With obesity continuing to increase in the West weight loss surgery has become a routine form of surgery in many medical facilities.
The sleeve gastrectomy is a restrictive type of weight loss surgery in which approximately 85% of the stomach is removed leaving a sleeve shaped stomach with a substantially reduced capacity of somewhere between 60 and 150 cc. Unlike most other types of weight loss surgery, the outlet valve and nerves to the stomach are left in place and, while the stomach is severely reduced in volume, its function is unaltered. Additionally, unlike other types of weight loss surgery such as the tried and tested Roux-en-Y gastric bypass the sleeve gastrectomy cannot be reversed.
Because the newly created stomach functions normally there are far fewer restrictions when it comes to the foods that patients can consume following surgery, although the quantity of food consumed will be considerably reduced. Many patients see this as being one of the chief advantages of the vertical sleeve gastrectomy, together with the fact that the removal of the greater part of the stomach also results in the effective elimination of hormones which are produced within the stomach and that stimulate hunger.
Perhaps the biggest advantage of the vertical gastrectomy lies in the fact that it does not bypass the intestines and patients do not therefore experience the complications of bypass including anemia, intestinal obstruction, vitamin deficiency and protein deficiency. It also makes it an appropriate form of surgery for individuals who already suffer from anemia, Crohn’s disease and various other conditions which would place them at high risk for intestinal bypass surgery.
Finally, it is one of the few types of bariatric that can be performed laparoscopically in patients who are extremely overweight.
Probably the chief disadvantage of the vertical gastrectomy is that it does not always result in the weight loss that people want and may even lead to weight regain in the longer term. This is of course the case with any form of purely restrictive weight loss surgery although it is possibly particularly true of the vertical sleeve gastrectomy.
Because the procedure requires stapling of the stomach patients do run the risk from leaks and other complications that are directly related to stapling. Additionally, as with any operation, patients are at risk from complications including post-surgical bleeding, small bowel obstruction, pneumonia and even death. The chances of experiencing these complications is nevertheless extremely small and varies from about 0.5 and 1%. This said, the risk of death from this form of surgery at about 0 .25% is very small indeed.
As a general rule the sleeve gastrectomy is most suited to patients who are either very overweight or whose health rules out other types of weight loss surgery. In the case of the first category of patient the sleeve gastrectomy would usually form the first of a two-part plan of weight loss, with further bariatric surgery being undertaken once the patient’s weight has dropped sufficiently to allow other types of weight loss surgery to be done.