The sleeve gastrectomy is a surgical procedure in which the left side of the stomach is removed. The result is a new stomach roughly the size and shape of a banana - about 35% of the original size. Since this operation does not involve any "rerouting" or reconnecting of the intestines, it is a simpler operation than the gastric bypass or the duodenal switch. Unlike the LAP-BAND procedure, a sleeve gastrectomy does not require the implantation of an artificial device inside the abdomen. The procedure is usually performed laparoscopically (minally invasive technique) and is not reversible unlike Lap-Band techniques.
For certain patients, in particular those with a body mass index greater than 60, the sleeve gastrectomy may be the first part of a 2-stage operation. The 2-stage operation may have substantial advantages for specific individuals.or such patients it may be used as the first stage of a 2-stage operation. In the first stage, a sleeve gastrectomy is performed. This allows a patient to lose 80 to 100 pounds or more, which will make the second part of the operation more safe.
The second stage operation is usually performed 8 to 12 months after the first. The "sleeve" stomach is converted into a formal gastric bypass or duodenal switch. This will permit additional weight loss and will provide a much more permanent result than sleeve gastrectomy alone.
Both stages of the surgery can be performed laparoscopically, giving the advantage of shorter recovery, shorter incisions, fewer incision-related problems and less pain.
The operation is done with 5 small incisions, and takes about an hour to do. The Laparoscopic Sleeve Gastrectomy involves an overnight stay in the hospital. There is no drain or nasogastric tube. You are able to return to work, resume heavy lifting and strenuous activity, in most cases, in about two weeks from the time of surgery. If you are able to do light duty at work, there is the possibility of going back to work sooner than two weeks for some patients.
The vertical sleeve gastrectomy is a restrictive form of weight loss surgery in which approximately 85% of the stomach is removed leaving a cylindrical or sleeve shaped stomach with a capacity ranging from about 60 to 150 cc, depending upon the surgeon performing the procedure.It differs from many other forms of bariatric surgery in that the outlet valve and the nerves to the stomach remain intact and, though the stomach is drastically reduced in size, its function is preserved. Also, unlike other forms of surgery such as the Roux-en-Y gastric bypass, the vertical sleeve gastrectomy is not reversible.Because the new stomach continues to function normally there are far fewer restrictions on the foods which patients can consume after surgery, though in a reduced quantity. The removal of the majority of the stomach results in the virtual elimination of hormones produced within the stomach which stimulate hunger
The surgery procedure generally has good results. Apart from losing weight, most of the patients recover physical and psychological health.
The patient feels full after a small intake of food. Since the stomach pouch is very small, it will feel full very quickly. Overeating can be very uncomfortable and may result in vomiting. Eating habits will therefore change drastically. A typical size lunch for most patients is half a sandwich and a piece of fruit.
In addition, after gastric bypass surgery, most patients develop a phenomenon called "dumping syndrome". When sweets are eaten the patient experiences sweating, fatigue, lightheadedness and diarrhea. This unpleasant experience helps patients avoid sweets and many patients report losing their desire to indulge in sweets. Furthermore, eating large amounts of fats may lead to poor absorption and result in diarrhea and abdominal cramping.
Weight loss varies widely, depending on many factors, such as the patient’s age, starting weight, ability to exercise etc. , patients lose one half to two thirds of their initial excess weight at the end of one yea on an average.
The degree of improvement of various obesity-related problems depends on the extent of the illness and the length of time the patient has had it. Patients find an improvement of their high blood pressure associated with diabetes. There is an improvement in obesity related respiratory problems, including sleep apnea and shortness of breath with minimal exercise. Joint and back pain associated with obesity, urinary incontinence, venous problems in the legs, acid reflex, menstrual irregularity, and certain types of headaches are also improved with weight loss after surgery
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