The laparoscopic sleeve gastrectomy, gastric sleeve surgery, procedure is one of the newer procedures used to treat obesity. The American Society of Metabolic and Bariatric Surgery approved it in 2009. Most studies show 60-70% excess weight loss with this procedure at one year. Studies have followed the patients out for 9 years and the maintenance of weight loss is similar to the gastric bypass results. Most studies show an average of 50-55% of the excess weight still off 9 years following surgery.
About the Procedure
Gastric sleeve surgery is primarily a restrictive procedure. It involves removing approximately 80-85% of the stomach, leaving just a “sleeve” of stomach remaining. This significantly limits the amount of food that can be eaten at a time and will, therefore, decrease the number of calories consumed. There is no “re-routing” of the intestine, therefore no malabsorption. Vitamins and minerals are all absorbed normally, so the risk of deficiencies decreases. Since patients do eat significantly less food, we recommend they take an adult multivitamin daily. We also recommend sublingual, under the tongue, vitamin B12, as the stomach that is removed does make a protein called “intrinsic factor” needed for absorption of this vitamin.
The sleeve gastrectomy historically was a two-stage procedure done for severely morbidly obese patients considered too high risk for a gastric bypass procedure. These patients underwent a sleeve gastrectomy, lose a hundred pounds or so, and then undergo a conversion to a gastric bypass surgery in a second operation. Many patients did not want to undergo the second procedure, so we followed them, and they kept off their weight. Atlanta General and Bariatric Ambulatory Surgery Center now offers the procedure to all weight loss patients as a primary operation, with no plan to undergo a second operation. While there is no long-term-follow-up yet, studies have followed patients for 3 years and 5 years after surgery, and they have maintained their weight losses.
Another potential benefit of gastric sleeve surgery is that the portion of the stomach that is removed is responsible for the production of ghrelin. “Ghrelin” is a hormone thought to be one of the factors leading to hunger. Studies show that ghrelin levels in patients undergoing a sleeve gastrectomy are significantly lower, and their hunger is less after this procedure than with other surgeries. Hunger is caused by many factors, but there is hope this will lead to better long-term compliance and sustained weight loss.
Aftercare and Recovery
Almost all gastric sleeve surgery patients are home within 24-hours following surgery and many go home on the same day as their surgery. The surgery usually takes less than an hour. Most people are back to work in 1-2 weeks. Weight loss is fast, and the average weight loss is approximately 60-70% of the excess weight at one year.
Click here to use our Body Mass Index (BMI) Calculator to help determine if you are a candidate.
Other Bariatric Procedures”
Johns Creek Surgery, PC, attracts patients from all over the Metro Atlanta area and beyond including Macon, Sandy Springs, Alpharetta, Milton, Roswell, Duluth and Marietta, GA. Our Board Certified experts provide carefully structured guidance for weight loss, vein health and general surgery. Contact us today to schedule a consultation.