Gastric Sleeve Surgery
(Vertical Sleeve Gastrectomy or Vertical Gastrectomy)
Gastric sleeve surgery is one the latest types of bariatric surgery. This surgery, also known as vertical sleeve gastrectomy, parietal gastrectomy, vertical gastroplasty and similar names, is generally reserved for people who are obese with a BMI of 35 or higher.
The gastric sleeve surgery will enable you to get to a healthy, safe weight. It’s thought that this method is particularly useful for people who are at high risk for all kinds of health problems. The gastric sleeve helps them to lose weight quicker and without any tremendous risk like they’d experience with other surgeries.
According to present-day scientific information, the sleeve gastrectomy is the most ideal bariatric procedure. What does that mean? Basically, the signs for the sleeve as similar to other covered procedures like the adjustable gastric banding or gastric bypass.
For persons to qualify for the procedure, the National Institutes of Health says a person must have a body mass index of 40 or more. Thus, it’s for men who are 100 pounds or more and women who are 80 pounds or more.
- High cholesterol
- High blood pressure
- This kind of surgery is best for any person who is unable to have regular follow up visits that the gastric banding procedures need such as the Realize Band surgery and the Lap Band surgery.
- A person scared of the long-term effects of intestinal bypass such as: anemia, intestinal obstruction and protein deficiency.
- People who don’t want foreign objects in their stomach like you see with the Lap Band surgery.
- People who are unable to do conventional weight loss surgery because of a serious medical condition like anemia and Chrohn’s disease, or a person who has had a number of surgeries.
- People who are using anti-inflammatory medicines and most avoid the gastric bypass surgery.
Thus, any person with the above issues can undergo the gastric sleeve procedure.
This procedure is also good for people who have had an problem with the lap band or have lost a lot of weight previously and don’t need the full bypass surgery done. With the help of the gastric sleeve, weight loss is usually quicker and results are typically in a short amount of time.
Gastric sleeve surgery and…
- Laparoscopic Gastric Bypass Surgery After either surgery, PYY levels rise in similar fashion. However, a significant decrease in ghrelin levels along with the PYY level increase after the gastric sleeve surgery leads to better appetite suppression and additional weight loss when compared to the bypass surgery.
- Lap Band Surgery The gastric sleeve surgery helps reduce the hunger feeling and increase weight loss between one and three years after having it done, which is better than what the lap band surgery provides. It’s common to have GERD (Gastroesophageal Reflux Disease) after one year from the gastric sleeve surgery but three years with the lap band surgery.
There are several advantages to the gastric sleeve surgery such as:
- None of your intestines will have to be rerouted during the procedure
- There are a minimum amount of complications and side effects like protein deficiency, osteoporosis and anemia; a real problem with other weight loss procedures.
- Only procedure to eliminate the hormone that increases one’s hunger and causes a weight gain.
- It’s simple to perform.
- No need for foreign objects to be inserted into the body.
- The pylorus is preserved.
- No adjustments will be needed.
- People with a BMI of 60 or more will find it a safe procedure.
Any lap band patient who is suffering a multitude of complications, such as band slippage, band erosion and reflux, might want to consider the gastric sleeve surgery. By undergoing the gastric sleeve surgery, the band will be removed, eliminating the uncomfortable side effects that come from the other surgeries.
Many people are worried that they’ll gain the weight back after they’ve had the band implanted. However, with the gastric sleeve, this isn’t a concern. After all, the gastric sleeve will allow a person to maintain their present weight and help them to lose additional weight. It’s thought to be the safest and most effective form of weight loss
Patients who had the gastric sleeve surgery lost between 33 percent and 70 percent of their extra bodyweight. In the long-term (of 3 years), the additional weight lost was between 64 percent and 75 percent.
When someone suffers with chronic obesity, the gastric sleeve procedure is seen as a life-saving procedure. In some rare cases, there are inherent risks to take into consideration. Some risks include:
- Blood clots
- Injury to body part/internal organ
- Internal bleeding
- Wound infection
- Leakage around the stomach edge
- This procedure comprises of a stomach resection, which will then need to be stapled. When the gastric sleeve procedure is done, it’s possible the staples can rip apart, causing the leak. If there is a leak of stomach acid, it can result in stomach problems that require additional surgery or a drainage tube.
