Sleeve Gastrectomy

The vertical sleeve gastrectomy, or sleeve gastrectomy, is a type of restrictive weight loss surgery. Vertical gastrectomy surgery causes weight loss by restricting the amount of food that is able to be consumed before feeling full. The vertical gastrectomy surgery isolates a small section of the stomach for processing food, limiting the size of meals to approximately one ounce after surgery.

The patient who undergoes this procedure must make significant changes in food intake and lifestyle in order for the procedure to have a successful long-term outcome. Because the stomach has the ability to stretch to accommodate food, the stomach can expand from the one-ounce capacity the surgery allows for. Meals should be small -- less than half a cup -- and drinking fluids with meals can fill the pouch, preventing the intake of solid food at that time. 

What are the risks of the surgery?

No surgical procedure is without risks. Risks for minimally invasive weight loss surgery are similar to other major abdominal surgeries. The risks, as well as the benefits of surgery, are discussed in detail with each individual patient. In general, complications resulting from severe obesity in the long-term are greater than the risk of surgery. The overall complication rate is small, at less than five to 10 percent. The major surgical risks include, but are not limited to:

  • Leaking at the newly created stomach (two to three percent)
  • Wound infections (five percent)
  • Narrowing of the connection between the stomach and small intestine
  • Blood clots (three percent )
  • Vitamin deficiency (iron, B12 and calcium)
  • Other infections (five percent)

The risk of death following the operation is small, but does exist, as it does with all types of major surgery.

What to expect from your first appointment

Prior to your arrival at the office, you will be asked to complete a demographic information sheet and a detailed questionnaire about your weight history and current medical condition. After watching the video, we will discuss and clarify your medical history, conduct a physical examination, and go into a detailed discussion about bariatric surgery specific to your situation. The doctor will determine if you are a reasonable candidate for gastric bypass. The remainder of the discussion will be to ensure that you are as informed as possible about the procedure and its ramifications. The doctor will also discuss the benefits and risks of the procedure.

Pre-operative appointment

You will see the doctor approximately two weeks prior to surgery after pre-op evaluations are completed. The doctor will review all medical data and make sure that planned testing has been done, and will answer any questions that you may have. Instructions for possible medication changes will be discussed preceding the surgery.

What to expect in the hospital

Your operation will be performed on the day of your admission. The procedure takes approximately three hours. Advantages of the laparoscopic approach include reduced postoperative pain, shorter hospital stay (two to three days), and a faster return to work (two to three weeks). You will be given explicit instructions on what and how much to eat. Pain is usually mild and controlled easily by medication. Nurses, dietitians, radiologists, and staff surgeons will all be monitoring your care closely.

What to expect right after my surgery

The day after your surgery you will be expected to sit up and walk around. At first you will be restricted as to what types of foods and how much food you can eat. Your physical activities will also be conservative. Within three to four weeks after your surgery your physical activities should be close to normal levels.

Weight loss results following surgery

Typically for the first year and up to two years you will lose about 15 to 25 pounds per month, depending on your beginning weight. After this time your weight will stabilize. The average patient loses about 70 to 85 percent of his/her excess weight. About 35 to 40 percent of patients will reach their ideal body weight range. Regaining lost weight after surgery may occur in a small percentage of patients. The doctor will review your weight, diet and overall health during follow-up appointments.

How well you maintain your diet and exercise regime will determine the stability of your weight. Our staff will monitor your weight frequently and provide important dietary and exercise counseling. In addition to the weight loss, you will also improve your overall health, noticing an elimination of many weight-related illnesses such as sleep apnea, diabetes, high blood pressure, and hypercholesterol. Nearly all patients report a significant improvement in their quality of life after surgery.

Review of Sleeve Gastrectomy weight loss surgery

Anatomy
Long narrow vertical pouch measuring 2-3 ounce (60-100 cc), No intestinal bypass performed.

Mechanism

  • Significantly restricts the volume of food that can be consumer.
  • NO malabsorption
  • NO dumping

Weight Loss
(United States Average Statistical Loss at 10 Years)

  • 60%-70% excess weight loss at 2 years
  • Long term results not available at this time

Long Term Dietary Modifications
(Excessive carbohydrate/high calorie intake will defeat all procedures)

  • Patients must consume less than 600 -800 calories per day in first 24 months; 1000-1200 thereafter
  • No dumping; no diarrhea
  • Weight regain may be more likely than in other procedures if dietary modifications not adopted for life

Nutritional Supplements Needed
(Lifetime)

  • Multivitamin
  • Calcium

Potential Problems

  • Nausea and vomiting
  • Heartburn
  • Inadequate weight loss
  • Weight regain
  • Additional procedure may be needed to obtain adequate weight loss
  • Leak

Hospital Stay
1-2 days

Time Off Work
1-2 weeks

Operating Time
1.5 hours

Our Recommendations
Utilized for high risk or very heavy (BMI >60 kg/m2) patients as a "first-stage" procedure. Very low complication rate due to quicker operating room time and no intestinal bypass performed. Insurance companies will authorize this procedure in select patients.

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There are a few steps necessary to determine if weight loss surgery is the right option for you.

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319-268-3990