Sleeve Gastrectomy Surgery
Vertical Sleeve Gastrectomy (Gastric Sleeve)
The Sleeve gastrectomy, also called a “Sleeve” or “Gastric Sleeve”, is a hybrid operation. 80% of the stomach is completely resected and removed from the body. The resection is done along the long axis of the stomach so that the new stomach looks like a banana or like a hockey-stick. The new stomach is a very stiff, tubular, narrow stomach that does not let you eat very much food. The portion of the stomach that is removed is the most elastic portion of the stomach.
For many people, the gastric sleeve surgery is appealing because it is not quite as drastic as a bypass and yet it does not involve an implant like the banding procedure. With the sleeve gastrectomy, there is NO dumping syndrome because there is no re-routing of the intestines.
The sleeve gastrectomy is a metabolic surgery. By removing this part of the stomach, we dramatically alter the neuro-hormonal pathways that control the sensation of hunger and the way our body manages the calories that we put in.
There is a hormone which is made primarily in the part of the stomach that we remove. This hormone is called ghrelin. It is a primary driver in the hunger pathway and with the dramatic drops in ghrelin levels seen after the gastric sleeve surgery, we see a commensurate decrease in hunger! We also see up-regulation of a hormone called GLP1. This hormone is involved with our body’s control of glucose. In fact many of the newer diabetes treatment medications are designed to up-regulate GLP1. The sleeve surgery does this without medications and in this way can cause remission of diabetes and metabolic disease quite rapidly.
With the sleeve gastrectomy surgery, the weight loss results are very similar to a bypass surgery for the first year or so. It is usually covered by insurance.
What to Expect post-op with Gastric Sleeve Surgery
With a sleeve, you should expect to stay in the hospital 1 or 2 nights. Your immediate goals in the hospital after surgery are to walk frequently and to do breathing exercises using a special tool called an incentive spirometer. In addition, we will give you some blood-thinning medication to prevent blood clots. Patients are usually allowed to begin to sip on liquids a few hours after surgery.
Post-op day 1 Goal: Transition completely from IV fluids and medications to oral intake and liquid pain medicine. We use a special 3 day local anesthetic in the tiny incision sites so the pain will be very well controlled.
Day 2: Most patients are ready to go home today. Don’t feel bad if you are not quite ready though. We realize that everyone is different, and we want you to be completely comfortable before we let you go home.
There are usually about 5-6 follow up visits in the first year. Patients are expected to start medial weight loss programs in our office beginning 6 months after surgery. Our 2 year post-op results for patients who have sleeve gastrectomy suregery are significantly better than national averages.