Sleeve Gastrectomy

What is a 'sleeve gastrectomy'?

A "sleeve gastrectomy" is one of the newer procedures that are being performed today. It actually removes a portion of the stomach, what we call the "great curvature" of the stomach, to make a tube of the stomach. There is no rerouting of the bowel as in gastric by-pass. The procedure has a less complication rate than the by-pass, but probably a greater complication rate than the labroscopic band.

Can a sleeve gastrectomy be dangerous or fatal?

As with any surgery, sleeve gastrectomy has a mortality rate, a fatality rate and a complication rate. Since it's so new, I don't think that rate is known. I would guess that it's less than a gastric bypass but more than the banding procedures. Any surgery, even a minor surgery, can cause problems and this is still a major surgery, removing almost three quarters or more of the stomach.

How fast can one lose weight after a sleeve gastrectomy?

I think that information on how fast you lose weight with a sleeve gastrectomy is still being worked out. From the few articles that have been released to far, it's probably like the gastric bypass where you're losing the weight over a year to a year and a half. The lapband, the weight loss is from a year and a half to three years so it is slower. The big question is going to come up, how fast, or what percentage of patients regain their weight with the sleeve gastrectomy and need to have the second procedure, in other words a gastric bypass, added on to it to make it successful.

What are the advantages and disadvantages of a sleeve gastrectomy?

The advantage of the sleeve procedure is its safety compared to the gastric bypass, especially in patients who are markedly overweight. Patients with a BMI of 60, 70, patients who are 400, 500 pounds. That safety issue is very important. The problem you will develop if a large percentage of those patients regain their weight and then have to have a gastric bypass done when it's safer to do, the complication rate of those two added together become the same as just having done the gastric bypass to begin with. That usually takes 5 to 10 years of research, of seeing what is going on to know for sure how that'll work out.

What are the chances of gaining weight back after a sleeve gastrectomy?

Since the sleeve procedure is relatively new I don't think there's any known data of exactly how much weight you'll gain back, what percentage of patients are successful over a five year period. It's more successful than the surgeons who are doing it thought of, they thought of at first they would do this as a two-stage procedure for patients who had a very high risk, to bring that risk down. Since it worked so well people are now doing it as a primary procedure and that question will be worked out sometime in the near future.