Gastric sleeve surgery, or vertical sleeve gastrectomy, is a weight loss surgery that removes about 80 to 85 percent of the stomach. This type of bariatric surgery can also be referred to as sleeve gastrectomy, vertical sleeve gastrectomy (VSG), tube gastrectomy, or stomach surgery .
Potential sleeve patients are those with BMI of 30 or higher and those with an increased risk of heart disease, Type II diabetes, and other obesity-related diseases. To see if you’re a qualified candidate for sleeve gastrectomy please contact our specialized staff.
How Gastric Sleeve Surgery Works
While the laparoscopic gastric sleeve surgery may be considered a new procedure, it has been performed since 1988. It was originally used as a “first-stage” procedure in patients with a high BMI and/or with serious co-morbidities. The Vertical Sleeve Gastrectomy (VSG) would be performed on the patient with the expectation that a second procedure (either the Roux-en Y gastric bypass or the duodenal switch) would be performed after the patient had lost enough weight so that the second procedure could be safely performed. It was discovered that many patients did so well with the gastric sleeve procedures alone as a successful treatment of morbid obesity that they did not need the second procedure.
In this procedure there is no rerouting of the small intestines, and no new connections need to be made. This makes the VSG safer, easier, and faster to perform. The lack of rerouting of the intestines also reduces the risk of vitamin and mineral deficiencies and can also be easily converted to another procedure such as gastric bypass or duodenal switch.
The surgery is laparoscopic in nature by making five little incisions on the abdomen of the patient. These are used to insert the instruments and scope needed to complete the procedure. The surgeon will then create a small stomach by stapling the larger stomach down to a size that is approximately 80–85% smaller than the original. Sleeve procedures take about 30 to 45 minutes to complete. The new, smaller stomach, shaped like a banana, will already be attached to the inlet and outlet for the stomach. The sense of hunger will be reduced because the portion of the stomach that contains ghrelin, the hunger hormone, will be removed.
Like your shoe size, everyone has a different sized stomach. When the surgeon makes your pouch, a cylindrical measuring device (bougie), is inserted into your stomach as a guide. As stomachs are different sizes, it may mean that your pouch is a little longer or shorter than someone else’s. The new smaller stomach will limit the amount of food you can eat at one time by about 85 percent. Your pouch might handle 4 ounces easily, while someone else’s can only handle 2.5 ounces. It is also important to know that the triple row of surgical staples is always over-sutured. Some surgeons call this suturing of the staple line “double buttress” but just means that the risk of complications and chances of developing a leak are greatly reduced. Some non-ALM surgeons skip this part, leaving patients with a higher risk of leaks and complications. The tiny medical grade titanium staples used are safe for CAT scans, MRIs, and airport scans. They will remain in place forever.
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Benefits of Gastric Sleeve Surgery
- Over 80% of type II diabetes cases are resolved after gastric sleeve surgery
- Hypertension is improved or resolved in many patients
- There is no foreign body that will break, slip, or erode
- Unlike the adjustable gastric band (lap band), there is nothing to be adjusted
- You don’t need to worry about getting follow-up care if you move to another city
- The feeling of fullness that you get from the VSG is much more satisfying than the feeling of obstruction or discomfort that you get with the lap band
- Can be performed on patients that otherwise do not qualify for gastric bypass, such as those with anemia, Crohn’s disease, etc.
- As with every type of bariatric surgery, the overall quality of life for patients improves greatly. A great deal of excess weight is lost, and patients experience resolution of many life threatening co-morbidities, improved appearance, social opportunities, and economic opportunities.
Gastric sleeve surgery can provide patients the ability to lose weight gradually and in a healthy way while helping them maintain their weight in the future. All of these benefits are long term. Many patients report keeping the weight they lost off 10–15 years following their procedure.
According to a study by Stanford University, 96% of patients did not experience any complication at all with VSG surgery. The study looked at 16,000 different sleeve patients in a pool of 270,000 bariatric surgery and metabolic patients. The same study found that the mortality rate for this surgical procedure was just .08% after 30 days. While the overall mortality rate for most weight loss surgeries is low (.14%), sleeve gastrectomy mortality rate numbers are much lower than that low average.
