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Laparoscopic Vertical Sleeve Gastrectomy

Laparoscopic Vertical Sleeve Gastrectomy

Are you a candidate for gastric sleeve surgery?

Patients who are candidates for the gastric sleeve procedure typically have a BMI of 30+ and are between 18 and 75 years of age. Patients must also be able to handle the physical stress of surgery as some may have health conditions that make major surgery risky.  Additionally, the gastric sleeve procedure requires psychological readiness.  Having the right attitude toward food, exercise, and health is important and most insurance carriers require a psychological consultation as part of the pre-operative process. 

Gastric Sleeve Procedure

The gastric sleeve procedure, or vertical sleeve gastrectomy, is a restrictive surgery that permanently removes approximately 70% of your stomach.

The laparoscopic approach to making the sleeve — long and tubular, resembling a “banana shape,” allows each working section of the stomach to remain intact with the outlet being your pyloric sphincter. The design also benefits the patient by removing much of the “appetite hormone” Ghrelin producing cells, so patients receive additional help with suppressing their hunger or appetite.

The vertical sleeve gastrectomy had been used for decades in conjunction with another procedure that is mal-absorptive. Bariatric surgeons began omitting the second part of this procedure in the early 2000’s, studying the sleeve as a standalone approach. The five-year data demonstrated very favorable outcomes in weight loss, reduced post-op complications and mortality, and saw favorable resolution of patients’ co-morbidities.

This makes the gastric sleeve a strong choice for balancing benefits and risks in comparison to combination choices such as gastric bypass.

Results

What to expect

Excess weight loss in the average patient ranges from 50 to 75% and almost all patients will see an improvement or elimination of type II diabetes, high cholesterol, high blood pressure and sleep apnea.

Benefits of the Gastric Sleeve

  • Because of its simplicity, the gastric sleeve has a lower incidence of long-term complications and mortality compared to gastric bypass surgery
  • Excess weight loss results are exceptional
  • Obesity-related disease resolution rates are excellent
  • Patients do not need any medical devices implanted into their abdomen as with gastric banding It can be performed laparoscopically, which means less pain, less blood, generally fewer initial complications and a shorter overnight hospital stay
  • In comparison to the gastric bypass where there are 5 surgical attachment points, there is less risk for leaks with the one attachment point in the sleeve
  • Over the course of time, the sleeve requires less maintenance compared to the gastric band, as the sleeve is a permanent change to the structure of the stomach

Considerations and risks of the Gastric Sleeve

  • The sleeve procedure is still major surgery and comes with a degree of surgical risk which may be exacerbated by a patient’s poor health due to obesity.
  • If the staple line begins to leak, the result could be bleeding or infection in the abdomen which requires emergency care and surgery.
  • The gastric sleeve is permanent unlike the gastric band.
  • The gastric sleeve is not adjustable. Initially, post-op, the vertical sleeve gastrectomy brings more risk than the adjustable gastric band due to the surgical separation of one’s stomach.
  • The band is handled as an outpatient procedure, allowing the patient to going home the same day, whereas the sleeve usually requires one overnight stay in the hospital.

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