Sleeve Gastrectomy

In a sleeve gastrectomy, more than half of your stomach is removed, leaving behind a thin vertical sleeve about the size of a banana. Because part of your stomach is removed, this surgery is not reversible.

Gastric sleeve surgery is becoming the most popular method of restrictive operations both because of its success rate and because the low incidence of complications. Those who have had this surgery report losing 40% to 50% of their overall weight.

The procedure is preformed either through a large incision in the abdomen (an open procedure) or laparoscopically (several small incisions using small instruments and a camera as a guide). Physical recovery takes 4 to 6 weeks.

Overview

Sleeve gastrectomy, also called a vertical sleeve gastrectomy, is a surgical weight-loss procedure. This procedure is typically performed laparoscopically, which involves inserting small instruments through multiple small incisions in the upper abdomen. During sleeve gastrectomy, about 80 percent of the stomach is removed, leaving a tube-shaped stomach about the size and shape of a banana.

Limiting the size of your stomach restricts the amount of food you are able to consume. In addition, the procedure prompts hormonal changes that assist with weight loss. The same hormonal changes also help relieve conditions associated with being overweight, such as high blood pressure or heart disease.

Why it’s done

Sleeve gastrectomy is done to help you lose excess weight and reduce your risk of potentially life-threatening weight-related health problems, including:

  • Gastroesophageal reflux disease
  • Heart disease
  • High blood pressure
  • High cholesterol
  • Obstructive sleep apnea
  • Type 2 diabetes
  • Stroke
  • Infertility

Sleeve gastrectomy is typically done only after you’ve tried to lose weight by improving your diet and exercise habits.

In general, sleeve gastrectomy surgery could be an option for you if:

  • Your body mass index (BMI) is 40 or higher (extreme obesity).
  • Your BMI is 35 to 39.9 (obesity), and you have a serious weight-related health problem, such as type 2 diabetes, high blood pressure or severe sleep apnea. In some cases, you may qualify for certain types of weight-loss surgery if your BMI is 30 to 34 and you have serious weight-related health problems.

You must also be willing to make permanent changes to lead a healthier lifestyle. You may be required to participate in long-term follow-up plans that include monitoring your nutrition, your lifestyle and behaviour, and your medical conditions.

Risks

As with any major surgery, sleeve gastrectomy poses potential health risks, both in the short term and long term.

Risks associated with the sleeve gastrectomy can include:

  • Excessive bleeding
  • Infection
  • Adverse reactions to anesthesia
  • Blood clots
  • Lung or breathing problems
  • Leaks from the cut edge of the stomach

Longer term risks and complications of sleeve gastrectomy surgery can include:

  • Gastrointestinal obstruction
  • Hernias
  • Gastroesophageal reflux
  • Low blood sugar (hypoglycemia)
  • Malnutrition
  • Vomiting

Very rarely, complications of sleeve gastrectomy can be fatal.

After the procedure

After sleeve gastrectomy, your diet begins with sugar-free, noncarbonated liquids for the first seven days, then progresses to pureed foods for three weeks, and finally to regular foods approximately four weeks after your surgery. You will be required to take a multivitamin twice a day, a calcium supplement once a day, and a vitamin B-12 injection once a month for life.

You’ll have frequent medical checkups to monitor your health in the first several months after weight-loss surgery. You may need laboratory testing, bloodwork and various exams.

You may experience changes as your body reacts to the rapid weight loss in the first three to six months after sleeve gastrectomy, including:

  • Body aches
  • Feeling tired, as if you have the flu
  • Feeling cold
  • Dry skin
  • Hair thinning and hair loss
  • Mood changes

Results

Sleeve gastrectomy can provide long-term weight loss. The amount of weight you lose depends on your change in lifestyle habits. It is possible to lose approximately 60 percent, or even more, of your excess weight within two years.

In addition to weight loss, sleeve gastrectomy may improve or resolve conditions related to being overweight, including:

  • Heart disease
  • High blood pressure
  • High cholesterol
  • Obstructive sleep apnea
  • Type 2 diabetes
  • Stroke
  • Infertility

Sleeve gastrectomy surgery can also improve your ability to perform routine daily activities, and can help improve your quality of life.

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