Gastric Sleeve Surgery

From its introduction as the first phase of a two-part procedure known as the duodenal switch, the gastric sleeve, also known as sleeve gastrectomy, has quickly become the most popular bariatric surgery in the United States. Despite being a simple operation, the system offers excellent weight loss and disease resolution potential.

How The Gastric Sleeve Works

The gastric sleeve is almost always performed in a minimally invasive manner, using four or five small, ½ to 1-inch incisions in the abdomen. The surgical team then uses a high-definition camera to visualize the abdomen. Next, specially made medical devices are inserted through the tiny incisions to perform the procedure. Over the past couple of decades, robotic technology has improved to the degree that our practice performs virtually every procedure using it.

The surgeon cuts away approximately 70 to 80% of the existing stomach pouch along the greater curvature, creating a newly formed, sleeve-shaped stomach pouch about the size and shape of a banana. The portion of the stomach that was cut away is removed from the abdomen.

Results of the Gastric Sleeve

Because the gastric sleeve is a purely restrictive procedure, it does not offer the excess body weight loss potential and obesity-related disease resolution potential of the gastric bypass or duodenal switch. However, the gastric sleeve does offer an average of 70% of excess body weight loss and excellent disease resolution or improvement prospects. The digestive system is not altered, setting the gastric sleeve apart from other stapled procedures. This usually means that patients have fewer dietary restrictions after surgery.

Recovery from the gastric sleeve

Patients who undergo the gastric sleeve will usually spend one night in the hospital. This will, of course, depend on the speed at which the patient is recuperating and healing.

Benefits of the gastric sleeve

  • Excellent excess body weight loss potential
  • Excellent obesity-related disease improvement for resolution potential
  • Fewer dietary restrictions versus the gastric bypass and duodenal switch
  • The laparoscopic/robotic nature of the procedure means that patients will experience less pain, less blood loss, a shorter hospital stay, and generally fewer complications than open surgery
  • While part of the stomach is removed from the abdomen, the overall digestive process is not changed. In particular, the valve between the stomach and the small intestine is not removed, minimizing dumping syndrome
  • Because the outer portion of this stomach is divided along the greater curvature, the fundus of the stomach is removed. The fundus secretes a hormone known as ghrelin, which regulates hunger. By eliminating this, many patients feel fewer hunger pangs after surgery.

Risks of the gastric sleeve

  • The gastric sleeve is major surgery and comes with risks inherent to any surgical procedure.
  • The procedure cannot be reversed. However, it can be revised in cases of poor weight loss or weight regain
  • In rare cases, the staple line may leak, which will require emergency corrective surgery.
  • In some instances, the procedure may cause Gastroesophageal Reflux Disease or worsen existing GERD.
  • Over the longer term, the stomach pouch may stretch, requiring a revisional procedure.
  • Weight loss is lower than the gastric bypass or duodenal switch because it does not provide malabsorption or excess bodyweight-loss potential.