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Gastric Sleeve (Vertical Sleeve Gastrectomy)
 How
Does The Sleeve Gastrectomy Work?
The vertical sleeve gastrectomy is a restrictive form of weight
loss surgery in which approximately 85% of the stomach is removed
leaving a cylindrical or sleeve shaped stomach with a capacity ranging
from about 60 to 150 cc, depending upon the surgeon performing the
procedure. Unlike many other forms of bariatric surgery, the outlet
valve and the nerves to the stomach remain intact and, while the
stomach is drastically reduced in size, its function is preserved.
Again, unlike other forms of surgery such as the Roux en Y gastric
bypass, the sleeve gastrectomy is not reversible.
Because the new stomach continues to function normally there are
far fewer restrictions on the foods which patients can consume after
surgery, albeit that the quantity of food eaten will be considerably
reduced. This is seen by many patients as being one of the great
advantages of the sleeve gastrectomy, as is the fact that the removal
of the majority of the stomach also results in the virtual elimination
of hormones produced within the stomach which stimulate hunger.
Perhaps the greatest advantage of the gastric sleeve lies in the
fact that it does not involve any bypass of the intestinal tract
and patients do not therefore suffer the complications of intestinal
bypass such as intestinal obstruction, anaemia, osteoporosis, vitamin
deficiency and protein deficiency. It also makes it a suitable form
of surgery for patients who are already suffering from anaemia,
Crohn's disease and a variety of other conditions that would place
them at high risk for surgery involving intestinal bypass.
Facts about the sleeve gastrectomy:
Alternative names: vertical sleeve gastrectomy,
sleeve gastrectomy, greater curvature gastrectomy, parietal gastrectomy,
gastric reduction and vertical gastroplasty.
Surgery for high BMI patients
For patients with a particularly high body mass index (typically
50+) many forms of weight loss surgery are either difficult to perform
or present increased risk. As a result, a vertical sleeve gastrectomy
(or increasingly a laparoscopic sleeve gastrectomy) is sometimes
performed as the first of a two-part weight loss solution to provide
an initial drop in weight which then makes other bariatric follow
up possible at a reduced level of risk.
Surgery for low BMI patients
For obese patients with a relatively low body
mass index the vertical sleeve gastrectomy can also prove a good
choice, especially where existing conditions (such as anaemia
or Crohn's disease) prevent them from having other forms of bariatric
surgery. In addition, patients may choose this form of surgery
if they are concerned about the long-term affects of bypass surgery
or object to having a 'foreign' body implanted into their body,
as is the case with lap band surgery.
Laparoscopic Sleeve Gastrectomy Surgery
During
sleeve gastrectomy, the surgeon will
remove the larger, rounded part of the
stomach.
- The
remaining stomach looks like a
sleeve (or hose or tube) and holds
about 15 percent as much food as
the original stomach.
- The
surgeon will remove the larger,
rounded part of the stomach from
the body. (This is the only gastric
surgery in which part of the
stomach is taken out of the body.)
- Unlike gastric bypass, which
changes stomach openings, sleeve
gastrectomy leaves the openings
intact.
- It
may be a safer and more effective
option than gastric bypass for
patients with very high BMI, those
with medical problems like anemia,
Crohn’s disease, osteoporosis,
extensive prior surgeries and other
complex medical conditions.
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