastrectomy?
The Sleeve Gastrectomy has become the most common bariatric surgery procedure performed in the United States. The surgery involves removing approximately 70-80% of the stomach. Using laparoscopic techniques the stomach is cut longitudinally creating a long tube or sleeve. This decreases the food capacity and it results in weight loss.
In average patients that undergo a sleeve gastrectomy can experience 60-70% excess body weight loss. This weight loss is usually achieved between 12-18 months.
The gastric sleeve was first described for super-obese patients. In other words, it was for patients to overweight to have a gastric bypass. Surgeons were doing a sleeve gastrectomy and after 1-2 years they will go back and convert the sleeve gastrectomy to a Roux en Y gastric bypass. After several years they found that many patients did not require convertion to a gastric bypass because they had adequate weight loss. Eventually, the gastric sleeve became its own one stage bariatric procedure.
The sleeve gastrectomy is one of the simplest and safest weight loss procedures. Unfortunately, complications can still arrive. If you are considering bariatric surgery of any kind, we recommend that you read this blog post about possible bariatric surgery complications.
In the Spotlight
Advantages & Disadvantages
Advantages
- Short hospital stay
- Excellent weight loss
- Low risk
- Short surgery time
- Minimal anatomic changes
Disadvantages
- Irreversible
- Potential for leak
- Potential for narrowing
- Potential for reflux
- Potential for dumping syndrome
Surgical Technique
How Is A Sleeve Gastrectomy Done?
The sleeve gastrectomy is done laparoscopically or with five small incisions in the upper part of your abdomen. The largest incision is approximately 15 mm, this is usually the incision were the cut portion of the stomach is removed from the abdomen.
Using a high definition camera, monitor and long special instruments a large portion of the stomach is removed. The stomach is divided with a special mechanical stapler that is designed to cut and sew the stomach. After the stomach is divided an endoscopy is performed to evaluate the staple line and to make sure that no leaks are present.
The surgery takes approximately 45-60 minutes. The patient is then awakened from general anesthesia and is transported to recovery room.
Long Term
Life After A Sleeve Gastrectomy
Most patients after surgery will be admitted to the hospital for two days. The day after surgery you will be started on sips of water. The second day you will be advanced to sips of protein drinks. After discharge, you will strictly follow the diet that was given to you prior to surgery during the preop class given by the bariatric coordinator. The diet progresses from liquids, to puree, soft food and eventually to regular food in a period of 6-8 weeks.
After discharge, you should stay away from any heavy lifting or any excessive physical activities for 4-6 weeks. Most patients will return to work 2-4 weeks after surgery. The routine follow up with Dr. Angel Caban is 2 weeks after surgery followed by visits every 3 months for the first year.
Weight loss after a Sleeve Gastrectomy is highly dependent on your initial weight, gender, age, diet, and exercise. Younger male patients with an initial weight around 400 pounds will tend to lose more weight than a 60-year-old post-menopausal female with an initial weight of 200 pounds.
The first 3 months after surgery are crucial for your success. You will lose the majority of the weight in this period. It is imperative that you put great effort during the first quarter to lose as much weight as possible. Weight loss starts to taper down after the first 3 months and most patients will achieve maximum weight loss after surgery around 12-18 months.
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