Vertical sleeve gastrectomy, also known as gastric sleeve surgery, is surgery to assist in significant weight loss. During this surgery, the surgeon removes a large portion of the stomach, leaving the stomach to be about the size of a banana. This limits the amount of food that is able to be consumed by making one feel full following a small meal. This type of surgery has become a popular choice for those looking for significant weight loss in a procedure that doesn’t require maintenance and high risks of complication, such as Lap Band surgery.
On January of 2010, United Healthcare was the first insurance company to add gastric sleeve surgery to one of their covered weight loss surgeries. As of 2012, almost all major insurance companies had done the same. Gastric sleeve surgery became the fastest growing weight loss surgery procedure between the years of 2010 and 2015.
You will receive general anesthesia before this surgery. This is medicine that keeps you asleep and pain-free.
The surgery is usually done using a tiny camera that is placed in your belly. This type of surgery is called laparoscopy. The camera is called a laparoscope. It allows your surgeon to see inside your belly.
Why is this surgery done?
This type of weight-loss surgery is an option for those who are morbidly obese, and are unable to lose weight through the traditional methods of diet and exercise. While gastric sleeve surgery is not a quick fix for obesity, it is able to significantly change a patient’s lifestyle. Following the surgery, you must not only limit your diet to healthy foods, but you must also control portion sizes and be physically active. Without these lifestyle changes, you may experience complications and not have the weight loss you hoped for or expected.
Gastric sleeve surgery may be recommended if you have a body mass index of 40 or over, meaning you are at least 100 pounds overweight. A healthy BMI is between 18.5 and 25, with a BMI of over 35 indicating a serious medical condition that may be improves with significant weight loss. Some conditions that may be improved with weight loss include obstructive sleep apnea, heart disease, and type 2 diabetes.
Gastric sleeve surgery is often done on patients who are too overweight to safely go through other types of weight-loss surgery, such as gastric bypass surgery. Some people who have gastric sleeve surgery, may eventually go on to require a second weight-loss surgery.
Before the Procedure
Prior to this surgery, you will have to have tests and consultations with your other doctors. This may include getting a complete physical exam including blood tests, an ultrasound of your gallbladder, among other tests to ensure your health prior to surgery.
You may also need to meet with your doctors to make sure you do not have any other medical problems, such as heart problems, diabetes, lung problems, or high blood pressure. It is also important to complete nutritional counseling prior to the surgery so you know how to eat once the surgery is complete. Classes are offered to help you learn what you should expect after the surgery and the risks and complications that may occur during the healing process.
For psychological benefit, you may consider visiting a counselor to make sure you will be able to emotionally handle this type of surgery. It is important that a counselor is able to determine your ability to make major lifestyle changes after surgery.
If you are smoker, you should permanently quit smoking several weeks prior to the date of your surgery. Smoking not only slows the recovery process, but it also increases your risk of complications.
Tell your doctor prior to surgery if you might be pregnant. Also, disclose all medications, supplements, vitamins, and herbs you take to make sure there are no contraindications.
Your doctor may ask you to stop taking certain medications up to a week before your surgery. This can even include over the counter medications such as ibuprofen and aspirin, as they sometimes act as anti-coagulants.
On the day of the surgery, you will be advised when to stop consuming any foods or liquids, only taking the drugs that the doctor has prescribed for the day.
This surgery takes 60-90 minutes. During this surgery, a surgeon makes 2 to 5 small incisions in the stomach. The surgeon then inserts the scope and the instruments that are needed to perform the surgery through these cuts.
The surgeon is able to view the inside of the patient’s stomach through a camera that is connected to a video screen in the operating room. The surgeon is then able to precisely guide the tools.
During the surgery, the surgeon removed most of the stomach, joining together the remaining portions of the stomach with surgical staples. This creates a vertical tube, or “sleeve” that is then the shape of the stomach.
Unlike other weight loss surgeries, this surgery does not require cutting or altering the sphincter muscles that let food to enter and leave the stomach. After the surgery is complete, the scope and other surgical tools are removed before the incisions are stitched closed.
There are not only risks involved with the surgery itself, but also with the anesthesia involved. Some patients may experience allergic reactions to anesthesia or other medications, as well as breathing problems, infections, blood clots, and bleeding. For the gastric sleeve surgery in particular, some risks include inflammation of the stomach lining, stomach ulcers, heartburn, injury to the stomach or intestines, leaking from the incision, and scarring in the belly that may lead to future bowel issues.
