Gastric Sleeve

Gastric Sleeve

Gastric Sleeve.
Copyright ©2012 Covidien. All rights reserved. Reproduced with the permission of Covidien Pty Ltd.

The gastric sleeve, also known as sleeve gastrectomy, developed around the year 2000, and is the newest of the commonly performed weight loss operations. In a sleeve gastrectomy, approximately four fifths of the stomach is removed, in order to turn the stomach from a food reservoir into a narrow tube or ‘sleeve’.

How it Works

Similar to a gastric bypass, this acts to interfere with the signals of hunger and satisfaction between the brain and the intestine, so that people feel satisfied after eating a small portion of food. The sleeve gastrectomy also limits the amount of food a person is able to eat in a sitting, however as no intestine is bypassed, there is no reduction in absorption.

Weight Loss

Average weight loss after a sleeve gastrectomy is very similar to that of a gastric bypass. Well designed studies comparing gastric bypass to sleeve gastrectomy, show the weight loss profiles of these two operations are comparable. If anything however, average weight loss after a sleeve gastrectomy may be a little less than that after a gastric bypass (in the region of 25-35% of starting body weight). Sleeve gastrectomy may also be a little less effective at producing remission of diabetes than gastric bypass. As sleeve gastrectomy has not been around as long as gastric bypass, we cannot be certain of the long term outcomes of this operation, however results published up to 7-years after sleeve gastrectomy appear promising.

Details and Risks

Similar to the gastric bypass, the sleeve gastrectomy is usually performed using laparoscopic or ‘keyhole’ surgery. It is performed under a general anaesthetic, and hospital stay is between one and two nights after surgery. Discharge diet and follow-up schedule are the same as that of a gastric bypass. As people are on a highly energy restricted diet after sleeve gastrectomy, vitamin supplementation is still recommended. However, the consequences of not taking these vitamins are not as critical as with a gastric bypass.

Laparoscopic sleeve gastrectomy has similar risks to that of gastric bypass. Overall, the risk of complications around the time of surgery is low, but serious complications may occur. With sleeve gastrectomy, there is a risk of leakage at the line of staples that is used to divide the stomach. Although the risk of this occurring is similar to the risk of leaking at the joins after a gastric bypass, it is a much more difficult complication to treat after sleeve gastrectomy. If this occurs, it may require a hospital stay of many months, with repeat operations, and feeding via IV lines or tubes instead of by mouth.

Sleeve gastrectomy is also a permanent change to digestion, and as part of the stomach has been removed this operation cannot be reversed. Late complications include narrowing of the sleeve, and development of reflux or heartburn. Up to one in three people will need to take medications for reflux (or have surgery for this) after sleeve gastrectomy. Ulcers, blockages to the intestine, and vitamin deficiencies are very uncommon after sleeve gastrectomy.

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