Sleeve gastrectomy surgery is one of a series of several different surgical weight loss procedures. Weight loss surgery may be recommended in cases of obesity (Body Mass Index higher than 30) or morbid obesity (BMI higher than 40) when other less aggressive treatments have already failed. The surgery itself involves the reduction of the stomach’s size, which limits food intake. A patient may be eligible for the surgery if they are diagnosed with morbid obesity or if a patient has a BMI higher than 35 and a comorbidity, such as type 2 diabetes, sleep apnea or heart disease. Given the type of surgery that sleeve gastrectomy involves, it is often performed in patients that are too heavy for other types of weight loss surgery.
What Sleeve Gastrectomy Surgery Involves
During sleeve gastrectomy surgery, physicians remove up to 90% of the stomach, leaving a considerably smaller organ that is shaped like a banana or sleeve, which explains the name of the procedure. The surgery is performed under general anesthesia to prevent the patient from feeling pain and it can be conducted through laparoscopy or open surgery. The most common approach is through laparoscopic surgery, during which small incisions are made in the abdomen for the surgeon to insert surgical instruments through and a small camera called a laparoscope.
The surgeon uses the video monitor connected to the camera to operate and will use surgical staples to join the remaining part of the stomach. The procedure takes about 60 to 90 minutes and it does require cutting or altering the stomach’s sphincter muscles, which is responsible for letting the food enter or leave the stomach. Prior to the surgery, the physician will conduct a complete physical exam, including blood tests and gallbladder ultrasound, as well as provide nutritional counseling. Patients should also be informed about both their options on weight loss, and the risks and benefits of the surgery.
Following the Sleeve Gastrectomy Procedure
About two days after sleeve gastrectomy surgery, patients may be able to return home, but will need a few weeks of additional recovery to return to work. By limiting the amount of food that can be eaten, sleeve gastrectomy is expected to result in weight loss, as patients will feel full faster. However, a healthy diet and physical activity are key to the success of the surgery. An appropriate diet may be discussed with the physician or a dietitian and, immediately after the procedure, the patients initiate a liquid diet, followed by a puréed diet. The weight loss results depend on each patient and it is a gradual process that will continue for years.
Patients are often provided pain pills or other medication, such as proton pump inhibitors, when they are sent home. There are a series of risks associated with the procedure including inflammation, scarring or leaking, as well as gallstones, for which an additional surgery called cholecystectomy may be needed to remove the gallbladder. In addition to the weight loss itself, the results of the surgery may help prevent or manage other medical conditions associated with obesity, including asthma, type 2 diabetes, arthritis, high blood pressure, sleep apnea, high cholesterol or gastroesophageal disease (GERD). Patients often regain their movement capacities to conduct daily activities.