Gastric Sleeve Surgery

What is Gastric Sleeve Surgery?

Gastric sleeve surgery, also known as sleeve gastrectomy, is a type of weight loss surgery that involves removing a large portion of the stomach, leaving a small, tube-like structure. The surgery significantly reduces the size of the stomach, limiting the amount of food it can hold. This procedure not only helps patients feel fuller with smaller meals but also affects hunger hormones, reducing appetite. Gastric sleeve surgery is one of the most popular bariatric procedures performed worldwide for effective, long-term weight loss.

What Does Gastric Sleeve Surgery Do?

Gastric sleeve surgery works by creating a smaller stomach pouch, which restricts the amount of food a person can eat at one time. With a reduced stomach size, patients experience a feeling of fullness after eating smaller portions. In addition, the surgery reduces the production of ghrelin, the hunger hormone, which helps curb appetite. Over time, this leads to significant weight loss, improved metabolism, and a reduction in obesity-related health conditions.

How Common Is Gastric Sleeve Surgery?

Gastric sleeve surgery has become one of the most commonly performed weight loss surgeries in recent years. According to the American Society for Metabolic and Bariatric Surgery (ASMBS), gastric sleeve procedures account for approximately 50-60% of all bariatric surgeries performed annually in the United States. Its growing popularity is due to its effectiveness, relatively lower risk compared to other procedures, and the fact that it does not require rerouting of the intestines, as is the case with gastric bypass surgery.

What Medical Conditions Does Gastric Sleeve Surgery Help Treat?

Gastric sleeve surgery helps treat a wide range of obesity-related medical conditions, including:

Type 2 diabetes: Many patients experience improved blood sugar control and even remission of diabetes.
Hypertension (high blood pressure): Weight loss often leads to a reduction in blood pressure.
Sleep apnea: As patients lose weight, symptoms of sleep apnea can improve or resolve.
Joint pain: Reducing excess weight alleviates pressure on the joints, especially in the knees and hips.
Fatty liver disease: Weight loss can help reduce fat in the liver and improve liver function.
High cholesterol: Gastric sleeve surgery can improve cholesterol levels in many patients.

Is Gastric Sleeve Surgery Safe?

Gastric sleeve surgery is generally considered safe when performed by a skilled and experienced bariatric surgeon. The procedure has a relatively low risk profile compared to other weight loss surgeries, and complications are rare. However, as with any surgery, there are potential risks, such as infection, bleeding, or blood clots. Following post-surgery instructions and attending follow-up appointments are crucial to minimize risks and ensure the best outcome.

What Qualifies You for Gastric Sleeve Surgery?

Gastric sleeve surgery is typically recommended for patients who:

Have a BMI (Body Mass Index) of 40 or higher (morbid obesity) or a BMI of 35 or higher with obesity-related health conditions like diabetes or hypertension.
Have made unsuccessful attempts at weight loss through diet and exercise.
Are committed to making permanent lifestyle changes, including following a healthy diet and regular exercise routine.
Are in good overall health and do not have conditions that would interfere with the surgery or recovery, such as severe heart disease or uncontrolled psychiatric disorders.

A thorough evaluation by a bariatric surgeon is necessary to determine if gastric sleeve surgery is the right option.

What Happens Before Gastric Sleeve Surgery?

Before undergoing gastric sleeve surgery, patients will go through a comprehensive pre-surgical assessment, which includes:

Medical history review and physical examination.
Blood tests to evaluate overall health, liver function, and nutritional status.
Psychological evaluation to ensure the patient is prepared for the lifestyle changes required after surgery.
Nutritional counseling to prepare for the post-surgery diet and understand dietary changes.
Pre-surgery diet: Many surgeons recommend following a liquid diet or low-calorie diet for 1-2 weeks before the surgery to reduce the size of the liver and decrease the risk of complications.

How Is Gastric Sleeve Surgery Performed?

Gastric sleeve surgery is typically performed using laparoscopic (minimally invasive) techniques, which involve making several small incisions in the abdomen. A camera (laparoscope) is used to guide the surgeon in removing about 80% of the stomach, leaving a smaller, sleeve-like structure that resembles a banana. This procedure usually takes 1 to 2 hours and is done under general anesthesia. Since it's minimally invasive, patients generally experience less pain and faster recovery than with traditional open surgery.

