Sleeve Gastrectomy

Overview

Sleeve gastrectomy, also called vertical sleeve gastrectomy, is a weight loss procedure in which a large part of the stomach is surgically removed. During the procedure, the shape of the stomach is changed into a tube, or banana-like shape, which limits the amount of food that can be taken in. Sleeve gastrectomies are a newer type of bariatric (weight loss) surgery that may work for obese people who cannot safely have other forms of surgery.

Before getting a sleeve gastrectomy, a complete physical exam is needed to make sure other health problems will not raise the risk of complications after surgery. Doctors will perform blood tests and gallbladder tests and may recommend seeing a counselor to ensure that the patient is emotionally prepared for the surgery. People who smoke should quit several weeks before the surgery and should not continue afterward to avoid serious complications. Because this surgery means that the patient will need to undergo significant lifestyle changes to maintain weight loss, nutritional counseling prior to the procedure is often recommended.

Before the surgery, the patient is given general anesthesia. The surgeon will then insert a tiny camera (laparoscope) into the stomach through small cuts in the abdomen. Using this camera to see inside the body, the surgeon will use surgical instruments to remove most of the stomach and then staple the remaining portions together. The result is a smaller, banana-shaped stomach. A skilled surgeon can complete the procedure within an hour or two. Since sleeve gastrectomies create a smaller, tube-like stomach, the patient will feel full after eating only a small amount of food. Most patients can return home a few days after the surgery and will need to take pain medications. At first, the patient will need to eat only small, pureed meals to avoid stretching the stomach. A doctor, nurse, or dietician will help to plan an appropriate diet. The weight loss from a sleeve gastrectomy does not occur as quickly as with other surgeries – patients may continue to lose weight for up to 3 years after the procedure. It is very important to maintain a healthy diet and become active to have successful weight loss following sleeve gastrectomy.

Before having this procedure done, it is important for patients to know that it is irreversible and not a quick fix for obesity. This surgery can increase the risk of gallstones, stomach lining inflammation, heartburn, and ulcers. There is also a risk of leakage from where the stomach has been stapled together. Additional risks specific to sleeve gastrectomies include injury to the stomach or other organs, poor nutrition, scarring that could block the bowels, and vomiting from eating too much. As with any surgery, there is always a risk of blood clots, heart attack or stroke, infection, and allergic reaction to anesthesia. Before deciding to have any type of weight loss surgery, it is important to talk to a doctor about options.

Recent Debates and Developments

Sleeve gastrectomy is a relatively new weight loss surgery, but it has become a popular route for weight loss in children and adolescents. Studies show that it is as effective as other forms of bariatric surgery for reducing weight.

More Information

Mayo Clinic: http://www.mayoclinic.com/health/gastric-bypass/my00825/dsection=what-you-can-expect
Medline Plus: http://www.nlm.nih.gov/medlineplus/ency/article/007435.htm
Wikipedia: http://en.wikipedia.org/wiki/Sleeve_gastrectomy