Gastric Sleeve Surgery Or Vertical Sleeve Gastrectomy
Gastric sleeve surgery for obesity is a relatively new comer to the world of bariatric surgery. It is by design a restrictive obesity surgery which means the operation is designed to reduce the amount of food consumed.
The gastric sleeve operation is also called sleeve gastrectomy, tube gastrectomy as well as vertical sleeve gastrectomy.
How does the gastric sleeve surgery or vertical sleeve gastrectomy work?
The aim of this bariatric surgery is to reduce the normal size of the stomach by about 80 – 85 percent. This is achieved by the surgeon cutting off greater curve of the stomach such that what is left is cylindrical in shape or you could say, it is shaped like a sleeve, hence the name or shaped like a tube.
The part of the stomach removed also produces hormones that stimulate hunger, so in theory, after the surgery you should feel hungry less often.
The outlet of the stomach that leads to the duodenum is not affected by the gastric sleeve operation which to a large extent preserves the function of the stomach.
How is the gastric sleeve or vertical sleeve gastrectomy performed?
The operation can be performed either through the open route or via key hole. When it is performed via keyhole, it is referred to as laparoscopic gastric sleeve.
Laparoscopic gastric sleeve is much preferred to the open approach because of the fact that the recovery time is quicker and your stay in hospital is shorter.
To do this operation laparoscopically, a small cut is made around the navel. A body-friendly gas is then introduced inside the tummy. What the gas does is to expand the inside of the tummy to give room for the surgeon to operate. A thin instrument called a laparoscope is then pushed inside the tummy with a camera attached to the top.
The camera gives the surgeon a good view of the ‘inside of the tummy’ with the images transmitted to a video monitor.
Two or three more long instruments are introduced via small cuts on the belly. With the aid of these instruments and the camera, the surgeon will proceed to slice off the greater curve of the stomach.
Staples are applied to close off the raw area and provide a good seal.
The tummy is then deflated to let out the gas and the small cuts sutured. That’s it.
You now have a stomach shaped like a sleeve or a tube.
Can I have the gastric sleeve or vertical sleeve gastrectomy operation?
You could be considered a suitable person for this operation if:
- Your BMI is 40 and over.
- Your BMI is between 35 and 39 but you have obesity-related illness like high blood pressure, high cholesterol, sleep apnoea, osteoarthritis, type 2 diabetes.
- You do not have an alcohol-depedency problem
- You may have a problem with frequent follow-up visits required for the other bariatric surgical procedures like gastric band, gastric bypass or the roux en y procedure as it is also called.
- You do not have serious mental health issues
- You are worried about the long term health risks or gastric bypass complications.
What happens after gastric sleeve surgery?
You will probably spend a day or two in hospital if the operation is done laparoscopically, but much longer if done by the open approach.
You will need some pain killers for about a week (or two if done openly).
You will be started off on a liquid diet for the first two weeks or thereabout to allow the raw areas of the stomach time to heal.
If your progress is satisfactory, then you will progress to semi-solid diet for about 4 weeks.
Solid food is then gradually introduced to your diet.
It is important that you learn to eat smaller quantities of food, chewing your food thoroughly before swallowing.
What are the health benefits of gastric sleeve or vertical sleeve gastrectomy?
The aim of the gastric sleeve surgery is to restrict the amount of food you eat at any given time. You however need to modify your behaviour and relationship with food.
Those who show this discipline after the surgery can expect to lose between 60 and 80% of excess body weight.
As an example, if your ideal body weight is 160 lbs and you actually weigh 300 lbs, then you are 140 lbs overweight i.e 300-160=140
Following gastric sleeve surgery, you could lose up to 112 lbs i.e 80% of 140 and much of the weight is lost in the first 12 months of the surgery.
Some people will lose more than that, some others less.
There is evidence to suggest that following vertical sleeve gastrectomy, patients have noticed objective improvements in:
- Blood pressure
- Sleep apnoea
- Cholesterol levels
- Type 2 diabetes
These improvements have occurred in the first 18 months following surgery.
What are the advantages of gastric sleeve or vertical sleeve gastrectomy surgery?
- Short recovery time and short stay in hospital when performed laparoscopically.
- Probably safer than the gastric bypass.
- No nutritional deficiencies like anaemia, osteoporosis, to be expected after the operation, therefore no need for vitamin and mineral supplements.
- Reduces the production of grehlin hormone that is responsible for hunger stimulation.
- Stomach digestive function is preserved as the normal outflow tract is not affected by the surgery.
- Does not involve insertion of foreign bodies like the silicone band used in gastric banding surgery.
- No adjustment is usually needed.
- Relatively inexpensive compared to other bariatric surgical procedures.
What is the cost of gastric sleeve surgery or laparoscopic sleeve gastrectomy?
The cost of this operation varies between regions and centers. You may be able to get insurance cover for the gastric sleeve with companies like United Healthcare, HCSC, Aetna and Cigna.
It is difficult to give you a single figure regarding the cost of gastric sleeve or laparoscopic sleeve gastrectomy but as a guide, you should expect charges in the region of $6,500 to $11,000.
See also: gastric sleeve complications and risks