Sleeve Gastrectomy
This procedure generates weight loss soley through gastric restriction (reduced stomach volume). The stomach is restricted by dividing it vertically and removing more than 85% of it. This part of the procedure is not reversible. The stomach that remains is shaped like a banana and measures from 2-5 ounces (60-150cc) depending on the surgeon performing the procedure. The nerves to the stomach and the outlet valve (pylorus) remain intact with the idea of preserving the functions of the stomach while reducing the volume.
Advantages
The stomach is reduced in volume but tends to function normally so most food items can be consumed, albeit in small amounts.
Eliminates the portion of the stomach that produces the hormones that stimulates hunger (Ghrelin).
No dumping syndrome because the pylorus is preserved.
Minimizes the chance of an ulcer occurring.
By avoiding the intestinal bypass, the chance of intestinal obstruction (blockage), anemia, osteoporosis, protein deficiency and vitamin deficiency are almost eliminated.
Appealing option for people with existing anemia, Crohn's disease and numerous other conditions that make them too high risk for intestinal bypass procedures.
Can be done laparoscopically in patients weighing over 500 pounds.
Disadvantages
Potential for inadequate weight loss or weight regain. While this is true for all procedures, it is theoretically more possible with procedures that do not have an intestinal bypass.
Higher BMI patients will most likely need to have a second stage procedure later to help lose the rest of the weight.
Soft calories such as ice cream, milk shakes, etc can be absorbed and may slow weight loss.
This procedure does involve stomach stapling and, therefore, leaks and other complications related to stapling may occur.
Because the stomach is removed, it is not reversible. It can be converted to almost any other weight loss procedure.
Considered investigational by some surgeons and insurance companies.
Potential Complications
Acute respiratory distress syndrome
Death
Deep vein thrombophlebitis
Gastric leak and fistula
Non-fatal pulmonary embolus
Pneumonia
Postoperative bleeding
Small bowel obstruction
Splenectomy
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