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Sleeve Gastrectomy Surgery
What is the sleeve gastrectomy?
The sleeve gastrectomy is a weight loss procedure that removes part of the stomach and restricts the amount of food that can be eaten. Like other metabolic surgeries, it also promotes weight loss by changing hormonal signals between the stomach, brain, and liver.
How does the sleeve gastrectomy work?
- Most of the stomach is removed except a small, sleeve-shaped pouch. It can hold 1 ½ to 5 ounces, and is about the size of a banana.
- Patients are unable to eat as much food, fewer calories are absorbed into the body, and the hormonal signals between the stomach and the brain are changed.
- Typically, patients will experience weight loss and improvement in metabolic syndrome and overall health and wellbeing.
What are the health benefits of the sleeve gastrectomy?
- Clinical studies show that patients experience a variety of benefits after surgery:
- An average of 66% excess weight loss1
- Over 70% saw improvement or remission of type 2 diabetes2
- Significant improvements in high blood pressure, hyperlipidemia, sleep apnea, and joint pain2
- Increased physical activity, productivity, wellbeing, economic opportunities, and self-confidence3
- Minimally invasive procedure leads to shorter hospital stays and recovery time
- Several patients saw improved or resolved health conditions after the sleeve gastrectomy surgery:
- Type 2 diabetes controlled (45%)4
- High blood pressure resolved (56%)2
- High cholesterol improved* (77%)5
- Obstructive sleep apnea resolved (54%)2
What are some advantages and disadvantages of the sleeve gastrectomy?
- Can lead to significant weight loss (average of 66% of excess body weight)1
- Can lead to significant improvement of obesity-related health conditions2
- Doesn’t use a foreign object (like the gastric band) and doesn’t reroute the digestive tract (like the gastric bypass)
- Short hospital stays and recovery time due to minimally invasive procedure
- Limits the amount of food that can be eaten
- Causes significant changes to digestive organs and hormones that result in reduced hunger and increased metabolism
- Permanent (won’t need more surgeries or readjustments, like the gastric band)
- Requires lifelong dedication to specific diet and exercise routines
- Permanent (cannot be reversed)
- Can lead to vitamin deficiencies
- Possible complications may include:
- Gastric leakage
- Separation of tissue
- Dyspepsia (stomachache)
- Esophageal dysmotility (swallowing disorders)
- Dumping syndrome
Metabolic and bariatric surgery is as safe or safer than other commonly performed procedures, including gallbladder surgery.6,7 When performed at a Bariatric and Metabolic Surgery Center of Excellence, bariatric and metabolic surgery has a mortality rate of 0.13%.6 This means that out of 10,000 people who have this kind of surgery, on average 9,987 will survive surgery and 13 will not.6 Gallbladder removals have a mortality rate of 0.4%.7 This means of 10,000 people who have their gallbladder removed, on average 9,960 people will survive surgery and 40 will not.7
All surgeries present risks. These risks vary depending on weight, age, and medical history. Patients should discuss the risks with their doctor and bariatric and metabolic surgeon.
*Figure is for hyperlipidemia. Hyperlipidemia is a general term used for high fats in blood, which may include cholesterol and/or triglycerides.
1. Fischer L, Hildebrandt C, Bruckner T, et al. Excessive weight loss after sleeve gastrectomy: A systematic review. Obes Surg. 2012;22(5):721-731.
2. Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Rel Dis. 2009;5(4):469-475.
3. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery. A systematic review and meta-analysis. JAMA. 2004;292(14):1724-1737.
4. Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012 Apr 26;366(17):1567-1576.
5. Weiner RA, Weiner S, Pomhoff I, et al. Laparoscopic sleeve gastrectomy—influence of sleeve size and resected gastric volume. Obes Surg. 2007;17(10):1297-1305.
6. DeMaria EJ, Pate V, Warthen M, et al. Baseline data from American Society for Metabolic and Bariatric Surgery-designated bariatric surgery centers of excellence using the bariatric outcomes longitudinal database. Surg Obes Relat Dis. 2010;6(4):347-355.
7. Csikesz N, et al. Current status of surgical management of acute cholecystitis in the United States. World J Surg. 2008 Oct; 32(10):2230-6.