Gastric Sleeve Resections

Emil Graf, MD, is a bariatric surgeon on staff at Banner Gateway Medical Center.

Question: I’ve been considering bariatric surgery for some time and would like to learn more about gastric sleeve resections. Will you please explain what a gastric sleeve resection is and how it is performed?

Answer: Most people are aware of gastric bypass surgery and gastric banding as popular options for bariatric surgery. However gastric sleeve resections have grown in popularity over the last five years. Laparoscopic sleeve gastrectomy was originally the first stage for duodenal switch operations. Surgeons began noting however that weight loss results were excellent with sleeve gastrectomy alone. In addition, surgeons noted that most medical problems associated with obesity also resolved after sleeve gastrectomy alone.

Gastric sleeve resection involves removing approximately 65 to 80 percent of the stomach. A narrow tube around 1.5 centimeters in diameter is inserted into the stomach and the sleeve is created around the tube. The resection begins approximately four to six centimeters from the end of the stomach and extends around the tube up to the beginning of the stomach near the diaphragm.

The stomach at the completion of the operation resembles a narrow tube. As you would expect removing this much of the stomach significantly reduces the amount of food that can be consumed. More importantly most of the hormones that stimulate your appetite are produced in the portion of the stomach that has been removed. Therefore the drive to eat and drink is significantly reduced as well.

Like gastric bypass, gastric sleeve resections are performed laparoscopically usually through five small incisions. Patients generally spend one or occasionally two nights in the hospital. Postoperatively patients are on a full liquid bariatric diet for two weeks which is then slowly advanced. Most patients are comfortable returning to work two weeks after surgery.

The advantages to sleeve gastrectomy include lower complication rates compared to gastric bypass, and significantly greater success for weight loss and resolution of medical problems when compared to gastric banding. Potential risks, which are associated with any surgical procedure, include the possibility of blood clots, leaking or bleeding at surgical sites, infection, and nausea after surgery.

It is important to realize that regardless of the bariatric procedure performed, bariatric surgery is only a tool. It is not a magic pill that will automatically resolve your medical issues take the weight off. Weight loss requires commitment and compliance with exercise plans, diet, and other lifestyle changes that will lead to healthy and sustained success over the long term.

If you are considering bariatric surgery, speak with your healthcare provider to determine if you are a candidate and which option is best for you.

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