Sleeve Gastrectomy Surgery

History Of Gastric Sleeve Surgery

Gastric sleeve surgery is one of the newest types of bariatric surgery. It was developed in the 1980s initially as the first step of open duodenal switch bariatric surgery in higher risk patients with super-morbid obesity. Soon it developed into a single-stage laparoscopic bariatric option for lower BMI patients. Today the gastric sleeve surgery popularity has increased and along to the gastric bypass surgery reaches around 54% of all bariatric surgeries performed in the world. In Sigulda Hospital sleeve gastrectomy is performed in around a half of all bariatric surgery cases. 

Who Is A Candidate For Gastric Sleeve Surgery

It might be confusing to know which type of weight loss surgery suits you the best. Here is some advise by Dr. Olegs Kozlovskis, bariatric surgeon, on who would be eligible for the sleeve surgery rather than other type of bariatric surgery.

• BMI under 35 & strong wish to reduce excess weight and improve health,
• Young women, planning pregnancy in the future. There is no bowel rerouting and no malabsorption with gastric sleeve surgery,
• Persons, who have had severe abdominal surgery/ies and there are inner adhesions,
• As the first step in weight reduction process for persons with extra high BMI,
• Research shows that gastric sleeve surgery should not be recommended to persons suffering from gastroesophageal reflux disease (GERD). In these situations gastric bypass surgery is recommended rather than the sleeve as the bypass resolves the problem effectively, while after gastric sleeve surgery the reflux issues can even intensify in ~30% of cases.

All inclusive cost of the sleeve gastrectomy surgery is € 5870.

Advantages And Benefits Of Gastric Sleeve Surgery

• Restricts the amount of food a person can consume at one time;
• Reduces appetite and enhances satiety as the part of stomach that produces the hunger hormone ghrelin is removed;
• Induces significant weight loss close to that of the RNY gastric bypass;
• Highly effective in improving or curing obesity related conditions;
• There is no bypass of the small intestine made, so all nutrients are absorbed;
• There is no foreign bodies left in patients stomach like after Lap Band surgery;
• Does not require adjustments or fills as with gastric band;
• There is a less wound infection possibility than with Lap Band surgery;
• May be converted to gastric bypass if necessary for additional weight loss.

Expected Weight Loss And Success Rates Of Sleeve Gastrectomy Surgery

• The Gastric sleeve long term success rate is approximately 80-90%;
• Most people reach their lowest weight goal 12-24 months after the surgery;
• Speed of weight loss is individual, however in general people lose 50-60% of excess weight during the first 6 months post-op.

Improvement Of Obesity Related Health Issues After Gastric Sleeve Surgery

Clinical research and studies have proven that gastric sleeve surgery leads to complete resolution or significant improvement of obesity related health issues such as:

• Type 2 diabetes;
• Hypertension;
• Fatty liver disease;
• High cholesterol;
• Sleep apnea;
• Decreased cancer risk;
• PCOS and Infertility;
• Asthma;
• Migraines;
• Joint pain and mobility problems;
• Depression and psychosocial problems;
• Low testosterone;
• Urinary incontinence;
• Gout.

Complications And Risks Of Gastric Sleeve Surgery

Gastric sleeve surgery is a newer type of bariatric surgery comparing to gastric bypass. During the past decades the surgical techniques have developed and the gastric sleeve surgery has become an overall safe and the most popular bariatric surgery procedure in the world. However, as with all general surgeries complications can still occur during and after the surgery. The main complications and risks of the gastric sleeve surgery:

• Leakage from the staple line – surgical techniques are developed to details to minimise the complication - our surgeons perform a 'leakage test' with a contrast liquid before finishing the surgery;
• Stenosis – narrowing of the proximal or distal third of the sleeve. A very rare complication;
• Blood clots – the risks are minimised by providing relevant medications after the surgery. Patients are encourage to start walking a few hours after the surgery;
• Heart burn – Gastro Esophageal Reflux Disease – most patients suffering from GERD before the surgery see improvement of symptoms after the surgery due to healthy diet and weight loss. However in 30% of cases patients may develop a new heartburn or situation with existing condition may get worse. The heartburn has to be controlled with proton-pump inhibitor medications (Omeprazole and similar);
• Nutrient or vitamin deficiency;
• Weight regain – 1-2 years post-op, slight weight regain is common after all bariatric operations. By research data about 10-20% of gastric sleeve patients experience significant weight regain. It is very important to remember that any type of bariatric surgery is only a tool in your weight loss journey. The first 2 years post-op is the period you have to learn a new, healthy lifestyle to maintain your reached weight loss goal;
• Excess skin.

Disadvantages Of Gastric Sleeve Surgery

• The operation is irreversible as the biggest part of the stomach is removed permanently;
• Big amount of staples, needed for stomach stapling, can cause leaking. Leaking fluids can cause health problems;
• Poor weight-loss results in a long-term may happen – the new stomach can stretch out after a while and cause regain of already lost weight.
• In ~30% of cases patients may develop a heartburn (GERD).

Please feel free to ask for a consultation to help you decide which type of bariatric surgery might be the most suitable for you!