What is a Gastric Sleeve?
The Gastric Sleeve, also known as the Sleeve Gastrectomy or Vertical Sleeve, is a type of weight loss surgery that combines restriction and metabolic changes.
The procedure involves reducing the size of the stomach by removing approximately 75% of it, thereby limiting its storage capacity.
The surgery promotes weight loss through hormonal changes in the gut. It involves removing the section of the stomach that produces hunger hormones and increasing the speed of food delivery to the small bowel.
These changes in the gut hormones lead to decreased appetite, increased energy expenditure, reduced conversion of calories to fat, and improved regulation of blood sugar levels.
On average, patients can expect to lose around 60-70% of their excess weight through this procedure. Individual results may vary.
Why Consider Weight Loss Surgery?
Weight loss surgery is the only proven and sustainable long-term treatment for weight loss.
It reduces the risk of developing obesity-associated cancers and can prevent, improve, or even cure conditions like Type 2 diabetes and other obesity-related diseases.
Additionally, weight loss surgery can enhance fertility, especially in individuals with Polycystic Ovarian Syndrome, and ultimately lead to a longer, happier, and healthier life.
Why Choose a Gastric Sleeve?
The Gastric Sleeve is the most commonly performed bariatric procedure in Australia due to its effectiveness in weight loss and resolution of obesity-related health conditions, such as diabetes and high cholesterol.
Compared to gastric banding, the Gastric Sleeve offers greater weight loss efficacy and a lower risk of long-term side effects like vitamin deficiencies and internal hernias compared to gastric bypass.
Who is a Suitable Candidate for a Gastric Sleeve?
A Gastric Sleeve may be appropriate for individuals who:
Desire more substantial weight loss than what is achieved with gastric banding. Lack the motivation to adhere to the required diet for gastric banding. Prefer a less complex operation compared to gastric bypass. Have conditions like Type 2 diabetes, high cholesterol, high blood pressure, osteoarthritis, obstructive sleep apnea, fertility issues, or Polycystic Ovarian Syndrome.
Indications for Gastric Sleeve Surgery Gastric Sleeve surgery is indicated for morbidly obese individuals who meet the following criteria:
BMI is ≥ 40. BMI is 35-39.9 with one or more associated co-morbidities. BMI is 30-34.9 with uncontrolled or poorly controlled Type 2 diabetes and multiple anti-diabetic medications.
It's important to note that these indications serve as a guide rather than absolute criteria, and a medical consultation with a healthcare professional is necessary to determine an individual's suitability for surgery.
Advantages of Gastric Sleeve Surgery
The advantages of Gastric Sleeve surgery include:
Reduced stomach size for better control of satiety. Decreased hunger hormones (Ghrelin) leading to appetite suppression. Superior weight loss efficacy compared to gastric banding. Higher rate of resolution or improvement of obesity-related conditions. Less follow-up visits compared to gastric banding and gastric bypass. Potentially lower long-term complications than gastric bypass, such as vitamin deficiencies and internal hernias. No implant device left in the body.
Disadvantages of Gastric Sleeve Surgery
Non-reversible procedure. Higher early complication rate compared to gastric banding, including the risk of staple line leak. Potential risk of heartburn. Lower diabetes remission rate compared to gastric bypass but higher than gastric band.
Risks and Complications of Gastric Sleeve Surgery While complications are relatively uncommon, potential risks associated with Gastric Sleeve surgery include:
Internal bleeding. Wound infection. Blood clots in the legs or lungs. Narrowing of the stomach tube. Staple line leak. The main risk of late complications is heartburn/reflux oesophagitis.
Gastric Sleeve Procedure
The Gastric Sleeve procedure is performed laparoscopically (key-hole surgery) under general anesthesia. It involves making small incisions in the abdominal wall to insert a camera and surgical instruments. Around 75-80% of the stomach is removed using a stapling/cutting device to create a thin tube-shaped stomach. If there are any weaknesses or herniation in the diaphragmatic muscles, they are corrected during the same operation to prevent heartburn/reflux. The removed stomach is then extracted through one of the incisions.
Post-operative Care for Gastric Sleeve
After the surgery, patients typically stay in the hospital for 2-4 days. Painkillers and anti-nausea medications are prescribed for comfort. Patients are encouraged to move early to prevent complications such as blood clots, respiratory problems, and bedsores. Swelling in the stomach is normal in the first few days, making it challenging to drink, but it's important to sip on fluids throughout the day to prevent dehydration, especially in the first 1-2 weeks.
Patients follow a liquid diet for the first 2 weeks after surgery and then transition to pureed and soft diets every 2 weeks. Specific diet plans and instructions will be provided by the surgeon or dietician. Medication to reduce stomach acid production is usually prescribed for the first 3 months, and lifelong intake of multivitamins is necessary.
