How Does Vertical Sleeve Gastrectomy Surgery Work?

Vertical sleeve gastrectomy, also known as gastric sleeve, is a restrictive procedure. Restriction is accomplished by stapling vertically and removing 80% or more of the stomach. As in gastric band, there is not intestinal bypass that would reduce the absorption of food.

Expected Weight Loss

Sleeve gastrectomy patients lose on average 49% of their excess weight at 17 months, according to the latest statistics by Strain and colleagues.

Pros

  • Like gastric band, gastric sleeve is less complex than bypass procedures and poses a lower risk for complications.
  • Unlike gastric band surgery, the gastric sleeve procedure does not involve the placement of a foreign object (a band) that would require adjustments, could slip, get infected or cause erosion of the stomach wall.
  • No protein or vitamin deficiencies. Because sleeve gastrectomy is a purely restrictive procedure, the intestinal function remains intact and therefore the risk for nutritional deficiencies is minimal.
  • No dumping syndrome. In sleeve gastrectomy the pylorus is preserved and therefore patients do not suffer from the dumping syndrome. The pylorus is a small muscular passage between the lower end of the stomach and the beginning of the small intestine that meters the emptying of the stomach into the intestine. In other procedures, such as gastric bypass, the pylorus is bypassed and food moves too fast from the stomach to the intestine (dumping) causing unpleasant symptoms, such as vomiting, sweating, cramping and diarrhea.
  • A good first step for super obese. Since sleeve gastrectomy has a relatively low risk, it is the procedure of choice for people who are super obese and therefore not good candidates for gastric bypass. Sleeve gastrectomy gives these people a safe way to lose some weight before they undergo the more invasive, more effective—but also riskier—gastric bypass procedure.

Cons

  • Unlike gastric banding surgery, gastric sleeve is an irreversible procedure. It permanently changes the anatomy of the stomach.
  • Gastric sleeve is much less popular than gastric band and gastric bypass. To date, gastric sleeve has been performed much fewer times than other weight loss surgeries and therefore its long-term effects are not fully known.
  • Very few surgeons perform this procedure.
  • Insurance companies avoid covering this procedure because they consider that it is still in the experimental stage.
  • Gastric sleeve usually is performed as a starting point for people who are very obese. By itself it does not produce as much weight loss as other procedures and therefore a second operation will have to be performed later on.
  • Gastric sleeve patients may gain the weight back because their stomach, although much smaller after the surgery, can stretch out over time allowing more food to be consumed.

Vertical Sleeve Gastrectomy Complications and Risks

  • Leaking of the sleeve. After the stomach is resected, it is sealed with staples. The content of the stomach may, however, leak along the stomach edge due to the staples tearing apart.
  • Blood clots, would infection and internal bleeding are other possible complications.

Vertical Sleeve Gastrectomy: Before and After

Vertical Sleeve Gastrectomy

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