VERTICAL SLEEVE GASTRECTOMY OR GASTRIC SLEEVE

Vertical sleeve gastrectomy or gastric sleeve (also known as sleeve gastrectomy, greater curvature gastrectomy, parietal gastrectomy, gastric reduction and vertical gastroplasty) is a surgical weight-loss procedure in which 85% of the stomach is removed without bypassing the intestines or causing any gastrointestinal malabsorption. The open edges are then attached together (often with surgical staples) to form a sleeve or tube with a banana shape. The procedure permanently reduces the size of the stomach and is seen as an alternative to a Roux-en-Y gastric bypass. The procedure is performed laparoscopically (laparoscopic sleeve gastrectomy) and is irreversible.

A candidate for gastric sleeve is someone who is extremely obese with a BMI of 35 or more and who is a high risk patient for gastric bypass or duodenal switch.

A two-stage procedure is performed: the first is a sleeve gastrectomy, and the second is a conversion into a gastric bypass or duodenal switch. Patients usually lose a large quantity of their excess weight after the first sleeve gastrectomy procedure alone, but if weight loss ceases the second step is performed.

For patients that are obese but not extremely obese, sleeve gastrectomy alone is a suitable operation with minimum risks. Some surgeons even prefer it over gastric banding, because it eliminates the need of having to insert a foreign body.

ADVANTAGES

An advantage of gastric sleeve as seen by many patients is that the new stomach continues to function normally and so there are far less restrictions on the foods which they can consume after surgery even though the quantity of food intake will be considerably reduced. Another advantage is that a major portion of the stomach which produces hormones responsible for stimulating hunger is removed from the digestive system. The biggest advantage of the gastric sleeve is that it does not involve any bypass of the intestinal tract and therefore patients do not suffer from the complications of intestinal bypass such as intestinal obstruction, anemia, osteoporosis, vitamin deficiency and protein deficiency.

RISKS AND COMPLICATIONS

Some of the risks and complications involved are:
•  gastric leakage related to stapling
•  dilation of the sleeve
•  post-operative bleeding
•  small-bowel obstruction
•  pneumonia
•  death

COST OF SLEEVE GASTRECTOMY

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