The gastric sleeve is the most popular bariatric surgical procedure in the United States and for good reason. However, as a standalone procedure, it is also one of the newest. Its benefits come in the form of relative simplicity on the surgical side, maintaining the normal gastrointestinal function in patients and exceptional results.
We believe it’s important to discuss the various questions our patients ask about the gastric sleeve, to help you understand if it’s the best procedure for you.
The gastric sleeve is a very safe procedure when performed by a skilled and experienced surgeon. The surgeons at MASJax have performed thousands of these procedures. Nationally, the risk of death associated with a gastric sleeve is about .5% which is equivalent to a routine gallbladder removal. Other than the risks inherent to any surgical procedure, there are a few specific risks of the gastric sleeve that will be discussed during your consultation with one of our surgeons.
Most definitely yes. The gastric sleeve can offer 60, 70 or even 80% excess body weight loss in patients who work hard on their postoperative lifestyle. Long-term, the gastric sleeve shows excellent promise, with most of that weight maintained past five and even 10 years.
That decision can only be made after consultation with an experienced bariatric surgeon like those here at MASJax. We can say, however, that patients with severe acid reflux and those with poorly controlled or uncontrolled type-2 diabetes may be better served with a gastric bypass. The majority of patients however, and especially patients with extreme BMIs – those over 50 – can benefit from the gastric sleeve. Further, if the gastric sleeve causes severe acid reflux, it can be converted to a gastric bypass during a revision. Alternately, a small implant known as the LINX Reflux Management System can be placed over the esophagus to reduce the symptoms of reflux
Whenever we screen a patient for bariatric surgery, and specifically the gastric sleeve, we always weigh the risks of surgery versus the risks of living with morbid or extreme obesity. Almost every analysis determines that the risk of living with obesity is greater than the potential drawbacks of surgery. Obesity comes with a number of comorbid diseases including high blood pressure, cholesterol and atherosclerosis, all of which can lead to significant heart disease. Obesity can also contribute to sleep issues, joint problems and even certain forms of cancer. Any complications associated with the gastric sleeve can be managed effectively with an experienced bariatric surgery team such as ours. The risk of death during a gastric sleeve, as we mentioned before, is extremely low…at .5% nationally.
The gastric sleeve is performed in approximately an hour and up to 90 minutes depending on the patient’s anatomy and whether the procedure involves a revision.
Patients will require one night in the hospital and will be discharged in the morning assuming they do not have any complications or concerns that may keep them longer. Over the longer-term, most patients will be able to return to normal activity about six weeks after the procedure.
Any major surgery comes with some degree of discomfort, but rarely do our patients complain of significant pain. Some patients with a lower pain threshold may be sent home with narcotic pain medication, but most are able to manage their pain with acetaminophen/Tylenol. Any discomfort usually dissipates within a few days after surgery.
During early recovery, you will be on a strict diet starting with clear liquids, followed by a liquid diet, soft food diet and ultimately a modified full diet. The bottom line? The gastric sleeve allows for a wide variety of foods. However, it is important that you avoid the causes of excess weight in the first place including high fat, high sugar and highly processed foods. Instead, your diet should consist of lean proteins like fish, chicken and turkey as well as fresh vegetables and fruits. At no time should you drink carbonated beverages and it is best to avoid alcohol and caffeine except on special occasions.
About 50-70% of gastric sleeve patients will experience significantly reduced hunger after the gastric sleeve. The portion of the stomach removed from the abdomen includes the fundus, which is the primary source of ghrelin, the hunger hormone. By removing ghrelin from the body, hunger signals to the brain are disrupted, allowing patients to lose more weight, more easily.
The gastric sleeve is only a tool – and it is up to you to maintain a new and improved lifestyle in the form of improved diet and exercise habits. There are always ways to cheat the surgery, which may lead to weight regain. Some patients may also experience mild weight regain due to causes beyond their control. Fortunately, there are endoscopic and surgical revision procedures that can help them get back on track.
Virtually all patients will require a daily multivitamin after their gastric sleeve procedure. This ensures that they have balanced vitamin and mineral levels in case they do not get enough from food and drink alone. Some patients may require additional vitamin B12, vitamin D3, iron and/or calcium early on, but may be able to reduce their dependence on supplementation longer-term.