Great! You're still reading! While bariatric procedures can help to dramatically change your life for the better, they aren't risk free. Some people are uncomfortable with the idea of a foreign object inside their body, as in gastric banding. Don't worry if gastric bypass was intimidating to you either though, gastric sleeve is another minimally invasive procedure that does not involve bypassing part of the intestine. So like banding, it also does not carry the risk of vitamin deficiency that bypass does. This is also a suitable option for those with Crohn's disease, anemia and some other medical conditions that disqualify you from bypass. Ready to hear more? Great, let's get down to business.
Name of surgery: Gastric sleeve or sleeve gastrectomy.
Medical criteria: BMI of 40 or more where diet, exercise and medicine have been unsuccessful (occasionally 35 or more with medical ailments such as Diabetes Type 2); Extensive screening process that will evaluate your psychological status (depression, sexual abuse, eating disorders, etc.) which will not disqualify you from your bariatric surgery, but it may postpone it.
They also will review your medical history looking for risk factors that could make surgery unsafe for you and have you undergo a physical exam and lab work.
If you are a smoker, you will be required to stop smoking one month prior (and continue to be smoke-free for at least one month after) surgery in order to reduce the risk of post-surgical risks.
Brief description/How it works: Gastric sleeve can be performed laproscopically and removes approximately 85% of the stomach, including the portion that produces grehlin, the hunger stimulating hormone. The remaining 15% is a long tube resembling a sleeve, which is where the name is derived. This portion continues to function normally, so there are no food restrictions as with bypass.
While there is no need for adjustments after the surgery (very common with banding), you should be aware that the gastric sleeve is NOT reversible, so it truly is a lifetime decision. Be sure to check with your surgeon as to what the remaining capacity of your sleeve will be. It ranges from 60cc to 150cc.
Gastric sleeve also can be used as the first step procedure in cases where gastric bypass or duodenal switch are too risky before a significant amount of weight loss (in patients with an initial BMI of 50+). In this case, the second surgery -gastric bypass or duodenal switch -- is done somewhere between 6 to 18 months post-op from the gastric sleeve.
Cost: $10,000+. As this is a newer surgery, not all insurance companies will cover the sleeve, but be sure to check as its popularity is increasing every day and more insurance companies are covering it.
Recuperation time: 6 weeks. It is not uncommon to spend a night or two in the hospital after surgery. You will be required to follow a liquid diet for the first week post-op, followed by two weeks of pureed food. After that you can eat solids again, but it will take the full six weeks for the stomach to heal where it was stapled back together. While gastric sleeve has a low rate of complications, a possible complication is leakage or bleeding from the staple line.
Average weight loss: On average, 30% to 50% of excess body weight will be lost within the first year.
Long-term success rate: Gastric sleeve data is restricted to 2 year and 6 year post-op studies because it is a relatively new procedure. However, it does show comparable results to other bariatric procedures. The 6 year success rate shows that greater than 50% of the excess body weight remains lost. Be aware that overeating will cause the stomach (sleeve) to stretch, which will cause weight gain.
Previous article: Is Gastric Banding the Right Surgery for You?
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You can read about my decision to have weight loss surgery back in 2003 and my journey to maintain a lifetime of obesity disease management since that time. My wish is to help you on your own journey of lifetime obesity disease management with shareposts along the way to help you navigate that journey successfully.
Published On: December 20, 2011