Sleeve Gastrectomy

Sleeve gas­trec­to­my (also known as ver­ti­cal sleeve, gas­tric sleeve, or tube gas­trec­to­my) is a weight-loss oper­a­tion per­formed using laparo­scop­ic or robot­ic tech­niques to treat obe­si­ty. This restric­tive weight-loss surgery helps extreme­ly over­weight patients with a BMI of 35 or high­er, or a BMI of 30 or high­er with obe­si­ty-relat­ed health con­di­tions, by lim­it­ing food intake. The pro­ce­dure works by reduc­ing stom­ach capac­i­ty, which nat­u­ral­ly decreas­es how much you can eat with­out dis­rupt­ing nor­mal digestion.

For patients with severe obe­si­ty (BMI of 60+), sleeve gas­trec­to­my some­times serves as the ini­tial phase of a two-part sur­gi­cal approach. This strat­e­gy allows for sig­nif­i­cant weight reduc­tion first, mak­ing any nec­es­sary fol­low-up weight-loss surgery safer to perform.

The Sleeve Gas­trec­to­my Pro­ce­dure Process

Dur­ing surgery, you’ll receive gen­er­al anes­the­sia for com­plete com­fort. The sur­geon cre­ates 5 – 6 tiny open­ings across your abdomen. Through one open­ing, they insert a laparo­scope — a slen­der tool equipped with a cam­era and light — enabling clear visu­al­iza­tion of your inter­nal organs on a screen.

Addi­tion­al sur­gi­cal tools enter through the remain­ing open­ings. The sur­geon removes approx­i­mate­ly 75 – 80% of your stom­ach. The remain­ing sec­tion is shaped into a banana-like tube and sealed with sur­gi­cal sta­ples. Once com­plete, the small inci­sions are closed with stitch­es. The entire oper­a­tion typ­i­cal­ly takes between 60 and 90 minutes.

Ben­e­fits of Choos­ing Sleeve Gastrectomy

• Small­er stom­ach capac­i­ty cre­ates ear­li­er feel­ings of fullness
• Pre­served nor­mal stom­ach func­tion allows eat­ing most foods in small­er portions
• Removal of stom­ach sec­tion that pro­duces hunger hor­mones (Ghre­lin)
• No dump­ing syn­drome because the pylorus sec­tion remains intact
• Avoids intesti­nal bypass complications
• Can be per­formed through min­i­mal­ly inva­sive techniques
• Less com­plex than gas­tric bypass procedures
• Pro­vides a safer first step for extreme­ly obese patients need­ing two-stage surgery
• Short­er oper­a­tion time com­pared to bypass surgeries
• Reduced hos­pi­tal stay ver­sus bypass procedures
• No arti­fi­cial implants, unlike band surgery

Draw­backs of Sleeve Gastrectomy

• High­er risk of insuf­fi­cient weight loss or regain­ing weight com­pared to pro­ce­dures that bypass part of the intestine.
• Can­not be reversed

Recov­ery and Aftercare

• Your health­care provider will sup­ply pain med­ica­tion to man­age dis­com­fort after surgery
• You’ll need to take stom­ach acid-reduc­ing med­ica­tion as directed
• Avoid heavy lift­ing and vig­or­ous phys­i­cal activ­i­ty until your sur­geon gives approval
• Dur­ing the first month post-surgery, con­sume only small por­tions of soft foods
• Drink water con­sis­tent­ly through­out the day to stay hydrated
• Focus on a nutri­tious diet high in pro­tein and low in fat
• Your nutri­tion spe­cial­ist will cre­ate a cus­tomized eat­ing plan for your needs
• Life­long vit­a­min sup­ple­men­ta­tion and fol­low-up are typ­i­cal­ly recommended

Poten­tial Complications

Like all sur­gi­cal pro­ce­dures, sleeve gas­trec­to­my car­ries cer­tain risks. The rec­om­men­da­tion for surgery occurs when ben­e­fits out­weigh these poten­tial risks. Under­stand­ing these pos­si­bil­i­ties before pro­ceed­ing is essen­tial. While most patients recov­er with­out issues, com­pli­ca­tions can arise depend­ing on indi­vid­ual health factors.

Com­pli­ca­tions fall into two cat­e­gories: gen­er­al med­ical issues and those spe­cif­ic to sleeve gastrectomy.

Gen­er­al med­ical com­pli­ca­tions relate to anes­the­sia and over­all health. This list isn’t exhaus­tive, but includes:

• Aller­gic respons­es to medications
• Sig­nif­i­cant blood loss requir­ing trans­fu­sion (which car­ries min­i­mal dis­ease trans­mis­sion risk)
• Heart attacks, strokes, kid­ney fail­ure, pneu­mo­nia, uri­nary tract infections
• Anes­the­sia-relat­ed problems

Seri­ous med­ical issues may result in ongo­ing health chal­lenges, extend­ed hos­pi­tal stays, or, in rare cas­es (less than 1%), death.

Spe­cif­ic sleeve gas­trec­to­my com­pli­ca­tions include:

• DVT (dan­ger­ous blood clots form­ing in deep leg veins)
• Injury to sur­round­ing organs
• Stom­ach con­tents leak­ing from the sta­ple line, poten­tial­ly caus­ing seri­ous infection
• Gas­troe­sophageal reflux dis­ease (GERD)
• Stric­ture or nar­row­ing of the sleeve