The sleeve gastrectomy is a surgery only on the stomach (it is only a restrictive procedure) and does not involve any surgery on intestine (which would make it malabsorptive). Sleeve gastrectomy has also been called partial gastrectomy and vertical sleeve gastrectomy.It basically consists of making a stomach that looks like a pouch into a long tube; therefore the name “sleeve”. The sleeve gastrectomy (SG) removes two-thirds of the stomach, which provides for quicker satiety (sense of fullness) and decreased appetite. The smaller stomach pouch restricts food intake by allowing only a small amount of food to be eaten at one time. After the separation of the stomach into a smaller tube, the remainder of the stomach is removed. The valve at the outlet of the stomach remains. This provides for the normal process of stomach emptying to continue which allows for the feeling of fullness.
SG is now an established first procedure (or first stage of a two part surgery) to prepare the obese patient for biliopancreatic diversion or gastric bypass. It is also used as a single stage procedure. There is no anastomosis or new connections made between the stomach and small intestine in this procedure. There is no rerouting of the intestine. There is no malabsorption. There is no dumping syndrome. The Sleeve Gastrectomy is believed to have an advantage over the Adjustable Gastric Band due to removal of the part of the stomach that produces the hormone (Ghrelin) that controls the desire to eat. The potential complications of the operation on average are typically less than 0.5% compared to 2%-3% in a combined procedure.
Why choose the Sleeve Gastrectomy?
The sleeve gastrectomy has the following advantages:
It does not require the implantation of a foreign body such as a silastic ring used in gastric banding.
The procedure mechanically decreases the size of the stomach but also decreases the secretion of the hormone, ghreliin, which is responsible for the feeling of satiety (fullness).
The procedure offers the benefit of initially decreasing the body weight in the severely obese patient to prepare this patient for a staged procedure or other surgery at a later time.