A gastric sleeve is a type of bariatric surgery that is indicated to treat obesity. The surgery, also known as vertical gastrectomy, involves removing the left side of the stomach, which reduces its ability to store food. It can lead to a loss of up to 40% of the initial weight.
Gastric sleeve surgery is recommended for treating obesity when other, more conservative methods have not shown any results even after 2 years, or when the person already has a BMI greater than 50 kg/m².
A gastric sleeve can also be performed on people with a BMI of 35 kg/m² who also present with comorbidities like heart disease, respiratory disease or decompensated diabetes
How it's done
Gastric sleeve surgery is performed under general anesthesia and takes about two hours to complete. It is common for patients to be hospitalized for at least 3 days for monitoring following this procedure.
This surgery is usually performed by videolaparoscopy, in which small holes are made in the abdomen. Tubes and instruments are then inserted through these holes to to make small cuts in the stomach.
During the surgery, the doctor makes a vertical cut, cutting the left side of the stomach and leaving the organ in the shape of a tube or sleeve, similar to a banana. Up to 85% of the stomach is removed with this surgery, and essentially makes the stomach smaller, leading to less eating.
Main benefits
The main benefits of the gastric sleeve in comparison to other types of bariatric surgery are:
- Ingesting between 50 and 150 ml of food at a time, instead of 1 L, which is the usual capacity before surgery
- Greater weight loss than the adjustable gastric band, without the need for band adjustments
- Ability to transform the gastrectomy into a gastric bypass, if necessary in the future
- Intestinal tissue does not undergo any changes, and normal absorption of important nutrients still occurs.
It is also a technically simpler surgery than the gastric bypass, allowing weight loss over several years and with less risk of complications.
Despite these advantages, it is still a very aggressive approach to weight loss and cannot be reversed, unlike other simpler forms of surgery, such as the placement of a gastric band or a balloon. Read more about other type of of bariatric surgery and the risks and benefits for each.
Which doctor to consult
The best doctor to consult if you wish to undergo bariatric surgery is an endocrinologist. He or she will perform a detailed assessment and provide guidance on the most appropriate forms of treatment, depending on your weight, health history and personal goals.
Possible risks
A gastric sleeve can cause nausea, vomiting and heartburn. However, the most serious complications of this surgery include the appearance of a fistula, which is an abnormal connection between the stomach and the abdominal cavity that can increase the chances of infections. In these cases, a new surgery to repair it be necessary.
What recovery is like
Recovery from surgery can take between 6 months and 1 year, and involves gradual weight loss with very necessary lifestyle changes.
A patient who has undergone this procedure are typically advised to follow these guidelines:
- A diet as recommended by a registered dietitian (read more about a bariatric diet)
- Take a gastric protector such as omeprazole, prescribed by your doctor, before meals
- Take oral painkillers, such as acetaminophen or tramadol, as advised by your doctor, if you have pain
- Practice light physical activities after 1 or 2 months, as approved by your doctor
- Maintain dressing and wound care for one week after surgery.
All of these precautions should be taken to promote a speedy and comfortable recovery.