Sleeve Gastrectomy

What is a Sleeve Gastrectomy?

Sleeve Gastrectomy is an irreversible weight loss procedure in which the stomach is divided into two partitions, creating a new stomach out of the smaller left part with laparoscopic surgery or vertical sleeve gastrectomy. In comparison, a full Gastric Bypass surgery consists of two stages, the first being the Sleeve Gastrectomy division and the second the Roux-en-Y end-to-side procedure, which is done to re-route and reconnect the intestines. However, Sleeve Gastrectomy surgery can be completed as a standalone weight loss procedure.

Why is Sleeve Gastrectomy surgery more appropriate?

When patients have very high BMI counts, such as those in excess of 55, coupled with obesity related health conditions or diseases, they are at higher risk of complications during full Gastric Bypass surgery. The aim of a Sleeve Gastrectomy is to allow for gradual decreasing of the BMI obesity level for further controlled weight loss. Sleeve Gastrectomy also allows, where appropriate, the Roux-en-Y end-to-side procedure to be provided six months after the Sleeve Gastrectomy. Patients are then in a surgically safer position for the full Gastric Bypass surgery. However, some patients do not need the Roux-en-Y end-to-side procedure, as they successfully manage to control their weight loss through medical supervision.

Who is eligible for Sleeve Gastrectomy Surgery?

Eligibility for Sleeve Gastrectomy is strict. Above all patients need to show that they are committed to addressing their obesity and medical condition through a medically supervised programme. This includes not only weight loss surgery, but also lifestyle and behavioural changes. Eligibility for Sleeve Gastrectomy includes:

• BMI measuring in excess of 34.
• Evidence of historic weight loss attempts without a successful outcome.
• Commitment to addressing obesity and medical conditions through a medically supervised programme, which includes surgery, dietary, lifestyle and behavioural changes.
• Responsibility for learning to control weight through health management.
• Understanding benefits, risks and complications associated with weight loss surgery.

What is involved in Sleeve Gastrectomy Procedure?

The Sleeve Gastrectomy can either be a Laparoscopic Sleeve Gastrectomy (LSG) or a Vertical Sleeve Gastrectomy (VSG) and occurs as follows:

• Patients are hospitalised and provided with general anaesthetic prior to LSG or VSG. A qualified surgeon makes small incisions in the abdomen-to-stomach area for insertion of a laparoscope, to provide visuals of the stomach area to be operated on.
• The surgical division of the stomach can either be done via the laparoscope or through an open procedure, in which the surgeon operates through a larger half-inch open incision in the stomach.
• Part of the stomach containing Ghrelin hormones is removed with surgical instruments via this incision, while the left side of the stomach is sectioned off with staples to provide a smaller stomach.
• The sphincter muscles in the upper and lower stomach are retained, and the new stomach, reduced between 45 to 75 percent, is tubular shaped.
• When these procedures are complete the surgeon uses dissolving sutures and sterile tape to seal the incision site, to allow for healing.

Why is the right side of the stomach removed?

The aim is to reduce the size of the stomach and remove the Ghrelin cells that produce appetite increasing hormones. Doing so allows patients to control their appetites better, feel fuller sooner and eat smaller portions of food.

What is recovery like?

Patients are monitored in hospital after surgery while the anaesthetic wears off. Once fully conscious patients are encouraged to gently move by walking to aid blood circulation to avoid blood clotting in the legs; this can otherwise cause Deep Vein Thrombosis. Intravenous fluids are provided throughout and after surgery to hydrate the body and painkillers are provided where necessary to reduce any discomfort.

Patients can expect to:

• Be discharged from hospital about a week after surgery.
• Have abdominal bruising and some discomfort, which is controllable through prescribed medication.
• Be encouraged to do gentle exercise to stimulate healthy circulation.
• Be advised not to do any rigorous activity or strenuous exercise for at least 8 weeks.
• Have to take time off work for full recovery.
• Follow a diet of fluids for a week after surgery, which is followed by soft food intake.
• Eat smaller portions and feel less hungry.
• Have full medical support throughout the surgical and recovery process.
• Be provided with ongoing weight loss management support post-recovery.

Are There Any Risks Associated With Sleeve Gastrectomy Surgery?

As with all surgery, risks and complications are inherent. However, medical practitioners are trained to reduce these risks and patients are monitored for a week in hospital during and after surgery. Any complications arising can be immediately treated, which may include bleeding and infection, nausea and vomiting, bowel rupturing or leaking, and scarring at the incision site. All patients are informed prior to surgery of what to expect, the benefits, risks and complications.

When weighed against obesity health risks, complications and shortened life quality and expectancy, the benefits of Sleeve Gastrectomy may greatly outweigh such surgical complications. Patients who smoke or choose not to follow recommended guidance for managing recovery place themselves at higher risk and may deter healthy healing. Discuss any concerns about surgery prior with your consultant.

What are the benefits of Sleeve Gastrectomy surgery?

The benefits of Sleeve Gastrectomy surgery includes a reduced stomach size and appetite, to enable a controlled weight loss programme managed and supervised by a qualified medical team. Patients gain control over lifestyle, dietary and behavioural habits, enabling positive recovery and improvement in obesity-causing health related conditions. Patients experience greater self-confidence and better life quality and expectancy. If necessary patients can go on to have the full Gastric Bypass surgery for enhanced health and well-being.

Where can I get further information treatment?

Speak with a member of our team about eligibility criteria for Sleeve Gastrectomy to be provided with more information about the surgery through appointment. We will provide you with a personalised evaluation and recommendations where appropriate.