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Tuesday 20 August 2019
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Bariatric Operations - Sleeve Gastrectomy

Sleeve gastrectomy involves converting the stomach into a long thin tube. This is done by stapling the stomach along its entire length and then removing of approximately 75% of it.


This operation reduces the capacity of the stomach and thus restricting the amount of food that can be eaten. It also significantly lowers the level of the hunger hormone, ghrelin (a hormone produced by the parietal cells in the stomach) with the added benefit of reduction in hunger sensation and excellent weight loss.

 

The sleeve gastrectomy is a suitable option for most patients seeking weight loss.

In particular, it is preferred over the gastric bypass in some special scenarios such as in those who have had multiple abdominal operations and/or complex abdominal hernia surgery with the placement of a mesh that could have resulted in extensive adhesions within the abdomen involving the intestine and rendering the gastric bypass rather hazardous due to risk of injury to the bowel and the likelihood for a considerable prolongation of the operating time with its added risk.

 

It is also a good choice for people who suffer with inflammation of the bowel such as ulcerative colitis and those who have coeliac disease (gluten allergy).

 

Although acid reflux might well improve with weight loss, it is likely that it might worsen after a sleeve gastrectomy especially in individuals with severe pre-existing symptoms, and for such individuals the gastric bypass is a better option.

 

The chance of resolution of diabetes with the sleeve gastrectomy is somewhat inferior to that of a gastric bypass (60-65% compared with 80-85% on average); the bypass therefore is a better option particularly in people who have had diabetes for more than 5-10 years and who require multiple drugs and perhaps insulin to treat it.

 

What are the other benefits of Sleeve Gastrectomy?

In addition to weight loss, the sleeve gastrectomy has the following benefits:

  • Marked improvement or resolution in health conditions related to obesity, such as type-2 diabetes (approximately 60-65% chance of resolution), hypertension, gastro-oesophageal reflux, obstructive sleep apnoea, asthma, liver disease, high cholesterol, and painful osteoarthritis
  • Improvement in overall physical and psychological health
  • Compared to gastric bypass surgery, the sleeve gastrectomy is a quicker procedure (25-40 minutes), as there is no cutting of bowel with less risk of nutritional complications. Also Dumping syndrome is unusual