A gastric sleeve surgery (sleeve gastrectomy) is a restrictive procedure to help you with weight loss. It restricts the amount of food you can eat by reducing the size of your stomach.

In sleeve gastrectomy surgery your surgeon will remove a large portion of your stomach leaving a new, smaller stomach about the size of a banana. Your new stomach size limits the amount of food you can eat. You’ll only be able to eat a small meal and you will keep a feeling of fullness for longer. Food will be absorbed in the normal way as your intestines aren’t by-passed, as in a gastric by-pass.

1. What is a gastric sleeve surgery?

In gastric sleeve surgery your surgeon creates a small stomach “sleeve” using a stapling device and the rest of your stomach is permanently removed. Your stomach’s size will be reduced by approx 75%.

It can be a single procedure for weight loss or it can be the first step before other weight loss surgical procedures, such as gastric bypass.

2. What is involved in a sleeve gastrectomy procedure?

Prior to your gastric sleeve surgery you will be given a general anaesthetic that will put you to sleep.

A sleeve gastrectomy is normally done using a tiny camera called a laparoscope that is placed in your stomach and allows your surgeon to see inside your stomach.

Your surgeon will make two to five small cuts in your abdomen and pass the laparoscope and other instruments needed to perform the surgery through these openings. They will remove a large portion of your stomach and the remaining portions of your stomach are joined together using surgical staples. This creates a long vertical tube or banana-shaped stomach.

The procedure should take between 60 and 90 minutes.

3. The history of the gastric sleeve surgery

Gastric sleeve surgery was first introduced in 1988 as the restrictive part of a bariatric surgery to treat morbid and super morbid obesity called biliopancreatic diversion with duodenal switch (BPD-DS). In these high risk patients sleeve gastrectomy was proposed as the first step of the procedure followed by a second procedure with the gastric bypass or BPD-DS.

Sleeve gastrectomy, the first step in the two-step procedure, showed excellent weight-loss results and led to the proposal of the sleeve gastrectomy as a stand-alone procedure. As a result, since 2003, gastric sleeve surgery  has been offered as a stand-alone bariatric procedure¹.

In 2012, the American Society for Metabolic and Bariatric Surgery (ASMBS) updated its position statement on sleeve gastrectomy as a bariatric procedure, recognising it as both a primary procedure and as the first stage in a two-step surgery².

4. Is a gastric sleeve surgery the right option for me?

If you prefer the idea of a weight loss surgery that will help you lose weight by restricting the amount of food you eat but doesn’t interfere with the absorption of your food and doesn’t involve having a foreign body inside your body then a sleeve gastrectomy might be the best option for you.

You will need to bear in mind that the weight will usually come off more slowly than with other procedures such as gastric bypass, and to lose weight you will need to be committed to following an exercise and eating plan. A gastric sleeve surgery should be recognised as a permanent procedure as it cannot be reversed.

It may be that your BMI dictates that you cannot have another surgical procedure initially and in this instance your surgeon might therefore recommend the sleeve gastrectomy to lose excess weight to enable you to then opt for a second weight loss surgical procedure at a later date.

It is best to talk with your bariatric nurse/surgeon about the weight loss surgery options and the most suitable one for you.

5. Am I eligible for a gastric sleeve surgery?

You will usually have weight loss surgery such as a sleeve gastrectomy if you cannot lose a large amount of weight and maintain the weight loss long term by dieting and lifestyle changes alone; or if you have serious health problems caused by obesity.

This procedure may be recommended if you have a body mass index (BMI) of 40 or more as this indicates you are at least 100 pounds over your recommended weight. It may also be advised for you if you have a BMI of 35 or more and also a serious medical condition that might improve with weight loss. Some of these conditions are sleep apnoea, type 2 diabetes, and heart disease. A gastric sleeve surgery may also be used to treat extremely morbidly obese people (with a BMI of 60 or above).

Your bariatric nurse/surgeon will discuss with you if you are eligible for this type of weight loss surgery.

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