Sleeve Gastrectomy
The gastric sleeve, or sleeve gastrectomy,is a restrictive weight loss surgery procedure that causes weight loss by restricting food intake. During the surgery, approximately 85% of the stomach is removed leaving a cylindrical or sleeve shaped stomach with a capacity ranging from about 60 to 150 cc, which will hold about ½ to 1 cup of food at one time.
This procedure generates weight loss solely through reducing the stomach volume and decreasing the appetite. This part of the procedure is not reversible. The nerves to the stomach and the outlet valve (pylorus) remain intact with the idea of preserving the functions of the stomach while drastically reducing the volume
This surgery is an option for those patients who are morbidly obese with a BMI greater than 40, or a BMI between 35-40 with significant comorbidities. The surgery is performed laparoscopically and robotically, and only requires an overnight stay in the hospital.
The average weight loss for this procedure is reported to be 50-60% of the excess weight loss over two years. This means, that if you are 100 pounds above your ideal body weight, you would expect on average to loose approximately 50-60 pounds. However, individual weight loss will vary based upon how well you follow the post-operative guidelines.
What is Endoscopic Sleeve Plication?
Endoscopic sleeve plication is a relatively new procedure that mimics the effect of laparoscopic sleeve gastrectomy. However, with the endoscopic approach, there are no incisions and we access the stomach through the mouth.
During this procedure, we put a patient under general anesthesia and assess their stomach to make sure there are no mass, tumors or ulcers. Once we know their stomach is okay, we put in a regular endoscope, a tube that has a light and camera attached to it, and attach an additional device that allows the surgeon to suture inside the stomach. We then suture the stomach in a way that it kind of folds into itself and into a banana shape.
Benefits of Endoscopic Sleeve
With an endoscopic sleeve, the patient will have the same restrictions in terms of food consumption as they do with a laparoscopic sleeve procedure. However, the difference is that we don’t have to make any cuts to access the stomach. It’s all done through the mouth and you can go home the same day and back to work the following day.
The obvious benefit of this procedure is that endoscopic sleeve plication is much less invasive. Still, it produces similar outcomes as a laparoscopic approach. Compared to a balloon procedure, in which a balloon is inserted into the stomach to make a patient feel partially full, endoscopic sleeve lasts longer and leads to more weight loss. Endoscopic sleeve plication also can be redone again several years later, so if a patient needs a revision we can easily perform one.
Who is a Candidate for This Procedure?
Patients who have a BMI under 40 are the best candidates for this procedure. Also, patients that have a BMI in the 30 to 35 range, which is considered obese, also have the option to get this procedure, since weight loss surgery typically isn’t a covered insurance benefit for people in this BMI range. That’s another significant benefit of the endoscopic sleeve procedure — it opens up weight loss surgery to a whole new selection of patients who haven’t been able to lose weight from diet and exercise alone and need other alternatives.
Sleeve Gastrectomy FAQs
A sleeve gastrectomy is a bariatric surgery in which the surgeon divides the stomach into slender pouch or tube, and then the removes approximately 80% of the stomach, leaving the new stomach size of approximately 3-5 ounces (1/2 cup to 1 cup of food) and shaped like a thin banana or sleeve.
People with a BMI over 40 or a BMI over 35 with other co-morbidities, people with complex surgical histories, those fearful of potential problems from a gastric bypass, people who wish to avoid potential nutritional deficits secondary to malabsorption issues that can be related to gastric bypass or those who might be interested in a Lap Band but want to avoid the foreign body concern of the band.
The stomach can never stretch back to original size. Patients who continue to overeat and lead sedentary lifestyles following surgery risk increasing their new stomach size and weight. The stomach will stretch but will not go back to it’s original size.
Because a portion of the stomach is removed, a gastric sleeve is not reversible.
This is different for every individual. Every person responds differently to weight loss surgery. With the gastric sleeve procedure you can lose approximately 50-60% of excess body weight loss in approximately two years. This means if you are 100 pounds overweight, you would expect to lose approximately 50-60 pounds.
You will get full with food between 1/2 to1 cup of food. Water and liquids will go through fine. You will be surprised at how well you feel after sleeve surgery. A big change is how quickly you get full when eating food (early satiety).
Bariatric surgeons recommend waiting 18 months before trying to conceive after weight loss surgery. It is important to use a form of birth control during this period even if you don’t believe you can become pregnant. During this time the body is healing and may be losing weight at a fast rate.
A sleeve gastrectomy reduces the amount of food you can consume, however you can eat most things in moderation. A healthy diet is key, the surgery is a tool to help you lose weight, but it is important that you make lifestyle changes so you are eating a healthy diet.
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If you are diagnosed as morbidly obese, sleeve gastrectomy weight loss surgery can help you lose your excess weight and improve your quality of life.
