Sleeve Gastrectomy
With a sleeve gastrectomy the stomach is reduced to a long tubular stomach. As a result, less food can be eaten. The procedure is performed laparoscopically. Three quarters of the stomach are removed. The part of the stomach where food enters the small intestine (pylorus) remains intact, so the risk of dumping is very low.
Banded sleeve gastrectomy
A variant is the “banded sleeve gastrectomy”. As with other weight-loss operations, a certain number of patients regain their weight after this operation. In addition to the patient’s own causes (snacking, eating too often, etc.), a dilatation of the pouch is often at the origin of this weight regain. By placing a ring (Minimizer) on the pouch close to the esophagus, we hope to avoid early pouch expansion. Longitudinal studies (5 years’ follow-up) have shown comparable good results with banded gastric bypass, with 75% loss of excess weight.
Results
Weight loss
Results are comparable to those of gastric bypass. Studies on large series of patients have shown that, on average, three quarters of the excess weight is already lost one year after the procedure.
For example, in a patient with 50 kg of excess weigth, this means a weight loss of 35 kg after 1 year. After 5 years, the weight loss would still be 60% of the excess weight. Of course, these results also depend on the cooperation of the patient, who must comply with the prescriptions.
A banded sleeve allows patients to lose 15% more weight after 5 years, with a much lower risk of re-operation because of weight issues.
Other beneficial effects
More than 80% of co-morbidities (diseases caused by obesity) disappear or improve following this procedure: arterial hypertension, type II diabetes, back pain, sleep apnea, depression, and others.
In more than 60% of patients with type 2 diabetes, the diabetes disappears without any treatment after 10 years. In the other patients, there is a reduction in the use of medication.
Advantages of sleeve gastrectomy
- Beneficial effect on diabetes, sleep apnoea, blood pressure, etc.
- Rapid feeling of satiety.
- Reduced sensation of hunger.
Disadvantages of sleeve gastrectomy
- The operation is irreversible.
- Possible distension of the stomach due to overeating.
- The absence of dumping makes it possible to eat sweets. Weight loss may be reduced as a result, and even regained.
- Reflux symptoms (burning sensation) may worsen or develop with inflammation of the lower esophagus.