Bariatric surgery, also called weight loss surgery, helps severely obese patients lose significant amounts of weight to improve their health. These procedures include sleeve gastrectomy, gastric bypass, adjustable gastric band and biliopancreatic diversion surgeries. The sleeve gastrectomy procedure, also known as a vertical sleeve gastrectomy, constitutes the first part of a biliopancreatic diversion but in the past five years surgeons have used it as a stand-alone procedure.
Significance
More than 72 million American adults or one third of the population over the age of 18 live with obesity, according to the Centers for Disease Control and Prevention. Obesity rates for adults doubled between 1980 and 2008 and the rate of childhood obesity has tripled. The consequences of obesity include higher risks for developing heart disease, high blood pressure, arthritis, liver disease, gallbladder disease and certain types of cancers. Bariatric or weight loss surgery may provide a permanent solution for obese adults by helping them to lose significant amounts of weight.
Sleeve Gastrectomy Procedure
The surgeon performs laparoscopic sleeve gastrectomy under general anesthesia using a laparoscope -- a tiny video camera -- and special surgical instruments. She makes two to five small incisions in the abdomen, inserts the instruments through the openings, and divides the stomach vertically. The surgeon removes 80 to 85 percent of excess stomach, leaving a vertical stomach pouch that restricts the amount of food the patients can eat at one sitting. The entire operation may last only 30 to 60 minutes for an experienced surgeon, says the National Institutes of Health. Sleeve gastrectomy does not cure obesity but it helps the patient control food intake by making him feel full after eating a small amount of food.
Patient Qualifications
Sleeve gastrectomy helps high risk patients, including those with complicated surgical histories, lose weight, according to the University of Maryland Medical Center. If you are considering a sleeve gastrectomy, you must be mentally capable of making long-term lifestyle changes; not dependent on alcohol or illegal drugs; and have a history of attempts at losing weight. You must also have a BMI of 40 or more -- at least 100 pounds over your ideal weight -- or a BMI of 35 or more and an obesity-related disease such as diabetes, sleep apnea or heart disease, according to NIH.
Advantages
If you have a sleeve gastrectomy, your digestive system functions normally except for the smaller size of the stomach, so you have a lower risk of vitamin and mineral deficiencies, according to the University of Maryland Medical Center. You will experience less hunger because the surgeon removes the portion of stomach that produces the hunger-stimulating hormones. Unlike gastric bypass patients, you will not experience dumping syndrome when you eat sugary or fatty foods and, in contrast to adjustable gastric band patients, you will not need to visit the surgeon frequently for band adjustments.
Results
Sleeve gastrectomy procedures help patients lose weight over a period of two to three years, according to NIH. You will lose weight more slowly than if you had a gastric bypass, but you may lose enough to relieve such conditions as asthma, high blood pressure, type 2 diabetes, sleep apnea and gasteroesophageal reflux disease or GERD. If you do not lose enough weight, you and your surgeon may decide that a second surgery such as a biliopancreatic diversion is appropriate.
References
- Surgery for Obesity and Related Diseases: Updated Position Statement on Sleeve Gastrectomy as a Bariatric Procedure
- Obesity Surgery: A Review of Laparoscopic Sleeve Gastrectomy for Morbid Obesity
- MedlinePlus: Vertical Sleeve Gastrectomy
- University of Maryland Medical Center: Laparoscopic Sleeve Gastrectomy
- CDC.gov: Overweight and Obesity
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