The Gastric Sleeve incorporates the latest developments in Weight Loss Surgery. It is usually much less invasive than Gastric Bypass and has the advantage of being available in a day surgery setting. All surgery has risks, but since your intestines are not rerouted in this procedure, healing time is faster.
The Gastric Sleeve procedure is performed laparoscopically with very small incisions made with long, thin instruments which are inserted into the abdomen. With the help of video equipment surgeons are able to reduce the size of the stomach and staple it back together to create a smaller stomach which reduces the amount of food you are able to eat. Since there is minimal cutting and no re-routing of the intestinal tract, you will experience a must faster recovery and reduced post-operative pain.
The Gastric Sleeve procedure was developed as a first step surgery for extremely obese (BMI over 60) people for whom gastric bypass surgery was too risky. Doctors soon realized that many of their patients achieved their needed weight loss without completing the second half gastric bypass procedure. Patients with diseases requiring treatment with NSAIDS or Steroids or other medications that irritate the stomach should consider the Gastric Sleeve, and there are some health conditions which are counter indicated with the LAP-BAND® or the REALIZE™ Band. These people can consider the sleeve with the advice of their physician.
TLCEdge Surgical Weight Loss is dedicated to providing our patients access to the many of North Texas' finest weight loss (bariatric) surgeons. Your surgery, aftercare, and maintenance will be followed by a team of healthcare professionals dedicated to your positive results. The Texas Clinic at Prestonwood is North Texas' most advanced multi-specialty destination for your complete wellness.
Many medical problems commonly associated with obesity such as hypertension, diabetes and sleep apnea are improved or, in some cases, totally eliminated after the Sleeve Gastrectomy. It is not necessary to lose all of your excess weight in order to achieve improvement with regards to many of these medical conditions. Please discuss any specific concerns with your surgeon.
As with most day surgeries you will arrive early on the morning of surgery after following simple preparation instructions at home. The majority of procedures will be complete in less than one hour. A general anesthesia is used and a normal recovery will include drinking liquids and walking within two hours. You will either be discharged the same day or the next morning following your surgery, depending on your particular circumstances and the instructions of your surgeon.
Many surgeons will require one to two weeks of a liquid protein diet before weight loss surgery. This diet helps reduce the size of the liver in preparation for surgery. If you doctor prescribes such a diet, it will be very important for you to follow it. In rare cases, surgeons have had to stop surgery because it is clear that the patient did not follow the routine, and the risk of complications is too great.
Recovery time is shortened as with any laparoscopic surgery. You will be encouraged to rest for 3 to 5 days, but depending upon how strenous your job is you may return to work in 3 to 7 days. Many people schedule the surgery on Friday and are able to return to a normal routine early the following week. Heavy lifting should be restricted for 4 to 6 weeks. Please discuss any specific concerns with your surgeon.
Unlike other forms of weight loss surgery, there are no prohibited foods with the Gastric Sleeve procedure, and since this procedure does not affect the pyloric valve, dumping syndrome is seldom a side effect of this surgery. You will eat less, so you will need to concentrate on eating foods that will supply your nutritional needs. Liquids pass through the stomach easily so you will need to refrain from drinking high calorie drinks. Most Gastric Sleeve patients find they are able to adjust to their smaller stomach without the nutritional supplements commonly required in bypass surgery, but your individual experience may be different. Your surgeon and the TLCEdge team will be there throughout your recovery to help you adjust to your own requirements.
Unlike the Gastric Banding procedures, there will be no opportunity to further reduce the size of your stomach with adjustments, so if your weight loss reaches a plateau, it will most likely be because you are eating too many carbohydrates. These plateaus will be an indication that you need to refocus on eating protein.
