The Sleeve Gastrectomy Alternative names: vertical sleeve gastrectomy, gastric sleeve, sleeve gastrectomy, greater curvature gastrectomy, parietal gastrectomy, gastric reduction and vertical gastroplasty. The vertical sleeve gastrectomy is a restrictive form of weight loss surgery in which approximately 85% of the stomach is removed leaving a cylindrical or sleeve shaped stomach with a capacity of about 150 cc, (5 ounces). Unlike many other forms of bariatric surgery, the outlet valve and the nerves to the stomach remain intact and, while the stomach is drastically reduced in size, its function is preserved Because the new stomach continues to function normally there are far fewer restrictions on the foods which patients can consume after surgery, this added to the fact the the portions are greatly reduced. This is seen by many patients as being one of the great advantages of the sleeve gastrectomy, in addition the removal of the majority of the stomach also results in the virtual elimination of hormones produced within the stomach which stimulate hunger, this is the reason why these patients don’t experience much hunger or binge eating. Another great advantage of the gastric sleeve lies in the fact that it does not involve any bypass of the intestinal tract and patients do not therefore suffer the complications of intestinal bypass such as intestinal obstruction, anemia, osteoporosis, vitamin deficiency and protein deficiency. It also makes it a suitable form of surgery for patients who are already suffering from anemia, Crohns disease osteoporosis and a variety of other conditions that would place them at high risk for surgery involving intestinal bypass. Perhaps the main disadvantage of this form of surgery is that it is not reversible and it may not always produce a long term reduction in weight since there can be weight regain. However revising this type of surgery is not very difficult. Weight regain because of lost restriction can be treated by banding the sleeve and if the desired weight was never reached converting to a gastric bypass is a low risk revision . This is why the sleeve has been used as a first step surgery for high risk patients and has gained popularity. Because the procedure requires stapling of the stomach patients do run the risk of leakage but this risk is minimal as compared to other stapled procedures. The sleeve gastrectomy is a lower risk procedure for extremely obese patients or those whose medical condition would rule out other forms of surgery. The gastric sleeve is frequently used as the first of a two-part surgical plan, with further bariatric surgery being performed once the patient has lost sufficient weight to lower the surgical risk. Some facts about the sleeve gastrectomy: Surgery for high BMI patients. For patients with a particularly high body mass index (typically 60+) many forms of weight loss surgery are either difficult to perform or present increased risk. As a result, a vertical sleeve gastrectomy is sometimes performed as the first of a two-part weight loss solution to provide an initial drop in weight which then makes other bariatric follow up possible at a reduced level of risk. Surgery for low BMI patients. For obese patients with a relatively low body mass index the vertical sleeve gastrectomy can also be an alternative, especially where existing conditions (such as anemia or Crohns disease) prevent them from having other forms of bariatric surgery. In addition, patients may choose this form of surgery if they are concerned about the long-term affects of bypass surgery or object to having a foreign body implanted into their body, as is the case with lap band surgery. Advantages of the sleeve gastrectomy: * Although the stomach is reduced in size and the amount of food which can be eaten is restricted, the stomach otherwise functions normally. * The major part of the stomach which produces hormones responsible for stimulating hunger is removed from the digestive system. * The problem of dumping is avoided as the pylorus is retained. * Minimizes the possibility of the patient developing ulcers. * Avoids the problems associated with bypass forms of weight loss surgery including anemia, intestinal obstruction or blockage, osteoporosis and protein and vitamin deficiency. * Provides a solution for patients with conditions which place them at an unacceptably high risk from other forms of bariatric surgery. * Provides a laparoscopic solution to patients with a particularly high body mass index (BMI). Disadvantages of the sleeve gastrectomy: * As this form of surgery does not provide any element of gastric bypass some patients may experience a disappointing weight loss or weight regain. * High BMI patients will often require follow-up weight loss surgery to achieve their goal. Although this may be seen as a disadvantage by some patients, in many cases, this two procedure option not only produces the results that the patient wants but may also provide a lower overall risk for the patient. This is something which need to de discussed with your physician. * Patients can slow weight loss if they do not stick to a strict diet following this form of surgery. * Complications may occur as the result of stomach stapling. * The procedure is not reversible as part of the stomach is permanently removed. It should be remembered though that the sleeve gastrectomy can be extended at a later date if required by performing additional bypass surgery
Posted on: Mon, 21 Oct 2013 09:57:55 +0000
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