The sleeve gastrectomy has become a good option for many people when choosing a weight loss surgery. This operation has increasingly gained popularity over the last few years. It was originally the restrictive part of a duodenal switch. The duodenal switch operation also contained a bypass in the small intestine which added some risk to the operation. To reduce the risk the procedure was changed to a two-step process; first the sleeve was done and after some weight loss occurred, the small bowel bypass was added. But what many observed was that most patients didn’t need the second operation as the sleeve provided sufficient weight loss on its own.
The sleeve gastrectomy involves the creation of a tube from the end of the esophagus to the end of the stomach. It is small in size, slightly bigger around than an adult index finger. It is designed to be small at first because it will stretch out to be about 25-30% the size of a normal stomach. Like the gastric bypass, the weight loss with a sleeve is rapid at first losing around 1/2 to 1 lb a day at first. The average weight loss with the sleeve at 6 months is about 90 to 100 lbs. Complete weight loss occurs by about 1 year and is usually around 70% of a person’s excess weight.
Also like the bypass, remission of co-morbid conditions is common. The remission of high blood pressure, high cholesterol, and obstructive sleep apnea is the same as remission rates with the gastric bypass. However, the remission rate associated with a sleeve for type II diabetes tends to be slightly less than observed with the gastric bypass. But having said that, just this last week I had a patient who had a sleeve that required an insulin pump preoperatively, and she went home 2 days later off her pump with normal blood glucose levels.
The sleeve gastrectomy is done with a scope laparoscopically. It is a 1-2 day stay in the hospital and back to work within 1-2 weeks depending on your type of job. The number of complications for the sleeve is low, but they can be serious. Leaks from the staple line occur in less than 1% and bleeding from the same staple lines occurs in about 2%. It is for these reasons that I only do this operation as an inpatient in a facility with full ICU, radiology, and operating room support. Although the chances for a problem are small, you do want the people and services in your facility to be immediately available and accessible if you should need them.
One of the major advantages of the sleeve is that it is only a restrictive procedure. Therefore, it will only limit what you take in. Unlike the gastric bypass, there is little risk of developing nutritional problems like iron, calcium, vitamin B or B-12 deficiencies. You can see why the sleeve gastrectomy has become a good option for many patients seeking weight loss surgery.
Please contact our office (303-861-4505)if you are interested in scheduling an appointment and want to begin achieving your desired weight loss goals. We have a complete multi-disciplinary program at one single location dedicated to our patients seeking weight loss surgery.
Tom Brown, MD
Colorado Bariatric Surgery Institute