How much you lose depends on how well you are able to use your new tool to manage eating. The Gastric Sleeve is a restrictive procedure not a malabsorbtive procedure, it is a tool to help improve your health by controlling what you eat. A weight loss of 1 to 3 pounds a week in the first year after the surgery is possible. The Gastric Sleeve procedure allows a gradual weight loss without the side effects of gastric bypass surgery as it helps you improve or resolve health problems associated with being seriously overweight and reach your ultimate weight loss goals. There are no long term studies on weight loss when the VSG was used as a stand alone procedure. Reported short term results for persons with a BMI of 50 to 60 indicate that a 50% reduction in excess weight is achieved in the first year, while those with a BMI in the 30 to 40 range had better results with a 70% reduction in excess weight1.
Because the pyloric valve and small intestine remain intact Sleeve Gastrectomy patients can expect fewer side effects than Gastric Bypass patients. In the short term the most often reported complication was leakage. This occurred in less than 2% of surgeries2and resulted in drain tube, or in a slightly longer hospital stay. Risk of embolism is about the same as with any surgical procedure. Long term complications are far fewer with the gastric sleeve, since the procedure is restrictive and not malabsorptive, there is no need for the routine blood tests and nutritional supplements required in bypass patients. One surgical practice with 800 cases in their study has had no cases of malnourishment with the Gastric Sleeve. There is also very little risk of dumping syndrome.
Many people experience nausea as a side effect of general anesthesia, some to a greater degree than others, if you experience this medications will be available during your recovery to manage nausea. Depending upon your surgeon's instructions, you will probably be dismissed on a liquid diet for 4 weeks following surgery and you will slowly add solid foods as you heal. Most people do not experience nausea beyond the recovery period.
Your surgeon will typically wish to follow your progress 2 to 4 weeks after surgery.
Generally speaking, you should plan for a few days of light activity following surgery. You may then return to normal activity. As you lose weight, you will be able to be as active as you want to be and you'll feel better! You will be encouraged to adopt an active lifestyle.
Plastic Surgery may be an option but is not required as a general rule. Most likely, plastic surgery should not be considered for at least a year after your Weight Loss Procedure as sometimes skin will mold itself around the new body tissue. Weight loss associated with the Gastric Sleeve is more gradual initially and this initial gradual weight loss often results in less skin related issues.
The Gastric Sleeve works to control hunger in two ways. First, it creates a smaller stomach which will only hold only 1 to 4 ounces of food. Secondly, the surgery reduces the amount of the hunger hormone Ghrelin which makes you feel less hungry also.5
Alcohol is a high calorie liquid so moderation is advised when losing weight. However, an occasional glass of wine or other alcoholic beverage is not considered harmful and generally will not cause any problems with your band3.
The Gastric Sleeve shouldn't interfere with the absorption of nutrients as other more drastic surgical procedures can. However, since you are eating less, it is possible that you might not get enough vitamins from your smaller meals. Doctors find that 85% of their patients had Vitamin D deficiency before surgery and recommend a calcium supplement and a multivitamin post surgery4.
You should continue taking all your medications as your doctor advises. As you lose weight you may need to have your normal medications adjusted and some may be discontinued as your weight reaches a healthy goal. Please discuss this with your primary care physician.
Perhaps. The Gastric Sleeve may be a better choice than the Gastric Band for patients who have GERD or esophageal problems, and reducing obesity has shown to reduce the incidence of GERD. This decision should be made in consultation with your surgeon. Most surgeons will prescribe a heartburn medication just to make sure you don't experience acid reflux during the healing process.2 This will be reduced over the first year.
1. Baltasar A, Serra C, Pérez N, et al. Laparoscopic sleevegastrectomy: a multi-purpose bariatric operation. Obes Surg. 2005;15:1124–8.
2. Mervyn Deitel & Ross D. Crosby & Michel Gagner. The First International Consensus Summit for Sleeve Gastrectomy (SG), New York City, October 25–27, 2007, OBES SURG (2008) 18:487–496
3. Dixon J., Dixon A., O'Brien P. Light to moderate alcohol consumption: Obes and the metabolic syndrome. Am J Bariatric Medicine. 2002;17(4):11-14.
4. Gumbs A, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17:962–9.
5. Ahmad Assalia, speaker. The First International Consensus Summit for Sleeve Gastrectomy (SG), New York City, October 25–27, 2007, OBES SURG (2008) 18:487–496