What is it? Gastric bypass surgery makes the stomach smaller and allows food to bypass part of the small intestine. A sleeve gastrectomy is a simpler operation that allows a lower-risk way to start losing weight.
You will feel full more quickly than when your stomach was its original size, which reduces the amount of food, you eat and thus the calories consumed. Bypassing part of the intestine also results in fewer calories being absorbed. This leads to weight loss.
What are the Advantages?
All stomach will function normally. As the stomach is reduced in volume, a small portions of food would give satisfaction resulting in to weight loss.
As the portion of the stomach that produces the hormones that stimulates hunger (Ghrelin) is not there, the craving for food will not be there.
Minimizes the chance of an ulcer occurring.
By avoiding the intestinal bypass, the chance of intestinal obstruction (blockage), anemia, osteoporosis, protein deficiency and vitamin deficiency are almost eliminated.
Very effective as a first stage procedure for high BMI patients (BMI>55 kg/m2).
Limited results appear promising as a single stage procedure for low BMI patients (BMI 30-45 kg/m2).
Can be done laparoscopically in patients weighing over 500 pounds.
Am I a Good Candidate for Sleeve Gastrectomy Procedure?
All men and women who are obese in nature and are looking forward to a fresh look in life are eligible for this procedure. The main considerations for surgery are generally:
You have been obese for at least 5 years.
You do not have an ongoing problem with alcohol.
You do not have untreated depression or another major psychiatric disorder.
You are between 18 and 65 years of age.
Your BMI should be greater than 50.
How Is the Sleeve Gastrectomy done?
This is a relatively new form of restrictive weight loss surgery. In the operation, this is usually done with a laparoscope. (By making a small incision and using small instruments and a camera to guide the surgery laparoscopic approach).
This procedure can be done by making a large incision in the abdomen (an open procedure)
The Sleeve Gastrectomy is a new procedure that induces weight loss by restricting food intake. With this procedure, approximately 80-85 percent of the stomach is removed laparoscopically so that the stomach takes the shape of a tube or "sleeve." This procedure is usually performed on superobese (BMI >60 or high risk patients with the intention of performing another surgery at a later time. This surgery may also be done on regular patients (BMI of 30+) who desire a lower risk procedure than the RNY Bypass while getting similar results. The second procedure a gastric bypass can then be done if necessary for the superobese to reach goal.
Recovery
This surgery usually involves a 4- to 6-day hospital stay (2 to 3 days for a laparoscopic approach). Most people can return to their normal activities within 3 to 5 weeks.
Disadvantages of Sleeve Gastrectomy Weight Loss Surgery
There are chances of weight gain depending on your food habits .
Higher BMI patients will most likely need to have a second stage procedure later to help lose the rest of the weight. Two stages may ultimately be safer and more effective than one operation for high BMI patients. This is an active point of discussion for Bariatric surgeons.
Soft calories such as ice cream, milk shakes, etc can be absorbed and may slow weight loss.
This procedure does involve stomach stapling and therefore leaks and other complications related to stapling may occur.
Because the stomach is removed, it is not reversible. It can be converted to almost any other weight loss procedure.
Considered investigational by some surgeons and insurance companies.
The Pros. For people who are very obese or sick, standard gastric bypass or biliopancreatic diversion may be too risky. A sleeve gastrectomy is a simpler operation that allows them a lower-risk way to start losing weight. Afterwards, once they've lost weight and their health has improved -- usually after 12-18 months -- they can go on to have a second surgery, such as gastric bypass. In people with high BMIs, sleeve gastrectomies result in an average weight loss of 40% to 50% of excess weight after three years. People with lower BMIs tend to lose even more of their excess weight. The preliminary evidence suggests that sleeve gastrectomy works about as well as adjustable gastric banding.
Because the intestines aren't affected, a sleeve gastrectomy doesn't affect the absorption of food, so nutritional deficiencies are not a problem.
The Cons. Since a sleeve gastrectomy is often just the first step in weight loss surgery, you will probably face further operations later on. Unlike gastric banding procedures, a sleeve gastrectomy is irreversible. Most importantly, since it's relatively new, the long-term benefits and risks aren't yet known.
The Risks. Typical surgical risks include infection, leaking of the sleeve, and blood clots.