Gastric sleeve surgery, also known as sleeve gastrectomy, is a type of bariatric surgery for those who are obese and want to achieve long-term weight loss.
Bariatric surgeries aim to alter the gut hormone levels responsible for hunger leading to a reduced feeling of hunger and a healthier lifestyle as a result.
Gastric sleeve surgery has been a very popular solution for obesity in the last few years and is one of the most common bariatric surgeries for permanent weight loss.
Sleeve gastrectomy is a restrictive procedure in which the stomach capacity is significantly reduced by about 75-80%, in order to sustain long-term weight loss. In gastric sleeve surgery, a large part of the stomach is removed, leaving a banana-shaped stomach.
Limiting the capacity of the stomach restricts the amount of food consumed, reducing the appetite, and therefore achieving weight loss. In addition, this operation positively impacts the hormones that aid weight loss and helps with resolving obesity-related conditions such as high blood pressure and heart disease.
Who Would Need A Sleeve Gastrectomy?
A sleeve gastrectomy is done to help you lose excess weight and prevent life-threatening obesity-related health problems. A gastric sleeve operation is usually done after attempts at losing weight by changing diet habits or doing regular exercise have been unsuccessful.
A gastric sleeve surgery could be a suggested option for people who are obese with a body mass index (BMI) of 40 or higher. Usually, a BMI of 35 and above indicates that the person is considered obese and is dealing with health problems that coincide with this and thus might qualify for certain bariatric surgeries.
The obesity-related conditions usually include:
- High blood pressure
- High Cholesterol
- Heart disease
- Obstructive sleep apnoea
- Diabetes Type 2
- Mobility problems
How Can I Prepare For A Gastric Sleeve Procedure?
Before having a sleeve gastrectomy, your healthcare team will advise you on the best diet to use and lifestyle changes to make before having the sleeve gastrectomy. This will help you to adjust to the new lifestyle and get in shape for the procedure.
You will have to follow a strict diet plan and do physical exercise. The bariatric surgeon will assess whether you need to cease any of your prescribed medication in preparation.
What Happens During A Gastric Sleeve Operation?
A sleeve gastrectomy procedure is usually undertaken laparoscopically, which involves inserting small surgical instruments through several small incisions into the upper abdomen. The procedure is performed under general anaesthetic.
During The Procedure
The bariatric surgeon will make two to five small incisions in the upper abdomen, where a long, thin laparoscope, (with a camera lens on one end) is inserted. Along with the surgical instruments that perform the incisions and the removal of a large part (the curved part) of the stomach. The surgeon will then join the remaining parts of the stomach forming a long “sleeve” shaped tube by stitching it vertically.
Finally, the surgeon will remove the laparoscope and surgical instruments and use surgical staples to close the incisions. The procedure usually takes one to two hours.
After The Procedure
After having a sleeve gastrectomy, you will stay in the clinic under close monitoring to assess any complications for about two nights. The doctors and/or nurses will give you medications, such as painkillers, to relieve any post-operation pain.
After the surgery, you will be able to drink only clear fluids and will follow a liquid diet (including soft, moist food and soups) for the next three weeks. You will be able to start eating regular food again about four weeks after the surgery.
You will have regular check-ups and examinations with your doctor and dietician to monitor your health for several months after the gastric sleeve surgery. Most people are usually able to restart their normal activities two to four weeks post-operation.
Several side effects that might present in the following weeks after a sleeve gastrectomy include:
- Bleeding, blood clots or wound infection
- Nausea and vomiting
- Burning feeling in the stomach (gastritis)
- Body aches
- Feeling tired
- Hair loss or thinning
- Dry skin
- Mood swings
Gastric sleeve patients usually lose between 70% and 75% of their excess weight, in about nine to twelve months after having the operation.
The sleeve gastrectomy is effective approximately 6 years after having the initial surgery. It is not a reversible operation and therefore permanently changes your body – to which you will adjust your eating habits – to achieve long-term sustainable weight loss.
What Are The Benefits Of Having Gastric Sleeve Surgery?
Having a sleeve gastrectomy can benefit most people dealing with obesity health problems by improving their health and lifestyle dramatically. The benefits of having a gastric sleeve operation can be both physical and mental, including:
- Long-term weight loss
- Improved and stabilised BMI
- Healthier lifestyle
- Reduced joint and body aches
- Increased mobility
- Increased self-esteem
- Improvement of related health conditions (such as high blood pressure, diabetes type 2, high cholesterol, heart disease, sleep obstructive apnoea or stoke)
The Risks And Long-Term Complications Of Sleeve Gastrectomy
As with any surgical procedure, sleeve gastrectomy has several possible risks and long-term complications.
The short-term risks of a sleeve gastrectomy include:
- Infection in the wound/stitches
- Blood clots
- Breathing difficulties
- Fluid leakage from the stomach
Long-term risks of having a sleeve gastrectomy include:
- Gastroesophageal reflux
- Gastrointestinal obstruction
- Low sugar blood levels
What Is The Cost Of A Gastric Sleeve Operation?
The typical cost of a sleeve gastrectomy, in private clinics in the UK, is approximately £8,000 to £10,000. This price usually includes the medications and aftercare, but this will depend on the clinic you choose.
Bariatric surgeries, including gastric sleeves, are available on the NHS, but only for those whose obesity is life-threatening and who have already tried non-surgical solutions that were not successful.