What is Sleeve Gastrectomy?
Sleeve Gastrectomy is a minimally invasive procedure performed laparoscopically. During the surgery, approximately 80% of the stomach is removed, leaving a narrow, banana-shaped tube. This reduces the stomach’s capacity from around 2 litres to just 100-200 mL. The smaller stomach size helps patients feel full and satisfied after eating smaller portions, which supports sustainable weight loss.
How Does Sleeve Gastrectomy Work?
Sleeve Gastrectomy works in two key ways to promote weight loss:
- Restrictive Effect: By reducing the size of the stomach, the procedure limits the amount of food you can eat, helping you feel full sooner.
- Metabolic Effect: The surgery also impacts the body’s hormonal balance. The part of the stomach removed during the procedure (the fundus) produces a hormone called ghrelin, which stimulates hunger and fat storage. By removing this portion, ghrelin levels decrease, reducing hunger and helping the body regulate weight more effectively. However, it’s important to note that the metabolic effect of Sleeve Gastrectomy is weaker compared to gastric bypass, which may influence long-term weight loss outcomes.
Many experts consider Sleeve Gastrectomy a hybrid procedure, combining the benefits of both gastric bypass and gastric banding without some of the drawbacks associated with those surgeries.
What Results Can You Expect?
Most patients achieve significant weight loss within 12 months, losing approximately 60% of their excess weight. However, individual results may vary. Weight loss with Sleeve Gastrectomy is comparable to gastric bypass but often occurs more quickly. While long-term data is still being collected, the procedure has shown excellent outcomes for weight loss and improvement in obesity-related health conditions. That said, some patients may experience more weight regain in the long term compared to gastric bypass, as the metabolic effect of the sleeve is less pronounced.
Recovery and Life After Surgery
- Hospital Stay: Most patients stay in the hospital for 2 nights.
- Recovery Time: Nausea and chest discomfort (especially when drinking quickly) are common in the first few days but typically resolve within weeks as the body adjusts to the smaller stomach size.
- Diet: Within a few weeks, patients can resume eating most foods, though portion sizes will be much smaller.
Advantages of Sleeve Gastrectomy
- Effective Weight Loss: Most patients achieve significant and sustained weight loss.
- Improved Health: Many obesity-related conditions, such as type 2 diabetes, high blood pressure, high cholesterol, and sleep apnea, improve or resolve completely.
- No Foreign Objects: Unlike gastric banding, there are no implants or adjustments required.
- No Malabsorption: The procedure does not interfere with nutrient absorption, reducing the risk of vitamin and mineral deficiencies.
- Flexibility: It can be performed as a standalone procedure or as the first step in a two-stage process for patients with severe obesity.
Potential Disadvantages
- Irreversible: The procedure permanently removes part of the stomach.
- Surgical Risks: As with any surgery, there are risks such as bleeding, infection, or leaks (though these are rare, occurring in 1-2% of cases).
- Long-Term Data: While short- and medium-term outcomes are excellent, long-term data is still being collected.
- Weight Regain: Some patients may experience more weight regain in the long term compared to gastric bypass, as the metabolic effect of the sleeve is weaker.
- Reflux: Approximately 25% of patients may experience new or worsening gastro-oesophageal reflux disease (GORD) after surgery. This is often managed with acid-suppressing medications (proton pump inhibitors), but in some cases, patients may require a revision to Roux-en-Y gastric bypass to address severe reflux.
Sleeve Gastrectomy vs. Other Weight Loss Surgeries
Compared to Gastric Banding
- Pros: Faster weight loss, no foreign body, no adjustments, and greater overall weight loss.
- Cons: Irreversible and slightly higher upfront surgical risk.
Compared to Gastric Bypass
- Pros: No alteration to gut continuity, lower risk of small bowel obstruction, ulcers, or nutrient deficiencies.
- Cons: Slightly lower overall weight loss compared to gastric bypass, and less long-term data available. The metabolic effect is also weaker, which may contribute to more weight regain over time.
The Importance of Lifestyle Changes
Like all bariatric surgeries, Sleeve Gastrectomy is a tool to help you achieve your weight loss and health goals. To maximize the benefits of the procedure, it’s essential to adopt a healthy diet and incorporate regular exercise into your lifestyle. Surgery is not a standalone solution but works best when combined with long-term lifestyle changes. Your commitment to these changes will play a significant role in your success.
Is Sleeve Gastrectomy Right for You?
Sleeve Gastrectomy is an excellent option for many patients seeking a safe, effective, and sustainable weight loss solution. However, it’s important to discuss your medical history, lifestyle, and goals with a qualified bariatric surgeon to determine if this procedure is the best choice for you.
At Southwest Bariatrics, we’re committed to helping you achieve your weight loss and health goals with personalized care and support. Contact us today to learn more about Sleeve Gastrectomy and whether it’s the right step on your journey to a healthier life.
