Sleeve Gastrectomy

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What is sleeve gastrectomy?

Sleeve gastrectomy is usually performed by laparoscopic (key-hole) surgery and involves removing about 80% of the stomach leaving a small volume “sleeve” of stomach. It reduces the amount one can eat and importantly the portion of stomach removed produces a hormone called Ghrelin that regulates appetite. Hence most patients do not feel as hungry and this helps with achieving weight loss.

Why choose sleeve gastrectomy?

Sleeve gastrectomy provides reliable weight loss. It requires fewer dietary modifications and less intensive review compared to gastric banding as there is no need for adjustments. The risk of nutrient deficiency is minimal compared with gastric bypass and although a portion of the stomach is removed, access to the biliary tree (ERCP) is preserved (compared with gastric bypass).

What are the disadvantages of sleeve gastrectomy?

Sleeve gastrectomy is not reversible. It is a more invasive procedure compared to gastric banding as it involves removing 80% of the stomach. Notable risks include staple line leakage, staple line bleeding and stricture ( narrowing of the stomach sleeve ) – see below for more information on risks. Sleeve gastrectomy is a relatively new procedure. Although deemed safe and effective, the is little data beyond 10 years as to how effective it will be with time. There is the possibility that the ‘sleeve’ may dilate with time and result in weight regain.

What are the risks of sleeve gastrectomy?

All types of weight loss surgery carry risks. Most patients will not experience any complications but it is important that you are aware of the risks so you can make an informed decision regarding your surgery. Risks can generally be divided into general surgical risks and specific risks. General risks include but are not limited to:

  • Risks of anaesthesia and medications
  • Bleeding
  • Infection
  • Injury to adjacent organs
  • Deep venous thrombosis (blood clots in the leg veins)
  • Pulmonary embolus (blood clots in the lung)
  • Lung infection
  • Failure to lose weight

Specific Risks of Sleeve Gastrectomy

  • Staple line leakage - 1-2%. This requires reoperation and may lead to a prolonged recovery
  • Staple line bleeding – 1-2 %. This may require reoperation
  • Stricture - uncommon

What are the results of sleeve gastrectomy?

On average sleeve gastrectomy patients can expect to lose up to 25-30% of body weight over the first 12-18 months following surgery. This of course depends on following an appropriate diet and maintaining an adequate regime of exercise.

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