What is a sleeve gastrectomy?
When a sleeve gastrectomy procedure is performed, around 85% of the volume of the stomach is surgically removed. This is a permanent change.
The benefits of this procedure are:
- Rapid post-operative recovery.
- Relatively rapid weight loss.
- Improvement to some common medical conditions suffered by obese / overweight patients, eg sleep apnoea, high cholesterol, high blood pressure, diabetes.
The procedure is sometimes referred to by different names - 'vertical sleeve gastrectomy' and 'gastric sleeve surgery' refer to the same procedure. It is however a completely different procedure to the similarly-named gastric banding.
How does it work?
A sleeve gastrectomy makes it physically impossible for the person to eat large quantities of food at one time, as the new 'stomach' is in the form of a banana shaped 'sleeve' which has a capacity of around 200ml (a normal adult stomach has a capacity of around 1.5 litres – 1,500ml).
Patients who have undergone this procedure generally modify their eating habits to eat 4-6 small a day. This reduction in food consumption allows the person to lose weight over time.
How successful is sleeve gastrectomy?
People who have a sleeve gastrectomy and who follow the guidelines suggested by their dietitian and surgeon will generally lose 65% of excess weight within a 12-month period.
How should I prepare for the procedure?
Smoking
Being an active smoker greatly increases the risk of poor wound healing and breakdown of wounds after the procedure. For this reason, we recommend you give up smoking entirely. Dr Silverman will only treat a non-smoking patient.
Medication
If you are taking an anti-inflammatory medication or Warfarin, Aspirin of Plavix you must stop taking these one week before the procedure. Please contact Dr Silverman if you have any questions relating to your current medication.
You will receive any further specific instructions on how to prepare for your procedure from Dr Silverman well ahead of the date of the procedure.
What is involved in the procedure?
A sleeve gastrectomy is performed using laparascopic surgical techniques under general anaesthesia and normally takes around two to three hours to complete. During the procedure surgical instruments will be inserted into the abdominal cavity through a number of small incisions to the abdomen and, using these, the surgeon removes the section of the stomach, leaving the much smaller 'sleeve' in place.
Recovery Guidance
Hospital Stay
It is usual for sleeve gastrectomy patients to stay in hospital for two or three days after the procedure.
Returning to normal activities
It is common to feel some weakness and fatigue for a few days after the procedure.
After a sleeve gastrectomy, patients will need to adopt a different approach to diet and exercise. Dr Silverman and her team will be able to give specific guidance on diet and exercise for each individual patient.
Risks / Complications
There are risks associated with all surgical procedures, such as wound infection, and risks relating to anaesthesia and bleeding during the procedure. In general terms, the sleeve gastrectomy procedure has lower complication rates than gastric banding and gastric bypass procedures.
The risks / complications specific to sleeve gastrectomy after the procedure include:
- Wound infection.
- Staple line leak.
- Blood clot (thrombosis).
- Stricture (inflammation/blockage of the stomach opening).
Longer term the following conditions may develop:
- Nutritional deficiencies (this can affect up to 12% of patients).
- Gallstones (up to 23% of patients may develop gallstones within two years of the procedure).
- GORD.
Dr Silverman will be able to discuss any possible risks or complications with you well ahead of the procedure.