What is the Sleeve Gastrectomy?
The Sleeve Gastrectomy (also referred to as the Gastric Sleeve, Vertical Sleeve Gastrectomy, or Tube Gastrectomy) is the most commonly performed weight loss procedure worldwide. It is also our most common procedure at OClinic, and we have performed over 3000 gastric sleeves. It involves significantly reducing the size of the stomach by removing the lateral portion, performed under a General Anaesthetic using advanced laparoscopic keyhole surgery. It is very important that the sleeve is performed by highly experienced surgeons so that the final shape of the gastric sleeve is not twisted or uneven, otherwise swallowing difficulties and reflux may develop. The other concern is staple line leakage, which studies show is much less likely if your sleeve is performed by an experienced surgeon.
Although the physical size of the stomach is reduced, the normal direction of the food stream through the stomach and the rest of the intestinal tract is not altered. This means that all nutrients including vitamins, minerals and protein will continue to be absorbed normally. It simply reduces the holding capacity from about 1.5 litres of food and liquid to approximately 200mls. This allows a person to feel comfortably satisfied and full with a meal size approximately equivalent to a cup of food.
Typically, Sleeve Gastrectomy patients will have between 4-6 small meals per day, which is actually the ideal way to eat. Dietitians recommend small frequent meals as a way of avoiding big swings in Insulin levels and achieving a more even intake of calories as part of a healthier eating pattern.
Despite being smaller, the stomach sleeve still functions normally- food and nutrients continue to enter and leave in the same way, acid continues to be made to assist in digestion, and essential vitamins and minerals such as B12, calcium, folate and iron can be absorbed normally.
How does it work?
The Sleeve Gastrectomy appears to work in three distinct ways:
- The major reduction in stomach capacity allows patients to become full and satisfied with a much smaller meal, providing portion control.
- Studies indicated the level of the hunger hormone Ghrelin is reduced considerably (individual results may vary), as the removed part of the stomach is rich in cells that make that hormone. Patients consistently report feeling less hungry between their meals as a result of this.
- There appears to be a change in way that fatty foods are handled by the digestive track- patients frequently report losing their taste for foods high in sugar and fat such as chocolate, fried food and soft drink, which seem to make them feel more bloated, unsettled, or queasy. Dietitians like this aspect of the Sleeve- it helps patients adopt healthier eating habits.