Sleeve gastrectomy is a restrictive weight loss procedure. It is restrictive in the sense that ‘restricts’ the amount of food the stomach can hold. In this procedure, stomach is reduced to 25% of the original size and a major portion of the stomach is removed. The open edges are attached leaving a small sleeve or tube, which is shaped like banana. Hence, the name sleeve gastrectomy.
The surgery is performed laproscopically involves stapling of the stomach upon removal of the left side of the stomach. Stapling of the stomach is done by harmonic stapling device. The surgery is performed by making a curve on the stomach. Surgery of the stomach is completed laproscopically and is irreversible.
Sleeve gastrectomy is performed on patients with BMI (Body mass index) more then 40, who are exceptionally considered as obese. Patients with high BMI rate are at increased risk of bariatric surgery. Hence, surgeon recommends the first part of sleeve gastrectomy to be performed in two stages. The first stage of surgery called as sleeve gastrectomy, helps to reduce weight for the first year earlier to second stage of surgery called as duodenal switch or gastric bypass surgery. For remaining weight loss, bypass is suggested. Complications related to weight loss are very less as the patient losses weight from sleeve gastrectomy. Therefore, the risks are very low associated with second surgery to do bypass. If patient losses weight by sleeve gastrectomy then the second stage of surgery is not required.
Sleeve gastrectomy advantages:
· The surgery is done laparoscopically
· The procedure performed is simpler compared to gastric bypass
· The recovery time is very shorter
· Pyloric part of stomach is left integral owing to dumping syndrome
· The operative time is very less than bypass surgery
· Foreign bodies are not used in this surgery
· Less pain, fewer incisions
· Condensed stomach volume enhances the sense of fullness
· Functioning of stomach is normal only when a small quantity of food is allowed.
· Hunger invigorating hormone is detached from the stomach portion
· For morbidly obese sleeve gastrectomy is a safer procedure
Sleeve gastrectomy disadvantages:
· Leakages and hemorrhages are seen sometimes, because of intra-abdominal pressure as a portion of stomach is removed and the edges are stapled. These kinds of leakages can be easily treated further.
· Irreversible
· Hernia is one of the possible complications. Therefore, surgery is required to treat the condition. Fifteen percent of the cases are seen.
· A hollow tube as passage linking the walls of the abdomen and stomach is called gastric fistula created by surgery. This is another possible complication.
· Gastro esophageal reflux the irritation caused due to acids in the stomach, which leads to heartburn. It is uncomfortable as it is caused due to the changes in the shape of the stomach.
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