Gastric Sleeve Surgery

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What is Gastric Sleeve Surgery?

The gastric sleeve or sleeve gastrectomy, is a restrictive procedure, which reduces the volume of the stomach. Keyhole surgery is used to remove 90% of the stomach, changing it from an expandable reservoir for eaten food, to a narrow tube approximately 1cm in diameter.

By removing, the part of the stomach that contains cells that release the appetite controlling hormone ghrelin, the surgery makes patients less hungry. The capacity of the sleeve is much less than a normal stomach, so portion sizes are much smaller.

After a gastric sleeve, patients need to work closely with our dieticians, following a recommended diet, slowly building up too bigger portions and less easily digested foods such as meat and fish. Good aftercare is needed, to ensure patients remain healthy. Patients need to take a multi-vitamin each day; most medication can be taken as normal although it is sometimes necessary to break tablets. As with the gastric bypass, annual blood monitoring is needed to avoid malnutrition

Weight loss after sleeve gastrectomy, is affected by many patient factors including age, activity level and basal metabolic rate. But, on average, a typical lady who is 8 stone overweight will lose 5-6 stone.

The gastric sleeve is sometimes recommended as a safe alternative to the gastric band, the evidence does not support this recommendation. Currently the published data suggests that the risk of complications with the gastric sleeve is similar to that of the gastric bypass, with evidence that the long-term weight loss is less than that of the bypass.

Although we offer the laparoscopic sleeve gastrectomy, we remain cautious about recommending it over a gastric band or a gastric bypass. A consultation is needed to explain the pros and cons of sleeve gastrectomy for each individual patient.

The gastric sleeve is probably not a good operation for patients with long-standing gastro-oesophageal reflux or hiatus hernias. Gastric bypass is probably a better option in this group of patients.

Risks

Although we have a zero mortality rate from our laparoscopic sleeve gastrectomy procedures, the latest published UK data from the National Bariatric Surgery Registry, suggests that the mortality risk with a gastric sleeve, is a little higher than for gastric bypass however it is still very low, approximately 1 in 1000.

The most serious complication is a leak from the staple line, which occurs in between 1 and 3% of patients. Unlike after the gastric bypass, these leaks do not always occur soon after surgery. Sometimes they occur, four or six weeks after surgery. It can be very difficult to get leaks after sleeve gastrectomy, to heal, with some patients spending months in hospital or needing repeated operations.

Book a consultation to see if the gastric sleeve is right for you.

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