Gastric Sleeve: An Intriguing Weight Loss Procedure
You could be among the many patients who are considering an appealing weight loss procedure called gastric sleeve. Also known as vertical sleeve gastrectomy, this procedure can combine the reliability and low maintenance of gastric bypass surgery with the simplicity of gastric banding.
Gastric sleeve surgery involves the removal of a section of the stomach called the greater curve (the outer side of the stomach). This leaves a narrow tubular section of the stomach that fills quickly with food – allowing you to eat less and still feel full.
The gastric sleeve was originally one part of a more complex procedure called biliopancreatic diversion with duodenal switch. However, surgeons eventually realized that this procedure could stand alone to help patients lose weight. Research has proven that the gastric sleeve improves health through significant weight loss – while also helping to correct the metabolic syndrome caused by obesity. This procedure usually results in weight loss almost equivalent to gastric bypass and is now the most commonly performed procedure.
More About Gastric Sleeve Surgery
In the gastric sleeve procedure, the surgeon uses a surgical stapling device to remove the large reservoir section of the stomach called the greater curve. When completed, the operation leaves a narrow tubular section of stomach to carry food into the intestine, which is not disturbed. People are sometimes confused that the “sleeve” part of the name means that something is wrapped around the stomach to give it a tubular shape – but in fact there is no wrapping material and the name comes from the tubular hollow shape of the newly reduced stomach.
The long tubular stomach fills quickly with small amounts of food, so that patients find it is easy to eat small meals and feel fully satisfied. With much smaller eating, patients lose substantial weight. Weight loss appears to be almost as brisk as the gastric bypass, but not quite as much weight loss on average.
The gastric sleeve is appealing because the surgery does not involve moving intestines from one place to another like the gastric bypass. Gastric sleeve surgery does not create significant changes in nutrient absorption, though we recommend supplement vitamins and lab follow-up because of the dramatically lower food intake.
The gastric sleeve is also appealing in comparison to the gastric band, because there is no plastic belt in the body and because there is not any requirement for frequent follow-up and band adjustment.
The gastric sleeve was originally conceived as a simple operation for very high-risk patients, but it is also gaining acceptance as an operation for patients on the lighter end of the weight scale, even down to a BMI of 30. The sleeve is commonly utilized as a conversion procedure in cases where the gastric band is not working, and in our experience, patients who change from the band to a gastric sleeve are usually very satisfied with the change.
Risks of the Gastric Sleeve
During the surgery, the surgeon creates a long tubular stomach pouch. The entire side of that pouch is a staple line or “seam” which can potentially leak or bleed. It is also possible for the narrow pouch to kink or fold, or become blocked in some other way because it is quite narrow.
It remains possible that, over the years, the narrow tubular stomach pouch may expand and the patient’s food capacity may return. Initial research results were encouraging, but now long-term research has proven that the gastric sleeve is a proven surgical option with results similar to gastric bypass.
The insurance coverage picture for gastric sleeve surgery has improved significantly in the past year and continues to change as insurers realize the benefits of this proven surgical option.