What happens during a gastric sleeve procedure? The surgeon will remove approximately 85 percent of the stomach so that it looks like a sleeve or tube. It’s done laparoscopically, which means the surgeon will make several tiny incisions rather than one large one. The surgeon will use a viewing tube with a tiny camera along with other instruments to remove some of the stomach.
The stomach, which is tube-shaped, is clasped closed with staples. There are some instances where the gastric sleeve surgery is followed by the gastric bypass or duodenal switch surgery after a significant amount of weight has lost. This is known as the “staged” approach in regards to weight loss surgery. A first weight loss surgery is generally risky but the second is seen as less so. When this second surgery is done is based on the amount of weight loss; but, usually within 18 months of the first surgery.
This is seen as a restrictive surgery, where about 85 percent of the stomach is taken out, which leaves a sleeve-shaped stomach with a 60 to 150cc capacity. This depends on the surgeon who is doing the operation. The stomach nerves and outlet valve will stay intact with this type of surgery where, in others, they are altered. However, the stomach is tremendously decreased in its size; but, its function is well-maintained. Keep in mind that this surgery is non-reversible. Thus, if you’re having second thoughts before you undergo it, you should really do your homework.
Since the new stomach works like normal, there are fewer restrictions on foods that patients can eat after surgery although the amount of it will be decreased. Many patients see this as being one great benefit to undergoing the gastric sleeve surgery along with the removal of most of the stomach and the elimination of the hormones produced inside the stomach to stimulate hunger. This surgery is primarily obstructive, which means it works to ensure you’re fuller quicker than before you had the surgery.
The procedure is still pretty new. However, health insurance companies are starting to cover its cost, which can run more than $15,000.
Under general anesthesia, the non-reversible, gastric sleeve surgery is performed in about two hours. You’ll have a hospital stay of no more than two days; however, recovery from it could last several weeks.
Before you’re released, your doctor will do a number of checks on you. One check will be to ensure there is no leakage problem. The doctor will also look to ensure the wound is healing correctly and help you get going right on the transitional diet.
Keep in mind that your new stomach is going to be extremely sensitive, especially in the beginning. Thus, you’re likely to be asked to do a liquid diet for two weeks before you introduce solid foods.
After leaving the hospital, you’ll be asked to return to the doctor in one week and then every couple of months to ensure everything is going right. While malabsorption is not as likely with the gastric sleeve surgery, a dietician will want to keep track of your diet to ensure you’re getting the bariatric vitamins your body needs such as the vitamin B12.
After the surgery, you’ll have to be reintroduced to solid foods. You’ll begin with a two week liquid diet and then a two week semi solid diet and then you can consume solid foods.
It’s not uncommon to have a sore, swollen abdomen for several days. Your doctor will give you pain medication for your pain. While you can go back to work in two weeks, it’s best to wait a month or so to be safe. Scarring can occur; but, can be covered using clothes.
When it comes to weight loss, most people lose between 50 and 80 percent of the additional bodyweight in the first six to 12 months after the surgery. According to studies, people who have undergone the gastric sleeve resection procedure had improvements in their blood pressure, diabetes, cholesterol levels and sleep apnea within a two –year period.
Remember, this is a new procedure, so any long-term data on weight loss or health improvement is relatively limited. After the surgery, there must be certain changes made to one’s lifestyle such as:
- Getting regular amounts of exercise
- Learn behavior variations methods
- Learn and use certain dietary instructions that must be used for the rest of one’s life such as eating slowly, chewing food thoroughly, consuming small amounts of food, swallowing when food is smashed up and not drinking and eating simultaneously.
A careful review of the gastric sleeve procedure suggests it is the least complex type of bariatric surgery with low mortality and complication rates. It’s possible you’ll suffer with complications that are seen with other weight loss surgeries like:
- Difficulty swallowing
Your stomach will be larger than the gastric bypass pouch and ensures the connection between the small intestine and stomach is lost after it’s done. Thus, these above issues should not be near as prevalent or felt.
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