Sleeve Gastrectomy

During a sleeve gastrectomy, the stomach is reduced to a long tubular stomach. As a result, less volumes of food can be consumed. The procedure is performed laparoscopically, removing about three-quarters of the stomach. The passage from the stomach to the small intestine (pylorus) remains intact and therefore, the risk of dumping complaints is very low.

A variation of this procedure is the “banded sleeve gastrectomy”

A part off patient’s insufficient adaptat to the operation (snacking, too frequent meals, i.e.), a dilatation of the pouch is often the basis of this weight gain. By placing a ring (Minimizer) high on the pouch, we try to prevent early expansion of the pouch. Longitudinal studies (5 years of follow-up) show the same good results, comparable with the “banded gastric bypass” with 75% loss of excess weight.

Results

The results are comparable to those of the gastric bypass. Studies on large series of patients have shown that on average, three quarters of the excess weight are lost a year after the procedure.

For example, in a patient with an excess weight of 50 kg, this means a weight loss of around 35 kg after 1 year. After 5 years, weight loss would still be 60% of the overweight. Of course, these results also depend on the adherence of the patient to the prescriptions.

Evolution of weight loss (BMI)

This graph shows the evolution of BMI over 5 years in which the sleeve gastrectomy is compared with the banded sleeve gastrectomy. Weight loss during a banded sleeve gastrectomy is much better and more stable even after 5 years.

Other beneficial effects

More than 80% of comorbidities (disorders due to the obesity) disappear or improve as a result of this procedure: high blood pressure, type II diabetes, back pain, sleep apnea, depression and others.

In more than 60% of patients with type 2 diabetes, diabetes disappears without any treatment after 10 years. In other patients, there is a decrease in medication.

Advantages of sleeve gastrectomy

  • Beneficial effect on diabetes, sleep apnea, blood pressure, etc.
  • Sensation of fast satiation.
  • Decreased feeling of hunger.

Disadvantages of sleeve gastrectomy

  • This procedure is irreversible.
  • Possible expansion of the stomach due to overeating.
  • Due to the absence of dumping, sweat eating is possible with reduction of weight loss and eventual weight regain.
  • Symptoms of reflux (burning sensation) may occur with possible inflammation of the distal esophagus.