Sleeve Gastrectomy

Sleeve Gastrectomy is the restrictive part of the more extensive mixed restrictive and malabsorptive operation, the Duodenal Switch. The Duodenal Switch and similar operations which include Sleeve Gastrectomy have been performed since the 1970's. Over the last 5-7 years, Sleeve Gastrectomy has been offered as a stand alone procedure to morbidly obese individuals. In June, 2007, American Society of Metabolic and Bariatric Surgery recognized Sleeve Gastrectomy as a form of weight loss procedure based on scientific data that demonstrated durable 5 year weight loss. The obesity-related medical problems that may be improved or cured with the Sleeve Gastrectomy operation include diabetes mellitus of the adult onset type (so-called insulin resistant), hypertension, high cholesterol, arthritis, venous stasis disease, bladder incontinence, liver disease, certain types of headaches, heartburn, sleep apnea and many other disorders. Furthermore, this operation has resulted in marked improvements in quality of life.

In Sleeve Gastrectomy, the surgeon removes approximately 85 percent of the stomach so the stomach takes the shape of a tube or "sleeve". The part of the stomach that is most susceptible to stretching and relaxing is removed. The removal of the majority of the stomach also results in the virtual elimination of hormone Ghrelin. Ghrelin is responsible for stimulating the appetite and has been found to increase the appetite before eating and to decrease it afterward. In laboratory tests, humans who were injected with ghrelin reported an increase in hunger. In addition, research seems to demonstrate that ghrelin suppresses the utilization of fat in the adipose tissue. In essence, ghrelin appears to be at least partially responsible for letting the body know when it is hungry and for keeping the body informed about the energy balance of the brain and the body. Sleeve Gastrectomy preserves stomach's normal outlet valve, the pylorus, and the nerves to the stomach with idea of preserving the functions of the stomach while reducing the volume. There is no intestinal bypass or malabsorption with this procedure, only the stomach reduction.

Sleeve Gastrectomy achieves restriction without the use of foreign body as in the Adjustable Gastric Banding operation and thus no adjustment is required. Long term complications of the adjustable band such as for port problems, erosions and slippage are also eliminated. It does not involve any bypass of intestinal tract and thus patients avoid the complications of intestinal bypass such as dumping syndrome, intestinal obstruction, anemia, osteoporosis, vitamin deficiency and protein deficiency. If weight loss is inadequate, the option to convert the operation to Gastric Bypass remains available. Scientific studies available to date document weight loss of 60-65 % of excess body at three years following the Sleeve Gastrectomy. Long tern weight loss results following the Sleeve Gastrectomy are unknown. As with all weight loss operations, success does require adherence to a simple and straightforward life style changes.