Sleeve gastrectomy is a surgical procedure that involves only the stomach and not the small bowel. At the operation a large part (85 percent) of the stomach is removed so it is much smaller than before. The remaining stomach is shaped like a tube or a sleeve – hence the name sleeve.
How it is done
The resected part of the stomach is removed from the abdominal cavity. The remaining tube shaped stomach is stapled with advanced surgical instruments. When the new stomach is filled it creates a pressure making you feel full sooner. Eating too much or too fast results in discomfort and at worst nausea and vomiting. The operation has a hormonal effect on reducing hunger.
Long lasting results after a sleeve gastrectomy
The sleeve gastrectomy is non-reversible (it can not be undone), but is considered to be less invasive (a bit “more forgiving”) than a gastric bypass. This is due to the fact that the intestines are not bypassed and therefore the absorption of nutrients from the intestines will function as normal.
After a bariatric operation the meal routines are the same whether you have a sleeve gastrectomy or a gastric bypass. But the clients with a sleeve gastrectomy are slightly less sensitive to fatty and sugary foods.
After a sleeve gastrectomy you can lose approximately 50-80 percent of your excess weight (weight over BMI 25) within 1-2 years, but the long-term results (after 5 years) are more uncertain than with a gastric bypass. Stomach volume may gradually increase over time and it is likely that you regain some weight. Follow-ups and a change of lifestyle are therefore important for long-term results. Studies have shown that a sleeve gastrectomy contributes to a higher quality of life and for most of the clients problems with obesity-related diseases will be reduced or completely disappear.
How the sleeve gastrectomy came into being
Earlier the sleeve gastrectomy was the first step in the weight-loss procedure called duodenal switch. After the sleeve was done the procedure also entailed an advanced intestinal switch. This technique was introduced around 1986 and was performed with open surgery. The sleeve gastrectomy as its own weight-loss procedure (without the following intestinal switch) began to be established in 1997. The method was refined and made laparoscopic around the year 2000. This resulted in a much easier postoperative recovery for the clients. In the last 5 years the prevalence of sleeve gastrectomies has increased in Sweden and today the procedure makes up a quarter of all weight loss surgery. At Aleris Obesitas we constantly strive to make weight loss surgery safer. We have the shortest average operating time in Sweden, resulting in short duration of anaesthesia and quicker mobilization afterwards.
Who is eligible for a sleeve gastrectomy?
The public health care in Skåne (Sweden) has certain criteria that need to be fulfilled:
- a BMI of 35 or more for at least 5 years, plus other obesity-related diseases
- several failed attempts to lose weight (these must be documented)
- age requirements 18-65 years of age
Our opinion is that these criteria, from a scientific point of view, result in an unnecessary delay of surgery:
At Aleris Plus the criteria for our clients are a BMI of more than 30 but without the requirement of a 5 year duration. You should have made at least one serious attempt to lose weight (3-5% of all overweight patients succeed in losing weight on their own). One should be motivated to go through with weight-loss surgery. Our upper age limit is based on biology, not calendar age.
What demands are made on you as a client?
Before and immediately after bariatric surgery there are lots of things to keep track of: preoperative weight loss, prescriptions, eating escalation, blood thinning injections and so on. We will provide necessary assistance but it is vital that you are thorough and take one step at a time. When the first 6 weeks have passed after surgery it is all down to one thing: to establish solid every day routines. It will take 3-6 months to learn this new way of eating, drinking, exercising and taking your vitamins. During this time you really put in an effort – get connected with your stubborn side! Your goal is to establish healthy daily routines. Once this is done, you are on ’autopilot’.