ABOUT THE PROCEDURE

Sleeve Gastrectomy, also known as Vertical Sleeve Gastrectomy or Gastric Sleeve, is the most commonly performed bariatric (weight loss) surgery in Australia.

In this procedure, first the fibrous tissues and blood vessels attached to the left side (greater curvature) and back of the stomach are divided, and then a calibrated sizing tube is passed through the mouth to the stomach by the anaesthetist. A surgical stapler is positioned externally on the stomach against the internal tube and used to fire 6 rows of staples. The stapler then divides the tissue between the middle 2 rows, leaving 3 rows of staples, with the other 3 rows being attached to the specimen. Around 80% of the original stomach is removed, leaving a new, smaller stomach with a volume of around 100mL.

No surgery is performed on the intestine. The gastric staples are permanent and do not need to be removed. They are safe with MRI scanners and are too small to be detected by airport security systems.

RECOVERY

The surgery is performed laparoscopically (keyhole) in almost all cases, with 5 small incisions in the upper abdomen. The average time in hospital after surgery is 2 nights. Office work can usually recommence after 2 weeks. Heavy work can recommence after 4 weeks.

RESULTS

This surgery results in a sensation of feeling full with much smaller quantities of food. Typically, an entree-size plate will provide the same feeling that a full dinner plate did before surgery. The surgery also leads to a reduction in certain hunger-promoting hormones, meaning that patients notice either the absence of or a decrease in the intensity of hunger between meals.

On average, patients who have a sleeve gastrectomy will lose around 30% of their total body weight, or between 60-70% of their excess body weight. Maximum weight loss is usually achieved between 12-18 months.

ADVANTAGES

Suitable for most patients
Least amount of surgical time required, and therefore lower cost
Lower risk of major complications compared to gastric bypass
Ulcer formation is very uncommon
Dumping syndrome is extremely rare
No increased risk of internal hernia compared to any other abdominal surgery
You have the option to be revised to a gastric bypass later if needed
There is a lower risk of nutrient deficiency compared to gastric bypass
The entire stomach and duodenum can be accessed endoscopically

DISADVANTAGES

There is a 20% risk of developing gastro-oesophageal reflux
It is not reversible
Weight loss is slightly less than gastric bypass (average 30% v 35% of total body weight)
The chance of weight regain at 5-10 years is higher than gastric bypass
Diabetes remission rates are slightly lower than bypass