Gastric Sleeve Procedure


Gastric Sleeve Surgery, also known as Gastric Sleeve Resection or Vertical Sleeve Gastrectomy (VSG), is a technique that radically reduces the size of the stomach, reshaping it into a cylinder, roughly the size and shape of a banana.

In most VSG procedures, about 85% of total stomach volume is removed leaving roughly 60-100 ml of remaining stomach capacity.

Like gastric bypass, the technique promotes weight loss by limiting food intake, but achieves this without intestinal rerouting. Nerve endings within the stomach remain intact, while hunger stimulating hormones are radically reduced.

AlthoughVSG has less historical data to support its efficacy, it is becoming more popular among patients with lower BMI (<37), or where traditional gastric bypass may be inappropriate.

Reasons for the attractiveness of VSG are its relative simplicity, that it can be performed laparoscopically and that no foreign objects are used like with Gastric Banding. If post-op endoscopic inspection is required, the entire upper digestive tract remains accessible. Longer term, a sleeve patient’s compliance and weight loss is helped because the absorption of nutrients, vitamins, minerals and drugs is not altered.
And finally, unlike Gastric Bypass, there is no risk of Dumping syndrome.\

If that weren’t enough one a number of recent studies confirm that VSG is a safe and effective treatment for the seriously overweight. For example between August 2004 and December 2007, the weight loss progress of 68 patients was followed to see if VSG was useful at achieving long term weight reduction.

The results were quite encouraging: Gastric Sleeve surgery (VSG) was effective 5 years out with improvements to BMI in the range of 55-60%, combined with significant considerable improvement or even remission of co-morbidities such as diabetes mellitus and hypertension.

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Price: £4900  (5750€)

IS GASTRIC SLEEVE RIGHT FOR ME?

While both gastric bypass and gastric sleeve work in part by reducing stomach volume, there are important differences, which can determine if a patient is a candidate. The biggest difference is that gastric sleeve surgery does not rely on nutrient malabsorbtion for weight loss because there is no re-routing of food.

By contrast, gastric bypass surgery can put patients at risk for conditions such as osteoporosis, anemia, protein and vitamin deficiency. Therefore, patients who undergo gastric bypass surgery must be more attentive to their diet and regularly take vitamins and mineral supplements. Besides malabsorbtion differences;

  • Gastric sleeve surgery removes the hunger inducing hormone, Gherlin.
  • The stomach entrance/exit structure remain intact and unaltered.
  • Gastric sleeve is a somewhat quicker procedure requiring 40-60 minutes.
  • Can be performed on high-risk patients, including those who have had prior surgeries.
  • Since patient’s pyloris is retained, there is no risk of “dumping” syndrome.

Patients should look at their relative obesity (mild, moderate, severe) and at their own ability for long term dietary and lifestyle compliance. The less able a patient is to adjust their eating and activity level, the more severely overweight they are, the more doctors will point them in the more radical direction of Gastric Bypass.


PROCEDURE FAQ

How much weight can I expect to lose with Gastric Sleeve vs Gastric Bypass?
Patients have been shown to lose an average of 66% excess body weight in 3 years , this is slightly less than what you can expect with Gastric Bypass. However, a 2/3 excess weight loss is quite significant and when combined with its other advantages, Gastric Sleeve can be your best option.

How long does it take to recover from the Gastric Sleeve (VSG) procedure?
Although recovery times do slightly vary, you can expect to leave the hospital after 2 to 5 days. After that, full recovery and resumption of normal activities may take up to 8 weeks.

What are the risks and complications?
As with any surgical procedure, there are potential risks and complications that can occur. The main problems doctor are alert for are suture leakage, infection, reflux and nausea. Risk of complication of any kind is around 1.5%, mortality <0.5%.

What should I eat after a Gastric Sleeve procedure
Sleeve gastrectomy patients can eat a wide variety of foods, in small portions. A typical meal might includes protein-rich foods such as lean meat, eggs, low-fat dairy, some starches like potatoes, whole grains, and of course always healthy fruits and vegetables.
Also you must stay away from high density, high volume foods such as breads, tough meat or raw vegetables, anything that could block the stomach opening.

Am I able to get pregnant after Gastric Sleeve surgery?
A full term pregnancy applies considerable metabolic and hormonal stress on the female body. For that reason the current recommendation is that patients wait 12-18 months before beginning a pregnancy. Nutritional intake and body metabolism must stabilize to ensure a safe and healthy pregnancy


LIFE AFTER GASTRIC SLEEVE

It’s important that you follow the recovery and maintenance diet given to you by our nutritionist. The capacity of your stomach is reduced so eating solid foods too soon or foods high in sugars and fats will likely result is some unpleasant side effects. Better to eat only small quantities, chewed well or completely mashed.

Equally important as the amount, is the schedule. Patients are advised to eat at least five times a day. Multiple meals broadens the variety of food and helps prevent binge eating since you are less likely to succumb to hunger cravings.

Supplementing more restricted food intake you will be taking multivitamins to get all of the nutrition you need. Our dietitian will specify which vitamins you need.

One of the unanticipated ways sleeve surgery changes food intake is the problem with ingesting liquid and food at the same time. Reduced stomach capacity means it´s better to drink between or before meals. However, when you to take in fluids be sure they are lower calorie liquids such as tea or coffee, diluted fruit juice, low fat milk or still mineral water.

Many patients are worried about pain. Post-op pain should slowly improve each day.
By the second month you should be off of all pain medications. At that point, if you’re still experiencing pain, it should be brought to your doctor’s attention.

And finally, there is the challenge of regular exercise. It begins with a commitment to exercise whenever you can. Not only should you not lay down or rest after eating, you should get back to walking as soon as possible. Couch slouching won’t do because assuming a horizontal position makes reflux more likely.