Sleeve Gastrectomy

When diet, exercise and non-surgical treatments have failed, it may be time to consider sleeve gastrectomy, a type of bariatric or weight-loss surgery. Sleeve gastrectomy, also known as gastric sleeve surgery, involves shrinking the size of the stomach to help an individual lose weight by limiting their calorie intake.

Obesity is a disease and a worldwide health concern that affects an estimated 93 million Americans. Environmental and genetic factors can cause a person to gain unhealthy amounts of weight that dieting alone cannot control. Learn how sleeve gastrectomy can be a treatment option for people who are unable to lose weight through conservative approaches.

What Is Sleeve Gastrectomy?

Sleeve gastrectomy or bariatric sleeve surgery involves removing around 80% of the stomach. It can be performed as a minimally invasive laparoscopy, which involves making small incisions where small surgical tools and a specialized camera will be inserted. In rare cases, sleeve gastrectomy may be done as an open surgery, wherein a large abdominal incision has to be made. In both cases, a patient receives general anesthesia, so they stay asleep throughout surgery.

Why Do People Get Sleeve Gastrectomy Surgery?

Bariatric surgery, like sleeve gastrectomy surgery, is performed to help people lose weight and reduce their risk of developing life-threatening health problems associated with excessive body fat, such as:

• Cancer
• Diabetes
• Gallbladder disease
• Heartburn
• Heart disease
• High cholesterol
• High blood pressure
• Osteoarthritis
• Psychological depression
• Sleep apnea
• Stroke

Bariatric surgery is not a cure for any of these conditions, but it can help reduce obesity-related health complications.

How To Prepare for Sleeve Gastrectomy?

You will meet with your healthcare team before gastrectomy surgery, which may include a bariatric surgeon, dietitian, internist/primary care provider and psychologist or psychiatrist. Preparation may include:

• Health assessments – your doctor will ask you about your personal and family medical history, perform a thorough physical examination and order blood tests.
• Readiness support – your psychiatrist or psychologist may help assess your readiness to face the challenges of bariatric surgery. Your surgeon will explain more about the surgery, preparation and aftercare.
• Dietary and lifestyle changes – your healthcare team will explain what dietary changes you will need to make before and after bariatric surgery. If you’re a smoker, you may be asked to stop smoking at least six weeks before surgery. Exercise routines pre-surgery may also be recommended to help your body prepare for the procedure.
• Managing existing conditions – your healthcare provider will help you manage your existing conditions before surgery, such as regulating your blood glucose if you have diabetes.

You will have to commit to following healthy eating habits, a diet and an exercise routine before the procedure, as this is what you must maintain for the rest of your life after surgery. Weight loss surgery should not be treated as an easy way to shed weight. Rather, it is recommended for patients whose diet, exercise, and non-surgical treatments don’t work well enough to shed excess weight.

How Is Sleeve Gastrectomy Performed?

A laparoscopic sleeve gastrectomy is usually performed in this manner:

1. Small incisions are made on the abdominal area where surgical instruments and a camera will be inserted.
2. A sizing tool called bougie will be inserted into the stomach to measure the right length of the stomach to be left intact. A bougie is a thin, flexible tube that guides the surgeon in creating the tubular shape of the stomach, ensuring consistency in the size of the stomach sleeve that will be created.
3. A surgical stapler will be used to divide the stomach into two and seal it in between.
4. The surgeon will remove the larger portion of the stomach and close the incision.
5. The surgical instruments will be removed, and the incisions will be stitched closed.

In a traditional sleeve gastrectomy, the surgeon accesses the stomach through a large incision made on the abdomen. This is in contrast to laparoscopic techniques that use only several small incisions. As such, surgical wounds from traditional sleeve gastrectomy tend to take longer to heal than laparoscopic. Sleeve gastrectomy may take up to two hours.

After surgery, patients are brought to the recovery area, where they are closely monitored. The doctor will provide them with post-operative care that includes instructions on managing pain, watching out for complications and consuming foods. Patients will also need to attend follow-up appointments with their healthcare provider to monitor their progress. Nutritional counseling and lifestyle adjustments may also be part of postoperative care.