Sleeve Gastrectomy in the Phoenix Area
During a sleeve gastrectomy (also called gastric sleeve, vertical gastrectomy, restrictive vertical gastroplasty, or vertical sleeve gastrectomy) the stomach is divided vertically with a line of staples allowing a large portion of the stomach to be removed. This is usually done using minimally invasive (laparoscopic) surgery. The remaining stomach is a long tube shaped like a very slender banana. It can hold between 1 and 5 ounces.
This procedure helps individuals lose weight by restricting the amount of food (and, therefore, calories) that can be eaten at one time. The part of the stomach that is removed secretes a hormone called ghrelin which is partly responsible for appetite and hunger. Due to the decreased amount of ghrelin, sleeve gastrectomy patients experience a loss or reduction in appetite. This loss of appetite induced by sleeve gastrectomy surgery helps individuals achieve weight loss.
The sleeve gastrectomy is a restrictive weight loss procedure.
The Sleeve Gastrectomy Procedure
This procedure works by several mechanisms. First, the new stomach pouch holds a considerably smaller volume than the normal stomach and helps to significantly reduce the amount of food (and thus calories) that can be consumed. The greater impact, however, seems to be the effect the surgery has on gut hormones that impact a number of factors including hunger, satiety, and blood sugar control.
Short-term studies show that the sleeve is as effective as the roux-en-Y gastric bypass in terms of weight loss and improvement or remission of diabetes. There is also evidence that suggests the sleeve, similar to the gastric bypass, is effective in improving type 2 diabetes independent of the weight loss. The complication rates of the sleeve fall between those of the adjustable gastric band and the roux-en-y gastric bypass.
Advantages of Sleeve Gastrectomy
- Restricts the amount of food the stomach can hold.
- Induces rapid and significant weight loss that comparative studies find similar to that of the Roux-en-Y gastric bypass. Weight loss of >50% for 3-5+ year data, and weight loss comparable to that of the bypass with a maintenance of >50%.
- Requires no foreign objects (AGB), and no bypass or re-routing of the food stream (RYGB).
- Involves a relatively short hospital stay of approximately 2 days.
- Causes favorable changes in gut hormones that suppress hunger, reduce appetite and improve satiety.
Disadvantages of Sleeve Gastrectomy
- Is a non-reversible procedure.
- Has the potential for long-term vitamin deficiencies.
- Has a higher early complication rate than the AGB.
Who should consider this procedure
- The sleeve gastrectomy is most similar to the lap-band procedure in that it is a purely restrictive procedure that causes weight loss by reducing your stomach’s capacity to hold food. Unlike the Adjustable Gastric Band, however, the sleeve gastrectomy does not require periodic adjustments. There is no band wrapped around the stomach that can slip or erode surrounding tissue. Unlike the Adjustable Gastric Band procedure, the sleeve gastrectomy is not reversible as part of the stomach is completely removed from the body.
- The tube portion of the stomach that remains after a sleeve gastrectomy is more resistant to stretching because it is formed from a very muscular portion of the stomach. This makes it less likely that chronic overeating will increase your stomach’s capacity over time. However, if sleeve gastrectomy patients consume a lot of soft, high-calorie foods like ice cream, milkshakes, and creamy cheeses, it is possible for them to defeat the benefits of the procedure and slow their weight loss.
- The Roux-en-Y procedure helps people lose weight through a combination of reduced stomach capacity and intestinal bypass that leads to nutrient malabsorption. The sleeve gastrectomy does not include an intestinal bypass, so it avoids the issues of nutrient deficiencies, marginal ulcers, and intestinal obstructions that may occur in intestinal bypass. The sleeve gastrectomy causes much less dumping syndrome than does the Roux-en-Y because the pylorus (the sphincter valve that controls the flow of food out of the stomach into the intestine) remains intact.
- Follow up information collected on sleeve gastrectomy patients at two and six years after surgery shows that the number of weight people lose and keep off following a sleeve gastrectomy is better than that seen with Adjustable Gastric Band surgery and in some cases approaches results reported with Roux-en-y gastric bypass.