Gastric sleeve surgery is a relatively new procedure and is also known as gastric sleeve resection, vertical sleeve gastrectomy (VSG), tube gastrectomy, and laparoscopic sleeve gastrectomy. Gastric sleeve is used for patients who are not eligible for gastric banding and have a very high BMI (>60). The gastric sleeve procedure is meant for the morbidly obese or high risk patients and with the intention of performing another bariatric surgery at a later time: gastric bypass or duodenal switch.
The gastric sleeve procedure
The gastric sleeve procedure is performed laparoscopically. About 60 - 80% of the rounded, larger part of the stomach is removed so that the remaining part of the stomach takes the shape of a tube or sleeve. The tube-shaped stomach is sealed closed with staples or sutures. The remaining portion of the stomach holds about 15% as much food as the original stomach.
Unlike gastric bypass or duodenal switch bariatric surgery techniques, the gastric sleeve bariatric surgery technique leaves the stomach openings intact and unchanged, therefore malabsorption and dumping syndrome (a condition in which the stomach contents empty into the small intestine too quickly, causing nausea or discomfort) should not be a problem. However, because the stomach is permanently removed, the procedure is irreversible. Surgery takes about one to two hours, with a hospital stay of about one to two days for recovery. Full recovery from surgery takes about three weeks. On average, patients lose approximately 30 - 50% of their excess body weight over six months to one year.
Additional surgery with the gastric sleeve
Gastric sleeve surgery can also be performed as the first of two stages of the duodenal switch procedure. Gastric sleeve resection jump-starts the weight loss. The gastric sleeve procedure is usually performed on those who are too obese or sick and cannot undergo gastric banding surgery or gastric bypass surgery.
When the patient reaches a safe enough weight for more invasive surgery, then the second stage for gastric bypass or the duodenal switch is performed. This staged approach to weight loss surgery is necessary for these high-risk patients. Timing for the second surgery varies based on the degree of weight loss, usually six to 18 months.
Gastric sleeve risks
- Leakage of sleeve from staples or sutures, causing infection
- Blood clots
- Stretching of stomach from weight gain
- Discomfort from overeating include vomiting and diarrhea
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