When obesity starts to be a medical problem that significantly impacts patients’ lives and they are unable to lose weight on their own or through the use of non-surgical medically supervised weight loss programs, bariatric surgery can be a viable option. In the United States, the most common surgeries for the treatment of obesity are gastric bypass, sleeve gastrectomy, adjustable gastric banding and biliopancreatic division with duodenal switch. Despite the encouraging results of bariatric surgery, there are advantages and disadvantages to all of these procedures.
During a sleeve gastrectomy procedure, surgeons cut and remove about 80% of the stomach, stapling the remaining part of the stomach into a tubular pouch resembling a sleeve or a banana. The surgery results in a considerable reduction of the stomach’s volume and the amount of food that the organ can hold. Patients are asleep under general anesthesia during sleeve gastrectomy, which is usually conducted laparoscopically. This means that the surgeons make small incisions in the abdomen to insert the surgical instruments and a small camera called laparoscope, in opposition to an open surgery.
Sleeve Gastrectomy Pros and Cons: Advantages
One of the pros of the sleeve gastrectomy is that, in addition to restricting the amount of food that the stomach can hold, it also has a major impact on gut hormones responsible for hunger, satiety, and blood sugar control. Therefore, it induces rapid and significant weight loss, higher than 50%, demonstrated in long-term data and three to five years or more research, according to the American Society for Metabolic and Bariatric Surgery (ASMBS).
“Short term studies show that the sleeve is as effective as the roux-en-Y gastric bypass in terms of weight loss and improvement or remission of diabetes. There is also evidence that suggest the sleeve, similar to the gastric bypass, is effective in improving type 2 diabetes independent of the weight loss.” In addition, the surgery involves a short hospital stay of only two days and it does not require bypass or re-routing of the food stream like in gastric bypass or a biliopancreatic division with duodenal switch.
Sleeve Gastrectomy Pros and Cons: Disadvantages
Despite the encouraging results of sleeve gastrectomy regarding weight loss, it is an aggressive surgery that involves the cutting and removal of part of the stomach and may result in adverse side effects of complications like staple line leaks, which affects about 2.1% of the patients and in severe cases, can lead to sepsis, organ failure, and even death, as well as bleeding, a copious discharge of blood from the blood vessels due to the surgery, which is experienced by 1.2% of gastric sleeve patients, and stenosis or strictures, which happens in 0.6% of patients and causes a narrowing or constriction of the stomach entrance diameter. “The complication rates of the sleeve fall between those of the adjustable gastric band and the roux-en-y gastric bypass.”
In addition, similarly to gastric bypass and biliopancreatric division with duodenal switch, there is a high potential for long-term vitamin deficiencies, leading the levels of calcium, magnesium, phosphorus, iron, and other vitamins to under recommended amounts. Due to this problem, patients may see their dietary restrictions conditioned to the rest of their live and may need to take supplements daily. Unlike adjustable gastric banding surgery, sleeve gastrectomy, gastric bypass and biliopancreatric diversion with duodenal switch are non-reversible procedures.