In the first few years, sleeve gastrectomy was a part of the biliopancreatic diversion with duodenal switch operation. But later, the gastric sleeve emerged as the first stage surgery for severely obese people who underwent duodenal switch operation to evade the perioperative perils. Some patients lost sufficient weight after the gastric sleeve surgery and did not undergo the intended duodenal switch operation. These occurrences urged bariatric specialists to consider gastric sleeve surgery as an independent bariatric procedure. The first gastric sleeve operation was performed in 2000. Since then, the number of gastric sleeve surgeries has been continuing to increase. Today, more than half of all obesity surgeries performed in the US are gastric sleeve procedures.
The gastric sleeve operation is done by removing approximately 80 percent of the stomach and connecting the remaining portions to each other creating a new banana sized tubular pouch, also known as sleeve. The surgery is generally performed using a laparoscope which is an instrument with a tiny camera that sends pictures to a monitor.
The surgeon also removes the part of your stomach generating gut hormones that affect a number of factors including hunger, satiety, and blood sugar control. Also, as there is a reduction in stomach volume, it will cause you to feel full much quicker after the surgery and you will not be able to eat as much as you used to because you will feel full a lot quicker than you did before. This will help you lose weight.
Some researches and clinical trials have shown that gastric sleeve operation makes way for remission of many weight related health problem. For example; type 2 diabetes, sleep apnea, hypertension, fatty liver disease, high cholesterol, asthma, migraine, joint pain, some psychological problems such as depression, infertility, low testosterone, urinary incontinence etc.
The surgery lasts approximately for 40 to 70 minutes and you will be discharged from the hospital usually after 1 or 2 nights of stay. During the operation, certain people can experience bleeding or leakage of fluid but in general it is a safe procedure. After the operation, most patients use fewer pain killer medications than recommended by the doctors, so the pain is a manageable one.
In the first couple of months after the surgery, patients usually consume liquid food and by the time they leave the hospital, they start to eat mashed food and protein shakes until they can eat solid ones. Also, due to their newly small stomach, they should chew everything thoroughly before swallowing, avoid high-calorie beverages etc. Also the portions will be pretty much smaller and some may even cannot drink with their meals. Therefore, patients usually lose about 60-70% of their excess weight in 12 to 18 months. In the first 2 weeks, most patients lose around one pound a day. In the first 3 months, they lose 35-45% of their excess weight. And between 6 and 12 months they lose 50-70% of their weight. Most patients reach their lowest weight 12-24 months after surgery. Nevertheless, it is in your hands to get the best results from the surgery by supporting it with your daily routines. You should make significant changes in your lifestyle after obesity surgery to reach your ideal weight and to keep it off. You may consult a dietitian on how to change your eating habits in a healthy way and most importantly, you should exercise on a regular basis. You should also keep in mind that fatigue is the most common problem after the surgery because of the low calorie intake so you may need to take some kind of vitamin or other supplementaries to avoid it.
The sleeve gastrectomy is a safe procedure as stated above thanks to the innovations in surgical techniques and talented specialist. However, risk of some complications still exist. Some of the potential problems during or after the operation are: leakage from the staple line (rare), infection, bleeding, bleeding, blood clot, vitamin deficiency, nausea, vomiting or weight regain.
Advantages of Gastric Sleeve
- The surgery limits the amount of food your stomach can hold
- The surgery generates favorable alterations in gut hormones that help you feel fuller and contribute to appetite suppression enhancing satiety.
- The surgery lower the risks of having weight related health problems.
- It offers a relatively short hospital stay of approximately 2 days
- It improves the overall quality of your life
Disadvantages of Gastric Sleeve
- It is a major and complex operation that could result in various complications. However, those could be avoided with proper care.
- The patients need to take some kind of supplementaries for the rest of their life because gastric sleeve surgery may lead to long-term vitamin and mineral deficiencies.
- It is a non-reversible procedure
Studies indicate that the sleeve is as effective as the roux-en-Y gastric bypass in terms of weight loss and improvement of type 2 diabetes. However, the sleeve gastrectomy has some advantages over gastric bypass. First of all, certain people may be too heavy to undergo gastric bypass surgery; however, gastric sleeve surgery is best for people who have a body mass index of at least 40. So it may be an alternative for such people. Another advantage is that gastric sleeve is a pretty much simpler surgery when compared to gastric bypass.
The operating duration for gastric sleeve is usually 40 to 70 minutes, while gastric bypass surgery takes approximately 2 or 3 hours to complete. Besides, there is lower chance for mineral or vitamin deficiency in the gastric sleeve operation and there is no malabsorption for patients. What is more, in gastric bypass it is more likely for some long term complications such as ulcer, hernias or bowel obstruction to arise. But in sleeve gastrectomy, the risk of developing such problems is relatively rare. For these reasons, it is possible to say that in recent years, gastric sleeve operation has replaced gastric bypass thanks to its simplicity and relatively fewer long or short term problems.
