How Does Gastric Sleeve Surgery Work?

By Peter Denk, MD, FACS

Gastric sleeve surgery involves permanently removing a large portion of the stomach, anywhere from 60% to 85% of the total stomach. The portion left behind is a slim tube or “sleeve” that will serve as your new stomach. This stomach is already connected naturally to the stomach inlet and outlet which means that no rerouting of the intestines is needed.

What differentiates a gastric sleeve procedure from other weight loss surgeries is the nerves to the stomach and the outlet valve (pylorus) of the stomach remain intact to preserve the functions of the stomach while at the same time, reducing the volume it is able to hold. There is no bypass of the intestines with the gastric sleeve, only stomach capacity reduction. A sleeve gastrectomy also works because it removes the part of the stomach that produces Ghrelin, which is a hormone that stimulates appetite. This helps to noticeably reduce without completely eliminating a person’s appetite.

Advantages of the Gastric Sleeve:
The primary features of gastric sleeve surgery are reducing the size of the stomach up to 85%, to restrict food intake while also reducing the hormones that create the craving for food due to the removal of the excess stomach portion. This reduces the production of the Ghrelin hormone which in turn reduces the hunger sensation. The advantages of gastric sleeve surgery include:

• 30 to 60% extra weight loss within the first 12 months of the procedure
• Less invasive than gastric bypass
• No cutting or, disconnection or alteration of the intestines
• No risk of “dumping syndrome” typically associated with gastric bypass
• No need for implementation of foreign devices  in to the body such as a gastric band
• Less restrictive post-surgery diet

In addition, sleeve gastrectomy can also help resolve many existing weight-related health complications such as:
• High blood pressure
• Type 2 diabetes
• Sleep apnea
• High cholesterol

Low BMI individuals may also qualify for
Gastric Sleeve procedure:
Another key piece of information is that the Gastric Sleeve has been shown to be quite safe and effective for individuals with less weight to lose, meaning safe and effective for individuals with a BMI less than 35-40.

Those that qualify include:
• Patients who are concerned about the potential long term side effects of gastric bypass.
• Patients who are considering gastric band surgery but are concerned about having an artificial device attached to their stomach, those who do not want band adjustments, or those who live in an area where they may have trouble finding a physician qualified to do the band adjustments.

What Can I Eat After My Surgery?
There will be a drastic change in your diet after your surgery and the amount of food you can physically eat. You will need to ease in to your new diet and retrain your body to the new, smaller amount of food you will be eating from that day on.

How Do I Know if This is the Right Surgery for Me?
The decision to have a gastric sleeve procedure for weight loss is a significant one. You should be fully informed of both the benefits and the risks associated with this surgery before you decide if this is the right weight loss solution for you. Your weight loss surgeon will carefully review any risk or complications associated with the procedure so that you are aware of any potential issues prior to your operation.

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