The sleeve gastrectomy, also called a vertical gastrectomy, restrictive vertical gastroplasty, or vertical sleeve gastrectomy, is one of the newer weight loss surgery procedures.
During a sleeve gastrectomy, Dr. Stewart divides the stomach vertically with a line of staples and removes a large portion of it using minimally invasive (laparoscopic) surgery. The remaining stomach is a long tube shaped like a very slender banana. It can hold between 1 and 5 ounces.
The surgery helps you lose weight by restricting the amount of food (and, therefore, calories) that can be eaten at one time. The part of the stomach that is removed secretes a hormone called ghrelin which is responsible for appetite and hunger. Because of the decreased amount of ghrelin, sleeve gastrectomy patients experience a loss or reduction in appetite. This loss of appetite also helps them achieve weight loss.
The remaining tube-shaped stomach has a limited ability to stretch and therefore, resists the amount of food you are able eat. This resistance to stretching creates feelings of fullness when you eat very small amounts of food and that feeling often lasts for an extended time.
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Why use the Sleeve Gastrectomy?
The sleeve gastrectomy is a surgical option that offers advantages over other laparoscopic weight loss options, like the LAP-BAND and Roux-en-Y, for some patients.
The sleeve gastrectomy is most similar to the lap-band procedure in that it is a purely restrictive procedure that causes weight loss by reducing your stomach’s capacity to hold food. Unlike the lap band, however, the sleeve gastrectomy does not require periodic adjustments. With the sleeve gastrectomy, there is no band wrapped around the outside of the stomach that can slip or erode surrounding tissue.
The tube portion of the stomach that remains after a sleeve gastrectomy is more resistant to stretching because it is formed from a very muscular portion of the stomach. This makes it less likely that chronic overeating will increase your stomach’s capacity over time. However, if sleeve gastrectomy patients consume a lot of soft, high calorie foods like ice cream, milkshakes, and creamy cheeses, it is possible for them to defeat the benefits of the procedure and slow their weight loss. However, unlike the LapBand procedure, the sleeve gastrectomy is not reversible.
The Roux-en-Y procedure helps people lose weight through a combination of reduced stomach capacity and intestinal bypass that leads to nutrient malabsorbption. The sleeve gastrectomy does not include an intestinal bypass, so it avoids the issues of nutrient deficiencies, marginal ulcers, and intestinal obstructions that may occur in intestinal bypass. The sleeve gastrectomy causes much less dumping syndrome than does the Roux-en-Y because the pylorus (the sphincter valve that controls flow of food out of the stomach into the intestine) remains intact.
What Results Can I Expect?
Follow up information collected on sleeve gastrectomy patients at two and six years after surgery shows that the amount of weight people lose and keep off following a sleeve gastrectomy is similar to that seen with LAP-BAND surgery and in some cases approaches results reported with Roux-en-y gastric bypass.