A Lighter Me works with some of the most experienced surgeons in the world who have thousands of gastric sleeve success stories. Call us today to further discuss your gastric sleeve surgery in Tijuana Mexico.
Gastric Sleeve Surgery Expectations
Many of the patients who opt for sleeve surgery are suffering from obesity-related medical conditions such as obstructive sleep apnea, high cholesterol, type II diabetes, cancer, high blood pressure, and coronary artery disease.
- Approximately 45–58% of all patients studied saw complete remission of their diabetes
- 77% saw complete remission of their high blood pressure
- 77% saw complete remission of their high cholesterol
- Nearly 60% of all patients experienced total resolution of their obstructive sleep apnea
The issue of poor weight loss occasionally arises with gastric sleeve and all other bariatric surgeries. Sometimes a patient’s post op weight loss is not what they’re expecting. This can be caused by many factors that include the following:
- Not following the recommended diet plan
- Not making good food choices
- Not instituting a routine exercise plan
- Emotional issues that cause overeating
- Medical conditions like menopause, thyroid, and decreased mobility
Gastric Sleeve Surgery Common Side Effects
Gastric sleeve surgery can have some unwanted side effects that range from mild discomfort to those requiring another surgery. The sleeve is a relatively safe bariatric procedure that has become widely popular and accepted. One of the biggest advantages is that its expected weight loss is comparable to gastric bypass surgery, yet its relative risks are fewer than the RNY bypass because its less complex and requires shorter operating room time.
Mild to Moderate Side Effects
Immediately after surgery, minor side effects such as pain from gas, bruising, bleeding, inflammation, and swelling are very common. For the vast majority of patients, these side effects and symptoms can be controlled with medication therapy, movement, and rest; these effects disappear within a day to several days following surgery.
Severe Side Effects
A few patients may suffer more severe complications, including: internal bleeding or leaking, gastritis (inflammation in the lining of the stomach), more than usual pain, and bloating in the abdominal area.
As with all surgeries, a very small number of patients may develop an infection, pneumonia, and nausea and/or vomiting. All severe side effects should be checked by a doctor without delay.
Blood clots, which can be fatal, occur in less than 1% of gastric sleeve patients (by comparison, it is estimated that 30–50% of knee and hip surgery patients develop blood clots).
Gastric Sleeve Surgery Risks
Bariatric surgery, in general, is a major metabolic procedure and all surgical procedures come with inherent risks, including death. As patients consider bariatric surgery as an option to take control of their obesity, it’s important to discuss the risks with your doctor/PCP/bariatric surgeon. No two patients are the same and no two will have the same level of risk. Risk factors tend to increase slightly with the number of co-morbidities a person has and subsequently can decrease with weight loss.
Bariatric surgery requires anesthesia, to which some patients may have an unknown allergy or allergic reaction. Some individuals may experience breathing problems. Gastric sleeve surgery can cause death, though life threatening complications are extremely rare. Complications can happen. We are prepared for any complications and will do all that we can to mitigate risk for our patients.
General Surgery Risks
- Blood clots
- Infection is possible in the incision, lungs (pneumonia), bladder, and kidneys
- Blood loss
- Heart attack or stroke
- Stomach injury, or damage to intestines or close organs
- Stomach leakage
- Rejected sutures
- Stomach or small intestines may become blocked or obstructed
Risks of Gastric Sleeve Over Time
Sometimes risks can arise several days, weeks, or even months after the surgery, and still have the potential to be serious. To reduce the risks, patients are urged to follow your bariatric surgeon’s recommendations, especially with diet, exercise, vitamins and supplements, and emotional support.
One main risk that patients should be vigilant about is not to stretch out the stomach. When patients eat too much food the stomach can expand, which can permanently increase the stomach capacity. The new stomach is 85% smaller than before, so it’s important to eat light, sparing meals. Lifelong small portions are the key! Patients should also consider these risks:
- Protein deficiency
- Anemia from low iron or vitamin B12 levels (bariatric surgery may require taking special supplements and vitamins)
- Kidney Stones
To truly understand and discuss all of the possible complications and side effects, it’s important to talk to a bariatric surgeon. Individuals may be at an increased risk of side effects due to their current health and medication status.