What Happens During Gastric Sleeve Surgery?

During gastric sleeve surgery, the patient is placed under general anesthesia. The surgeon makes small incisions in the abdomen and uses specialized tools, including a laparoscope, to remove a large portion of the stomach. The remaining stomach is then shaped into a sleeve-like structure, which significantly reduces its size. The surgery typically takes 1 to 2 hours, and patients are closely monitored in a recovery room afterward. Unlike gastric bypass surgery, gastric sleeve does not involve rerouting the intestines, making it a simpler procedure with fewer complications.

How Long Does Gastric Sleeve Surgery Take?

Gastric sleeve surgery typically takes 1 to 2 hours to complete, depending on the patient’s individual situation and the complexity of the procedure. The use of laparoscopic techniques allows for faster surgery times and a more streamlined recovery process. The procedure is done under general anesthesia, and patients usually remain in the hospital for 1-2 days post-surgery for monitoring and recovery.

What Happens After Gastric Sleeve Surgery?

After gastric sleeve surgery, patients are monitored closely in the hospital for 1 to 2 days to ensure there are no immediate complications. Once discharged, the recovery process continues at home and involves:

Rest and gradual increase in activity: Light walking is encouraged to promote healing and circulation.
Dietary adjustments: Initially, patients will follow a liquid diet, which transitions to pureed foods, and then to solid foods as the stomach heals.
Follow-up appointments: Regular check-ups with the surgeon to monitor progress, check for complications, and track weight loss.
Lifestyle changes: Ongoing dietary changes, exercise, and emotional support are essential for long-term success.

Will I Need to Follow a Diet After Gastric Sleeve Surgery?

Yes, following a strict post-operative diet is crucial for success after gastric sleeve surgery. The diet typically progresses in stages:

Weeks 1-2: Liquid diet, including broths, protein shakes, and water.
Weeks 3-4: Pureed or soft foods, including mashed vegetables, eggs, and low-fat dairy.
Months 2-3: Gradual reintroduction of solid foods, with a focus on high-protein, low-calorie foods and smaller portion sizes. Patients must also avoid high-sugar and high-fat foods, as they can hinder weight loss and lead to complications such as dumping syndrome.

What Are the Advantages of Gastric Sleeve Surgery?

The main advantages of gastric sleeve surgery include:

Significant weight loss: Most patients lose 50-70% of their excess weight within the first 18-24 months.
Improved quality of life: Patients often report higher energy levels, increased mobility, and enhanced self-esteem.
Health improvements: Many obesity-related conditions, such as diabetes, sleep apnea, and hypertension, are improved or resolved.
No rerouting of intestines: Unlike gastric bypass surgery, gastric sleeve does not alter the digestive tract, making it a simpler procedure with fewer risks.

What Are the Possible Risks or Complications of Gastric Sleeve Surgery?

Like all surgeries, gastric sleeve surgery carries some risks, including:

Infection: As with any surgery, there is a risk of infection at the incision sites.
Leaks: Rarely, a leak may develop at the site where the stomach is stapled, requiring additional treatment.
Nutritional deficiencies: Because the stomach is smaller, patients may not be able to absorb enough nutrients and may need vitamin supplements.
Blood clots: There's a risk of blood clots, which can be minimized by following post-surgical instructions and staying active.
Gastroesophageal reflux disease (GERD): Some patients may experience acid reflux after surgery.

What Is the Recovery Time After Gastric Sleeve Surgery?

Most patients are able to return to light activities within 2 to 3 weeks after gastric sleeve surgery. Full recovery, including the resumption of regular physical activities, typically takes 6 to 8 weeks. Patients must follow the post-surgery instructions, attend follow-up appointments, and commit to lifestyle changes to ensure a smooth recovery and long-term success.

How Much Weight Do You Lose with Gastric Sleeve Surgery?

Patients can typically expect to lose 50-70% of their excess weight within 12 to 18 months after gastric sleeve surgery. The amount of weight lost varies based on factors such as adherence to dietary and exercise guidelines, metabolism, and overall health. Gastric sleeve surgery offers significant weight loss that can improve overall health and reduce or resolve obesity-related conditions like diabetes, hypertension, and sleep apnea.