Gastric Sleeve

What is Gastric Sleeve?

Gastric sleeve, or vertical sleeve gastrectomy (VSG), is a restrictive weight loss surgery available to patients who were unable to achieve a healthy weight using traditional weight loss methods. Gastric sleeve is regarded as one of less invasive weight loss surgeries and is different from gastric bypass or duodenal switch. Unlike gastric bypass or duodenal switch, gastric sleeve does not involve rerouting of the digestive tract. As a result, patients who undergo the procedure do not experience the serious side effects associated with nutrient malabsorption such as dumping syndrome (rapid emptying of the digestive tract resulting from eating foods high in refined sugar, dairy, or certain fats).

How Does It Work?

As mentioned above, gastric sleeve is purely a restrictive procedure; meaning, it limits the amount of food a patient can eat. The restriction is achieved by surgically decreasing the stomach’s volume, or in other words, removing 60-85% of the stomach. The “new” sleeve shaped stomach that is left, can hold approximately 3 to 5 ounces of food, forcing patients to eat smaller portions and limit their daily caloric intake. The portion of the stomach that is removed also contains hunger hormones – the lack of hunger hormones also contributes to the decreased food intake after surgery. Following the procedure, patients must follow a strict diet in order to let the “new” stomach heal. The initial diet progresses in stages from clear liquids to solids over the period of five weeks. Once the healing process is complete, it is recommended that patients follow a higher protein diet with vegetables, fruit and small amounts of whole grains. . Due to the decreased volume of the stomach, patients need to adjust the way they eat in order to achieve the most optimal weight loss and stay healthy.

How Is Gastric Sleeve Different Than The Lap-Band?

Both Lap-BAND and gastric sleeve work on the same principle of limiting patients’ portion sizes and therefore allowing easier weigh loss. The main difference between LAP-BAND and gastric sleeve is that gastric band does not involve any cutting or stapling of the stomach and is fully reversible. Gastric sleeve involves permanent removal of a major part of the stomach and cannot be reversed. Even though the band doesn’t require cutting or stapling, it does require an elaborate follow up process which is not necessary for the gastric sleeve patients. In addition, the success of the band is largely dependent on achieving the optimal restriction via ancillary procedure, lap-band adjustments or fills. Following gastric sleeve, patients do not need any additional procedures or visits with the surgeon. The only recommended follow up visits following gastric sleeve are periodical appointments with the bariatric dietitian.

How Is Gastric Sleeve Performed?

Initially, the gastric sleeve was used as a first step toward gastric bypass surgery. It was intended for patients too heavy to undergo the full gastric bypass surgery in one surgery. Fortunately, in many cases, gastric sleeve turned out to be more effective than expected. It was in fact so effective that now it is performed as a stand-alone weight loss surgery option. The best thing about the gastric sleeve is that it is much less invasive than the gastric bypass, but allows the same weight loss results. In addition, gastric sleeve allows restriction without an implant or elaborate maintenance.

Like most weight loss surgeries, gastric sleeve is performed laparoscopically under full anesthesia. The surgeon will begin the surgery by making five small incisions in your abdomen – with four of them less than ½ inch and the fifth one inch long. Once the surgeon has access to the stomach, he will clamp the stomach with a surgical stapler.

The stapler will simultaneously cut off about 60-85% of the stomach and seal the remaining part. The new banana or sleeve-shaped stomach will be able to hold approximately 5 ounces of food. The excised part of the stomach will be removed out of the abdomen. The gastric sleeve surgery usually takes between 60-90 minutes.

Recovery

When you wake up after the surgery you will feel groggy from anesthesia, but your stomach won’t feel any different than before the surgery. Immediately after the procedure, you may not even feel the incisions; nevertheless, it is expected for you to feel a little sore once the anesthesia wears off. Once you are fully awake and the recovery nurse clears you, you will be able to go home with your care taker. We ask you that after you go home, someone stays with you for the next 48 hours if you needed any assistance. Most of your recovery will concentrate around the diet. Following the surgery you will slowly progress from clear liquids to solid foods over the period of five weeks. The first week following the procedure will be the most restrictive in terms of diet. Your bariatric dietitian will be there to guide you throughout the process of advancing your diet. .