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Gastric sleeve surgery, also known as sleeve gastrectomy, is a type of bariatric (weight-loss) surgery. This surgical procedure alters the size of a person’s stomach to promote weight loss. Doctors surgically remove a significant portion of a person’s stomach during the procedure, which reduces the volume that the stomach can hold by 80%. As a result, the stomach looks more like a tube that food travels through rather than a pouch that can hold and help digest food. Sleeve gastrectomy is not reversible.
Gastric sleeve surgery is the most commonly performed weight-loss surgery in the United States, accounting for about 58% of all bariatric surgical procedures. It’s also a safe procedure, resulting in few serious short- or long-term complications. Doctors may recommend sleeve gastrectomy or other types of weight-loss surgery to certain people with obesity who have been unable to lose weight through diet, exercise, and other nonsurgical interventions.
Patients who undergo sleeve gastrectomy are expected to gradually lose about 60% of their excess body weight. The weight loss associated with sleeve gastrectomy may reverse and/or reduce the future risk of chronic health conditions associated with obesity, including type 2 diabetes, high blood pressure, and/or sleep apnea, enabling them to live longer, healthier lives.
During the surgery, the surgeon creates a narrow sleeve by stapling the stomach vertically and removing the larger, curved part of the stomach⁸. The surgery is most often done laparoscopically, which involves inserting small instruments (including a thin scope) through several small incisions in the abdomen. Stomach tissue is then removed via one of the small incisions. All told, about 75 to 80% of the stomach is taken out, with the remaining portion being formed into a pouch. This reduces the amount of food you can eat at one time, while also lowering overall appetite and sensation of hunger.
Gastric sleeve surgery has a significant impact on hunger and encourages changes in hormones and metabolism. The surgery removes a portion of the stomach along the greater curvature that includes the fundus, which produces a great deal of the hunger-producing hormone called ghrelin. The secretion of ghrelin from the fundus triggers the brain’s hunger switch telling us that we must eat. After the surgery, ghrelin levels are drastically reduced. This leads to a decrease in hunger and an increase in the feeling of fullness after meals.
In addition to reducing ghrelin levels, gastric sleeve surgery also results in increases in glucagon-like peptide 1 (GLP-1) and peptide YY (PYY), hormones that decrease appetite and make patients feel satiated. These hormonal changes, combined with the physical reduction in stomach size, contribute to the weight loss seen after gastric sleeve surgery.
Gastric sleeve surgery, also known as sleeve gastrectomy, is a type of bariatric (weight-loss) surgery. This surgical procedure has several advantages:
Despite its advantages, gastric sleeve surgery also has some disadvantages and potential risks:
Gastric sleeve surgery and gastric bypass are the two most common types of bariatric (weight-loss) surgery. Both surgeries share the goal of weight loss by reducing the amount of food consumed and how the body absorbs it. However, there are some important differences between the two surgeries.
In gastric sleeve surgery, the surgeon permanently removes about 80% of your stomach. What remains is sewn into a small banana-shaped stomach pouch. The surgeon makes no other changes. This procedure reduces the amount of food you can eat before you feel full and your body produces less ghrelin, commonly known as the “hunger hormone”.
On the other hand, during gastric bypass surgery, the surgeon creates a small stomach pouch by removing most of your stomach and the first part of your small intestine. Then, they reconnect the newly created stomach pouch to the remaining small intestine. The part of your stomach that’s removed is attached further down the small intestine, so it still provides the acid and digestive enzymes produced by those organs. The portion of your small intestine that’s removed along with your stomach typically absorbs some nutrients and calories. Since food no longer passes through this section, those calories aren’t absorbed, contributing to weight loss.
While both surgeries aim to promote weight loss, they each have unique pros and cons.
Pros: Gastric sleeve surgery is a more straightforward procedure and is associated with fewer complications. It also results in significant weight loss and improvement in obesity-related health conditions.
Cons: Gastric sleeve surgery is irreversible. There's also a potential for weight regain if patients do not adhere to a healthy diet and regular exercise.
Pros: Gastric bypass surgery may lead to longer-lasting weight loss and better blood sugar control. It also offers a slightly higher weight loss and reversal of comorbid conditions.
Cons: Gastric bypass surgery is more complicated than gastric sleeve surgery and is associated with a higher risk of complications. It's also more expensive.
In conclusion, understanding the pros and cons of Gastric Sleeve Surgery is crucial for anyone considering this weight-loss procedure. This surgery can offer significant benefits, including substantial weight loss and improvement in obesity-related health conditions. However, it also carries potential risks and complications.
Therefore, it's important to have a thorough discussion with your healthcare provider about these pros and cons to make an informed decision. Your doctor can provide personalized advice based on your health history, weight loss goals, and lifestyle.
Remember, the choice to undergo any surgical procedure should be made in consultation with your healthcare provider, considering your personal health and circumstances. It's your body, and you have the right to understand all aspects of the procedures available to you before making a decision.
Pros of Gastric Sleeve Surgery:
Cons of Gastric Sleeve Surgery:
The hardest thing about gastric sleeve surgery is the significant lifestyle changes that are required for long-term success. This includes adhering to a strict diet and exercise plan, as well as dealing with potential complications and side effects following surgery.
As with any major surgery, gastric sleeve surgery poses potential health risks, both in the short term and long term. Risks associated with sleeve gastrectomy can include excessive bleeding, infection, adverse reactions to anesthesia, blood clots, lung or breathing problems, leaks from the cut edge of the stomach. Longer term risks and complications of sleeve gastrectomy surgery can include gastrointestinal obstruction, hernias, gastroesophageal reflux, low blood sugar (hypoglycemia), malnutrition, vomiting. Very rarely, complications of sleeve gastrectomy can be fatal.
After gastric sleeve surgery, patients are required to make significant lifestyle changes, including adhering to a strict diet and exercise plan⁸. The surgery also limits the amount of food and liquid a person can ingest, helping them feel fuller sooner⁸. However, it's still possible to eat too much after gastric sleeve surgery. If you do, you may not lose much weight⁵.
Ten years after gastric sleeve surgery, most people are able to maintain an excess body mass loss of between 51% and 54%. This means they lost around half of their extra weight and were able to keep it off for 10 years. However, about 20% of patients will experience long-term complications that can range from food tolerance problems to weight gain and even relationship issues.
Yes, gastric sleeve surgery can be unsuccessful in some cases. Studies have shown that nearly 30 percent of gastric sleeve patients failed to lose the amount of weight they wanted or even regained weight within five years. It's crucial to follow your post-op diets and exercise routines regularly as your bariatric surgeon recommends.
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