Following this surgery, if you are not strict with diet, you may experience poor nutrition or malnutrition. However, the risk of this with gastric sleeve surgery is much lower than it is with gastric bypass surgery. If you take in more food than your stomach is able to handle following surgery, it may result in vomiting.
Following the Procedure
After recovering for two days in the hospital, you will likely be released to go home. The day after your surgery, you will be instructed to drink clear liquids, followed by a diet of pureed food once you are home.
It is important to be very conscious of your eating following this surgery, as the small pouch that is now your stomach will fill quickly. You will feel full very quickly after eating a small amount.
The weight that is lost with gastric sleeve surgery may not be as much as it would be with gastric bypass. The weight also tends to come off slower with gastric sleeve surgery than it does with gastric bypass. It may take up to three years to lose all of the intended weight.
However, losing this excess weight can improve other health issues you may suffer from. Weighing less should also make life easier, as you are able to more effectively do everyday activities.
It is important to note that this surgery by itself is not a single solution to significant weight loss. It can help you to eat smaller portions of food, but you still need to put in the work for this surgery to be effective and successful. To avoid failure and complications, you need to follow the nutrition and activity guidelines that are provided to you.
Benefits Over Other Bariatric Surgeries
Gastric sleeve surgery reduces the hunger inducing hormone called ghrelin. This is done when a portion of the stomach that is responsible for the production of this hormone is removed. While the reduction in hunger happens for most patients, it does not happen for everyone.
This procedure offers a shorter operating time than other surgeries such as gastric bypass surgery, and it does not incorporate the complicated task of re-routing the intestines.
Patients who have other forms of bariatric surgery often experience dumping syndrome, which refers to a group of symptoms including abdominal pain, weakness, and very rapid bowel evacuation that occurs after eating. This does not happen in patients who undergo gastric sleeve surgery.
After gastric sleeve surgery, the opening from the stomach into the small intestine remains intact, which allows sugars to have time to digest, because the intestines remain in tact. Additionally, no adjustments are needed during this surgery and no foreign objects are left in the body. While these things happen with other forms of bariatric surgery, they require regular adjustments and doctor visits to maintain the effects of the procedure. For example, the Lap Band requires a patient to have regular adjustments to the band, and it leaves a silicone band across the upper portion of the stomach.
While gastric bypass weight loss is much more rapid, often occurring within one year, Lap Band surgery and gastric sleeve surgery result in a gradual weight loss. Because this requires serious lifestyle changes over a long period of time, the effects are likely to stick and someone getting this surgery is less likely to regain the weight.
Once this procedure has been completed, it cannot be reversed. This is a commitment that you need to seriously consider before going under to knife to understand if you are ready to make the vast change in your life.
Gastric Sleeve vs. Lap Band Surgery
Surgeons want their patients to be successful in their weight loss journey. Many surgeons have performed lap band surgery that has not resulted in great amounts of weight lost. This isn’t to say that the band is not effective, but some patients are unable to adapt to the new lifestyle that is needed in order for this surgery to be effective.
The percentage of patients who fail to lose weight with gastric bypass or gastric sleeve surgery is significantly lower than those who get lap band surgery. It is important to remember, however, that once the weight is lost, it’s up to you to continue your healthy habits that will keep the weight off.
For a surgeon that is trying to help, it’s difficult to identify patients that are truly dedicated to implementing exercise and healthy, nutrient dense foods into their diet.
Tools for Success
Use information that is available to you online, such as apps on your smart device to track your diet and exercise, and books to keep you on the right track to success. It may also be helpful to join a forum with other patients who are going through the same surgery. This is a good way to relate to other people, ask questions, and continue to be motivated throughout the weight loss journey.
You can also join a Facebook group, which makes it easy to speak to people anonymously about your struggles. You can make this private so your facebook friends are unaware you are in one of these groups.
Local support groups are also available and are a great way to make connections and friends and to keep yourself committed to your goal. Let them keep you accountable as you continue to be healthy and lose weight.
Gastric sleeve surgery is a long process that takes dedication. It requires a commitment to turning away from unhealthy habits in order to keep the weight off. It is not an easy route to take, and it requires dedication, perseverance and hard work. It is important throughout the process to remember to celebrate your small victories.
Gastric sleeve surgery is only a tool to help you lose weight, so you can live a healthy lifestyle.
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