Gastric Sleeve*

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How the Gastric Sleeve Operation Works*

The primary means by which the Gastric Sleeve operation works is by removing the storage capacity of the stomach. Because of this the patient has a subjective feeling of fullness with a much smaller amount of food. This means that he/she can more easily control his/her hunger and stop eating sooner.* The new capacity of the narrower stomach is hard to measure but likely is between 4 and 8 ounces.

Several studies on the amount of time it takes the new stomach to empty are somewhat in conflict, and therefore, the stomach transit time is of doubtful importance. A slower transit time would improve the feeing of fullness (satiety), but a faster transit time could help generate several intestinal hormones that have a negative affect on hunger, specifically PYY and PIP. These are generated in the duodenum – the first part of the small intestine – and their action is not yet well understood.

One intestinal hormone shown to be favorably affected by the gastric sleeve operation is Ghrelin. This is produced in the part of the stomach that is removed, and therefore, drops to a low level in the bloodstream after the operation. Ghrelin is important for how the brain perceives hunger, and low levels cause the patient to be less hungry – turning down the drive to take in too many calories.

Why a Gastric Sleeve Operation May Be Right For You

Because of a combination of the above factors the Gasrtric Sleeve operation has demonstrated excellent weight loss for almost all patients.* Its ability to produce very good weight loss – as good or better than the LapBand – with no implantation of a foreign body, and the ability to avoid some of the complications related to the rearrangement of the intestinal tract as seen with the gastric bypass makes the Gastric Sleeve a very attractive option for weight loss surgery for the future.*

Risks Associated with the Gastric Sleeve Operation

While complications associated with the Gastric Sleeve operation are rare, Dr. Marvin wants you to be aware of potential issues that may need to be addressed after the procedure. Watch the video below to learn more about the gastric sleeve operation as well as risks associated with the procedure.

Laparoscopic Sleeve Gastrectomy

Fact Sheet

Laparoscopic surgery – not open
Several (5) small scars
Less pain than open surgery
Quick recovery

  • Immediate activities of daily living
  • Return to work 7-10 days
  • No lifting > 20 lbs or strenuous activity 3 weeks

Change from big-baggy stomach to narrow non-stretchy stomach

BMI 35-40 with comorbidities

  • Diabetes
  • High blood pressure
  • High cholesterol or triglycerides
  • Obstructive sleep apnea
  • Family history of heart disease or stroke

BMI > 40 with or without comorbidities
BMI 30-35 if favorable surgical candidates and acknowledge that he/she does not meet the 1991 NIH criteria for weight loss surgery and that the benefit to risk ratio is unknown

Deformity or pathology of the esophagus or stomach – e.g. esophageal strictire
Previous Bariatric Surgery – e.g. gastric bypass
Previous gastric surgery – e.g. Nissen fundoplication

Surgical risk
Limited missed work
Must remove part of the stomach (humans in 21st century do NOT need a high capacity stomach)

Low sugar clear liquids 4 hours -7 days
Low sugar low fat soft diet 7-28 days
Low sugar low fat high protein diet after 28 days

Not reversible, but…
Revision to other procedure is possible – gastric bypass, duodenal switch
Amenable to laparoscopic “re-sleeving” or ESG

Bleeding

  • Transfusion < 0.5%
  • Re-operation <0.2%

Leak with peritonitis (re-operation) < 0.5%
Narrowing requiring endoscopy with balloon dilation – 5%
Conversion to LRYGB (late) < 0.5%
Vitamin and mineral deficiencies – rare after 12 months

Patients start an exercise program before LSG
Interruption approx. 3 weeks by procedure
Minimum of 150 minutes a week of some activity

  • Measure the exercise – steps/distance/time
  • Set goals
  • Exercise with someone else – family, co-worker

General Anesthesia in Operating Room
20-40 min
Recovery with Overnight Stay or 6 hour discharge at ASC

Eat less*
Feel full faster*
Less hunger due to favorable effect on intestinal hormones*
Weight loss*

* Results will vary by person and are based upon the patient, the surgery type and the compliance with the aftercare program. As with any medical procedure or surgery, there are specific risks and possible complications. The testimonials, statements, and opinions presented on our website are applicable to the individuals depicted. Results may not be representative of the experience of others. Testimonials are voluntarily provided and are not paid, nor were they provided with free products, services, or any benefits in exchange for said statements. The testimonials are representative of patient experience but the exact number of pounds lost and experience will be unique and individual to each patient.

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