Laparoscopic Sleeve Gastrectomy Surgery

(click here to see the vertical sleeve gastrectomy in pictures!)

This is a gastroplasty but unlike earlier gastroplasties, with the vertical gastric sleeve, as much as 95 percent of the stomach is stapled off and removed from the body. (It states that 60% of the stomach is stapled off and removed on obesity-help but from early weight loss results, they had to begin taking most of the stomach to achieve sufficient weight loss).

So is it effective? Questionable according to one weight loss surgery surgeon who says he has placed lap bands in several vertical gastric sleeve patients who failed to lose weight after the original surgery.

Is it safe? Patients apparently, suffer similar repercussions to those connected with other WLS surgeries such as vomiting, pain, heartburn and stomach ulcers according to the NIH gastric sleeve website. One repercussion listed on the NIH gastric sleeve site is "Scarring inside your belly that could lead to a blockage in your bowel in the future."

And so far, little to no long term information about repercussions can be found on the web.

Gastrectomies seem safer but this may not necessarily be accurate. The following 30 year patient had a vertical gastroplasty and still retained most of her stomach which is not true in the case of the gastric sleeve, but Vicky's stomach didn't work well at all (to put it mildly) and she suffered many other repercussions additionally: Vicki's WLS story

Gastrectomy is a combination of two Latin words: gastro, meaning “stomach,” and -ectomia, which means “to cut out.”

Advantages

It may be safer for the long term than the gastric bypass or duodenal switch procedures
The stomach valve is retained however there is so little left of the stomach, food may still get stuck going down, in the esophagus or the remnant stomach. Once it's stuck, it may require a hospital trip to restore flow.
Although they advertise no vitamin deficiencies with this procedure, this may not be accurate - in truth, they really have no long term data on it (and often are not in a rush to obtain such data which is usually not positive) and the many vitamins and proteins digested in the stomach may be poorly or not digested at all in other parts of the gut.

Risks

This is a new procedure and the long term information always takes many years to be released publicly
Patients have complained with perforation of the stomach with this procedure as a longer term repercussion.
The gastric sleeve cannot be reversed - as much as 95% of the stomach is cut away and discarded. (In other to cause significant weight loss, the procedure had to be modified to remove most of the stomach.)
Since the remnant stomach is very small, it likely does not work sufficiently to digest proteins and fats (these are mostly digested in the stomach), thus protein deficiency may be a repercussion
Acid reflux is common
In the long term, the risk for a herniated stomach or distention of the esophagus is substantial. Some patients have complained that the tiny part of the stomach left can "twist", causing a lot of pain and problems and likely requiring additional surgery.
Will likely need vitamin B12 shots
Complications can occur with the sleeve, such as leaks or bleeding.
Many foods that you eat now may cause discomfort, nausea or vomiting after your surgery.
Any WLS puts you at higher than normal risk of developing gallstones and gallbladder disease.
Unlike the lap band, the amount of restriction is not adjustable. If you need a revision, it's another risky surgery but even if the patient becomes ill, the stomach can not be restored.
With any weight loss surgery, you may not lose much weight unless you diet and exercise. That's why long term follow up is important.

NOTE: Since this is a reasonably new procedure, some insurance companies may not cover this surgery. Also, there is a lack of published evidence for sustained weight loss beyond 3 years however even with WLS surgeries on which studies exist, the evidence suggests that gastrectomy patients do NOT retain much weight off. The Swedish Obesity study reported at the 10 year point after gastric bypass and VBG, the average retained weight loss was 16 percent of the original weight and that only 35 percent of those with diabetes were still "disease free"

(If there are any gastric sleeve patients who would like to tell their story, fill out our contact form here and I'll get in touch with you)