Gastric Sleeve

Overview

What is gastric sleeve?

Gastric sleeve, also known as a sleeve gastrectomy, is a type of bariatric (weight-loss) procedure.  It involves removing a large portion of the stomach, leaving behind a smaller, sleeve-shaped stomach that resembles a banana or a sleeve. The procedure is performed laparoscopically, using small incisions and a camera-guided instrument called a laparoscope.

Cost of gastric sleeve surgery

The average cost of a sleeve gastrectomy is between $10,000 to $25,000. There are several factors can affect the cost of gastric sleeve surgery. These factors include:

Are you a candidate?

• Uncontrolled bleeding disorder
• Severe psychiatric illness (e.g. depression, psychosis, etc.)
• Negative reactions to general anesthesia
• Gastroesophageal reflux disease (GERD)
• Barrett’s esophagus
• Large hiatal hernia

It’s important to consult with a qualified bariatric surgeon to determine if gastric sleeve surgery is a suitable option for you.

How does it work?

Gastric sleeve surgery involves the removal of around 80% of the stomach. This leaves a tube-shaped stomach that is roughly the size and shape of a banana.  Rapid weight loss will occur shortly after the surgery, because the stomach can only hold small amounts of food at a time and absorb very little.

Additionally, the sleeve gastrectomy removes the part of the stomach responsible for producing ghrelin, the hunger stimulating hormone. As a result, appetite is reduced for years after surgery.

Patients report losing up to 50% of their excess weight within 3 years of the procedure.

Treatment details

Gastric sleeve is typically performed laparoscopically, which involves making small incisions in the abdomen and using specialized instruments to perform the procedure. Here is a general overview of how the procedure is performed:

1. Anesthesia: The patient is given general anesthesia to ensure they are asleep and pain-free throughout the surgery.
2. Incisions: Several small incisions, typically ranging from 5 to 12 millimeters in size, are made in the abdomen.
3. Insertion of Laparoscope: A laparoscope, which is a long, thin tube with a camera and light attached to it, is inserted through one of the incisions. This allows the surgeon to visualize the surgical site on a monitor.
4. Stomach Division: Using surgical instruments, the surgeon carefully divides the stomach vertically, creating a long tube or sleeve shape. The larger portion of the stomach, which produces the hunger hormone ghrelin, is removed.
5. Stapling and Closure: The remaining stomach is sealed and divided using surgical staples or sutures to create the smaller sleeve-shaped stomach pouch.
6. Surgical Site Examination: The surgeon inspects the surgical site to ensure there are no leaks or bleeding.
7. Closure of Incisions: The small incisions in the abdomen are closed using sutures or surgical staples.
8. Recovery: After the surgery, the patient is moved to the recovery room and closely monitored for any complications or discomfort.

Overall, the procedure takes between 60 to 90 minutes.

Recovery time

Following surgery, most patients stay in the hospital for 1 or 2 days before returning home to heal.

It is common to experience pain and swelling in the abdomen after surgery, and your doctor may prescribe pain medication.

Typically, patients return to work within 2 to 4 weeks after surgery, but strenuous exercise and heavy lifting should be avoided for 6 to 8 weeks.

There is a strict diet to adhere to after a sleeve gastrectomy, beginning with sugar-free, noncarbonated liquids for the first week (protein shakes, broth, milk, yogurt, and juice).

Fatigue is common during this time, due to the low-calorie nature of the diet. After this, you will transition to pureed foods for 3 weeks, and finally progress to eating solid foods around 4 weeks after surgery.

Since your stomach cannot absorb as much as it used to, it is important to take multivitamins and calcium to supplement your diet. A vitamin B-12 injection will also be required once a month for life.

One benefit of the sleeve gastrectomy compared to other bariatric surgeries is that most patients are able to continue eating the variety of foods they did pre-surgery; these include fibrous vegetables and meats.

How much weight will you lose?

Patients can expect to lose at least 50% of their excess body weight within 1.5 to 2 years following the surgery. Some people may even lose up to 60% to 70%.

It is common to regain some weight 2 to 10 years after bariatric surgery. Weight gain is caused by stomach stretching, which is a result of poor diet choices and overeating.

It is important to maintain diet and lifestyle changes to keep the weight off.

Alternatives to gastric sleeve

There are other surgical alternatives to the sleeve gastrectomy that can provide similar weight loss benefits. These include:

• Roux-en-Y gastric bypass (RYGB): With gastric bypass surgery, a portion of the stomach is stapled off to form a gastric pouch; the small intestine is then attached in a “Y” formation to the pouch to bypass the lower stomach and intestines.
• Adjustable gastric band: A band is placed around the upper part of the stomach to separate it from the main part of the stomach; the smaller part will fill up with food faster and empty slowly into the rest of the stomach, limiting food intake. An example is the LAP-BAND surgery.

It is important to note that the sleeve gastrectomy is a permanent procedure and cannot be undone. Other options, like the adjustable gastric band and gastric bypass, can be reversed.

Ready to take the next step?

To see if you are a candidate for gastric sleeve surgery, contact a weight loss surgeon near you.