The Sleeve Gastrectomy is a relatively new surgical procedure for weight loss and is permanent and irreversible. It involves permanently removing approximately two-thirds of the stomach, which is performed laparoscopically using surgical staplers.
Because the size of the stomach is significantly reduced, patients feel full quickly or are satisfied by smaller meals. Normally a stomach can hold about 1.5 litres of food or liquid, however after the gastric sleeve; this volume is reduced to between 200-300mls. This allows a person to feel a sense of fullness with a meal size approximately equivalent to a cup of food. The remaining stomach still functions normally allowing food and nutrients to enter and exit the stomach sleeve in the normal way, and essential vitamins and minerals such as B12, calcium and iron can continue to be absorbed normally.
The Sleeve Gastrectomy is well suited to patients who live far away or have very busy lifestyle which restricts them to adhere to the follow up of the gastric band. Another advantage is that there are generally fewer dietary restrictions as the entrance to the stomach is not narrow like a gastric band.
Generally all types of food, including breads and steak, can be comfortably eaten once the sleeve has settled in. (Generally around 3-6 months after surgery).
Although the average weight loss overall is similar between the band and the sleeve, weight is usually lost quickly after the sleeve gastrectomy (typically the goal weight is reached within 9-12 months with a sleeve gastrectomy instead of 12-18 months with a gastric band). The sleeve gastrectomy is more powerful, as it restricts the quantity of both liquid and solid calories, where as the band can easily be ‘cheated’ with liquid calories, although this cannot be completely avoided if meals that are consumed are poorly balanced, eating processed carbohydrates and drinking sweetened beverages. Whilst the gastric band is very good at reducing hunger and allowing small meals to be satisfying, it relies more heavily on patients improving their dietary habits and lifestyle in order to achieve best results.
When the entire stomach has been removed, it is common to give regular vitamin B12 injections and oral iron replacement. However when the antrum part of the stomach is preserved (as is the case with the sleeve gastrectomy), then simple monitoring of these levels is sufficient. The thing to remember is that, because you will be eating less, it is important to focus on good quality nutritious meals to ensure your body gets all the nutrients it needs. Regular follow up with your dietitian can assist with this.
Also, because the procedure is still relatively new, long term data beyond 6 years has not yet become available. Whilst the majority of patients with a sleeve gastrectomy achieve significant weight loss in the short and medium term, there is a chance that the stomach sleeve could eventually stretch over time which could lead to weight being regained in the long term if dietary and lifestyle modification is not adhered to.
The sleeve gastrectomy procedure is permanent and irreversible.