“I didn’t lose weight to look cute. I did it to be
healthy and feel better mentally and physically.
After my Gastric Sleeve, I feel awesome.... looking great is the
icing on my sugar free cake.”
~Morgan (Lost 121 pounds)
More and more patients who are researching bariatric procedures are asking us about a “new” procedure called the ”Sleeve Gastrectomy.” Sleeve gastrectomy, gastric sleeve and vertical sleeve gastrectomy (VSG) are all names describing the same surgical procedure. This operation for weight loss is done in the laparoscopic technique. About 5 or 6 small incisions on the abdominal wall are used to introduce the surgical instruments and camera, in order to allow the surgeon to complete the operation without making a long midline abdominal incision. The Sleeve Gastrectomy, or Gastric Sleeve procedure, involves removing about 4/5 of the stomach. This results in a restrictive pouch which looks like a thin banana. The nerves to the stomach and the outlet valve (pylorus) remain intact. The removal of the majority of the stomach results in the elimination of most of the gastric hormones which cause or stimulate hunger. The remission of Type II adult onset diabetes (the metabolic syndrome) is thought to be related to the changes in the gastric and intestinal hormones. This effect starts to happen before any significant weight loss occurs. This demonstrates that the Sleeve Gastrectomy works in a restrictive and metabolic fashion to produce the desired results of weight loss and elimination or improvements of co-morbid diseases.
The Gastric Sleeve involves solely decreasing the size of the stomach. There is no intestinal bypass. This makes it a simpler operation than the gastric bypass. Compications which can be potentially long term (i.e., ulcers, vitamin and mineral deficiencies, bowel obstructions) are usually avoided due to the lack of intestinal bypass.
The excess weright loss after the Sleeve Gastrectomy, at five years, approaches that of the gastric bypass and is much greater than the LapBand, on average. The operative risk of the vertical sleeve gastrectomy is slightly higher than the LapBand, but much lower than the gastric bypass.
A very appealing factor of the Gastric Sleeve involves the hunger hormone, Ghrelin. The area of the stomach that is removed in surgery contains the cells which secrete Ghrelin, the hunger stimulating hormone. In the vast majority of patients, hunger and appetite are greatly reduced when this area is removed. With this reduction of appetite, small amounts of food create early and prolonged feelings of satiety and fullness.
Many of our patients ask if the new stomach pouch will stretch. In the vertical sleeve gastrectomy, the banana shaped stomach is less likely to expand and stretch over time, as compared to the pouch of the gastric bypass.v
For those patients who have voiced concern about the implantation of a foreign body (the silicone band), the adjustable gastric band is not an option. For those patients who object to the idea of bypassing a part of the intestine, the gastric bypass is not an option. For those patients, the Sleeve Gastrectomy is an excellent choice due to low risk, no rerouting or bypassing of the intestines and no implantation of a foreign body or device. Also the Sleeve Gastrectomy has a very acceptable excess weight loss compared to other weight loss procedures. As with any weight loss surgery, there are risks.
Advantages of the Sleeve Gastrectomy
Disadvantages of the Sleeve Gastrectomy
Individuals who should consider Sleeve Gastrectomy:
At Oxford Bariatric, we are very excited about the Sleeve Gastrectomy, or Gastric Sleeve. We feel that this operation has many positives and few negatives. The procedure can be done safely and the excess weight loss is excellent, late complications are uncommon and resolution of co-morbidities are similar to more complex procedures. The metabolic effect of the Sleeve Gastrectomy, which leads to remission of Type II adult onset diabetes, is impressive. This result is separate from the effect incurred by weight loss and adds to the ability of this procedure to make our patients healthier and happier in their lives.
To view an animation of the Laparoscopic Sleeve Gastrectomy, click here.
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