Weight loss or bariatric surgery is often the last resort for patients struggling with obesity or morbid obesity who have tried but failed to lose weight with other non-surgical methods. Sleeve gastrectomy is among the four main types of bariatric surgery types performed in the United States, alongside gastric bypass, adjustable gastric band, and biliopancreatic diversion with duodenal switch. Before deciding on sleeve gastrectomy or any other type of bariatric surgery, patients need to take into consideration numerous factors, like success rate and risks associated with the surgery.
Sleeve gastrectomy is performed with the patient asleep under general anesthesia and usually laparoscopically, which means that the surgeon makes small incisions in the abdomen to insert the surgical instruments and a small camera called a laparoscope. During the procedure, the majority of the stomach is removed and the remaining part is stapled together, creating a long vertical tube or banana-shaped stomach. Even though the surgery does not involve cutting or changing the sphincter muscles that allow food to enter or leave the stomach, it works by reducing the size of the organ, making the patient feel full faster and with smaller amounts of food.
Sleeve Gastrectomy Success After Surgery
“Laparoscopic vertical sleeve gastrectomy was first reported as an initial stage of the laparoscopic biliopancreatic diversion with a duodenal switch in super morbidly obese or high-risk patients. It was observed that some patients who had undergone the laparoscopic vertical sleeve gastrectomy lost significant weight and did not require the second malabsorptive stage. As a consequence, and due to many surgeons’ dissatisfaction with the long-term results of laparoscopic adjustable gastric band, laparoscopic vertical sleeve gastrectomy has gained popularity in recent years and is now performed as a stand-alone procedure for weight loss,” as explained in the study “Quick fix or long-term cure? Pros and cons of bariatric surgery.”
The authors note that since the procedure is relatively new, there is a certain lack of data regarding its results. However, available data demonstrates that sleeve gastrectomy has complication rates similar to gastric bypass, but higher than the adjustable gastric band, a procedure that has lower results regarding weight loss, but also low complication rates. Regarding achieving and maintaining weight loss, a sleeve gastrectomy has been shown to be more effective than a gastric band in several studies, but less successful than a gastric bypass or a biliopancreatic diversion with duodenal switch. In addition to weight loss, patients will also experience improvements in overall health, mobility, comorbidities like type 2 diabetes, hypertension or sleep apnea, and in quality of life.
Long-Term Impact of Sleeve Gastrectomy
Sleeve gastrectomy is a non-reversible surgery that has implications for the rest of the patient’s life. Despite the fact that it will help the patient lose weight when paired with a long-term treatment plan, after the weight loss, it is important for patients to maintain a healthy lifestyle. Regarding potential complications, the most common is staple line leaks, which affects about 2.1% of patients. In the most severe cases, it can lead to sepsis, organ failure, and even death. 1.2% of patients also experience bleeding, a copious discharge of blood from the blood vessels due to the surgery and 0.6% suffer from stenosis or strictures, which causes a narrowing or constriction of the stomach entrance diameter.
“LSG is a safe procedure with a low complication rate. The complications encountered nevertheless can result in morbidity and even mortality. The most significant complications are staple-line bleeding, stricture, and staple-line leak,” a different study titled “Late Complication of Laparoscopic Sleeve Gastrectomy,” notes about the surgery, which has a mortality rate of 0.19%. In order to prevent complications and assure long-term success, it it key for patients to follow the doctor’s recommendations about lifestyle alterations, a healthy diet, supplements, and regular exercise.
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