Sleeve gastrectomy is a type of weight loss or bariatric surgery performed to help patients who struggle with obesity, while other types of bariatric surgery include adjustable gastric banding, gastric bypass, and biliopancreatic diversion with duodenal switch. Bariatric surgery is often the last option for patients who have previously tried but failed to lose weight with non-surgical medically supervised weight loss programs. However, there both pros and cons to all types of bariatric surgery, which is why the methods have been carefully studied.
During laparoscopic sleeve gastrectomy, the patient is asleep under general anesthesia, while the surgeon makes small incisions in the abdomen to insert the surgical instruments and a small camera called a laparoscope. About 80% of the stomach is cut and removed in a sleeve gastrectomy, while the remaining part is stapled, leaving a tubular pouch that resembles a sleeve or a banana. Due to the reduction in the size of the organ, patients feel full faster and with smaller amounts of food, leading to weight loss.
Data on Sleeve Gastrectomy Safety
Despite the fact that sleeve gastrectomy is a complex surgery, it does not require the use of foreign objects in the body, like a gastric band, nor bypass or re-routing the digestive system like a gastric bypass or a biliopancreatic diversion with duodenal switch, according to the American Society for Metabolic and Bariatric Surgery (ASMBS). The more complex the procedure, the more risks tend to exist for the patient, which is why it is more common and recommended to undergo a laparoscopic surgery as opposed to open surgery.
The complication rate following a sleeve gastrectomy is higher than gastric banding, but lower than gastric bypass, as stated in the study “Effectiveness and Safety of Sleeve Gastrectomy, Gastric Bypass, and Adjustable Gastric Banding in MorbidlyObese Patients: a Multicenter, Retrospective, Matched Cohort Study.” The most common complication is staple line leaks, which occur in about 2.1% of the cases, followed by bleeding, a copious discharge of blood from the blood vessels due to the surgery (1.2%), and stenosis or strictures, which causes a narrowing or constriction of the stomach entrance diameter (0.6%).
Sleeve Gastrectomy Efficacy Studies
“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. The complication rates of the sleeve fall between those of the adjustable gastric band and the roux-en-y gastric bypass,” explain the ASMBS, which also states that the procedure is effective in both reducing the size of the stomach and causing favorable changes in gut hormones that suppress hunger, reduce appetite, and improve satiety.
In adults, sleeve gastrectomy is able to induce rapid and significant weight loss similar to that of the gastric bypass, according to comparative studies. Three to five years or more after the surgery weight loss is higher than 50% of excessive weight, with a maintenance higher than 50% as well. In addition, the study “Laparoscopic vertical sleeve gastrectomy significantly improves short term weight loss as compared to laparoscopic adjustable gastric band placement in morbidly obese adolescent patients” demonstrated that sleeve gastrectomy is an effective treatment strategy in morbidly obese adolescents who have failed medical management, and that it results in greater short term weight and BMI loss when compared to gastric banding.
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