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SLEEVE GASTRECTOMY

Gastric Sleeve Surgery

Sleeve gastrectomy is a type of restrictive surgery that affects the integrity of the gastrointestinal tract amending its structure to evoke weight loss. The main goal of the surgery is to make the stomach smaller and in doing so limit food intake.

How is it performed?

Sleeve gastrectomy is a surgical procedure performed inside the abdominal cavity of the patient. There are two different ways to open up the abdominal cavity. First, and more common, is the minimally invasive laparoscopic technique – several small incisions are made to insert instruments and a camera to guide the procedure. The second way to enter the abdominal cavity is open surgery – the stomach is accessed through the vertical incision in the patient’s abdominal wall. During the procedure about 80% of the stomach is removed* leaving a narrow “sleeve” looking tube, hence the name of the procedure. Surgical staples or sutures are used to close the loose ends of the stomach.The procedure permanently reduces the size of the stomach and decreases food intake without rearranging the other parts of the digestive system leaving your intestines intact.

Weight loss mechanism

After the surgery the stomach will be able to contain around 150ml of food, compared to the 500ml or more before the undergoing the procedure.This reduction provides a couple of mechanisms to reduce the weight of a person. First of all, the amount of food that can be eaten at one time is lessened, the stomach walls are stretched more readily and this quickens the feeling of satiety. Secondly, hunger is directly affected due to the reduced stomach area that produces ghrelin („hunger hormone“), a substance that activates the appetite centre in the brain and plays a role in how you feel and relieve hunger. These two mechanisms contribute to a weight loss.

Obesity rates and the number of super-obese patients (BMI >50 kg/m2) has risen dramatically across the world. It is almost impossible to treat severe obesity using only diet and exercise. This has led to the search for surgical techniques which would provide adequate weight loss. Surgery is the only and most effective treatment of severe obesity that provides effective long lasting weight loss. Currently performed laparoscopic surgeries are modern, technically easier, and effective and are safer than ever before. Newer laparoscopic options for obesity treatment include laparoscopic sleeve gastrectomy, gastric bypass surgery, gastric banding and some others operations. All these options differ in complexity, reversibility, complications and extent of excess weight loss. The choice of procedure depends on a patient and a surgeon factors.