Sleeve Gastrectomy Surgery
Weight Loss Surgery
Sleeve gastrectomy, also called a vertical sleeve gastrectomy, is a surgical weight-loss procedure. This procedure is typically performed laparoscopically, which involves inserting small instruments through multiple small incisions in the upper abdomen. During sleeve gastrectomy, about 75-80 percent of the stomach is removed, leaving a tube-shaped stomach about the size and shape of a banana.
Limiting the size of your stomach restricts the amount of food you are able to consume. In addition, the procedure prompts hormonal changes that assist with weight loss. The same hormonal changes also help relieve conditions associated with being overweight, such as high blood pressure or heart disease.
Why it's done
Sleeve gastrectomy is done to help you lose excess weight and reduce your risk of potentially life-threatening weight-related health problems, including:
Sleeve gastrectomy is typically done only after you've tried to lose weight by improving your diet and exercise habits.
In general, sleeve gastrectomy surgery could be an option for you if:
Your body mass index (BMI) is 40 or higher (extreme obesity).
Your BMI is 35 to 39.9 (obesity), and you have a serious weight-related health problem, such as type 2 diabetes, high blood pressure or severe sleep apnea. In some cases, you may qualify for certain types of weight-loss surgery if your BMI is 30 to 34 and you have serious weight-related health problems.
You must also be willing to make permanent changes to lead a healthier lifestyle. You may be required to participate in long-term follow-up plans that include monitoring your nutrition, your lifestyle and behavior, and your medical conditions.
Check with your health insurance plan or your regional Medicare or Medicaid office to find out if your policy covers weight-loss surgery.
What are the Benefits
Sleeve gastrectomy is similar to Gastric Bypass procedures because it restricts the size of the stomach and its ability to hold food. However, there are some benefits of Sleeve Gastrectomy surgery that make some people prefer this option of weight loss surgery over gastric bypass.
There’s no rerouting of the intestines
No band is being introduced into the body
Can be performed if you are ineligible for gastric bypass or LAP-BAND
However, unlike LAP-BAND, the removal of part of the stomach during the sleeve gastrectomy means that the procedure is not reversible and is therefore a permanent surgery.
As with any major surgery, sleeve gastrectomy poses potential health risks, both in the short term and long term.
Risks associated with the sleeve gastrectomy can include:
Adverse reactions to anesthesia
Lung or breathing problems
Leaks from the cut edge of the stomach
Longer term risks and complications of sleeve gastrectomy surgery can include:
Very rarely, complications of sleeve gastrectomy can be fatal.
How your prepare
If you qualify for sleeve gastrectomy, your health care team gives you instructions on how to prepare for surgery. You may need to have various lab tests and exams before surgery.
Food and medications
Before your surgery, give your doctor a list of all medicines, vitamins, minerals, and herbal or dietary supplements you take. You may have restrictions on eating and drinking and which medications you can take.
If you take blood-thinning medications, talk with your doctor before your surgery. Because these medications affect clotting and bleeding, your blood-thinning medication routine may need to be changed.
If you have diabetes, talk with the doctor who manages your insulin or other diabetes medications for specific instructions on taking or adjusting them after surgery.
You'll be required to start a physical activity program.
You'll be required to stop any tobacco use 12 weeks before surgery and may be tested for nicotine prior to your surgery.
You may also need to prepare by planning ahead for your recovery after surgery. For instance, arrange for help at home if you think you'll need it. People who have a sleeve gastrectomy are typically off work for four weeks.
What you can expect
Sleeve gastrectomy is done in the hospital. Depending on your recovery, your hospital stay may last one to two nights.
Before the procedure
Before you go to the operating room, you will change into a gown and will be asked several questions by both doctors and nurses. In the operating room, you are given a general anesthetic before your surgery begins. The anesthetic is medicine that keeps you asleep and comfortable during surgery.
During the procedure
The specifics of your surgery depend on your individual situation and the hospital's or doctor's practices. Some sleeve gastrectomies are done with traditional large (open) incisions in the abdomen. But sleeve gastrectomy is typically performed laparoscopically, which involves inserting small instruments through multiple small incisions in the upper abdomen.
The surgeon then creates a narrow sleeve by stapling the stomach vertically and removing the larger, curved part of the stomach.
Surgery usually takes one to two hours. After surgery, you awaken in a recovery room, where medical staff monitors you for any complications.
After the procedure
After sleeve gastrectomy, your diet begins with sugar-free, noncarbonated liquids for the first seven days, then progresses to pureed foods for three weeks, and finally to regular foods approximately four weeks after your surgery. You will be required to take a multivitamin twice a day, a calcium supplement once a day, and a vitamin B-12 injection once a month for life.
You'll have frequent medical checkups to monitor your health in the first several months after weight-loss surgery. You may need laboratory testing, bloodwork and various exams.
You may experience changes as your body reacts to the rapid weight loss in the first three to six months after sleeve gastrectomy, including:
Sleeve gastrectomy can provide long-term weight loss. The amount of weight you lose depends on your change in lifestyle habits. It is possible to lose approximately 60 percent, or even more, of your excess weight within two years.
In addition to weight loss, sleeve gastrectomy may improve or resolve conditions related to being overweight, including:
High blood pressure
Obstructive sleep apnea
Type 2 diabetes
Sleeve gastrectomy surgery can also improve your ability to perform routine daily activities, and can help improve your quality of life.