Laparoscopic Sleeve Gastrectomy (Tube Gastrectomy)

The sleeve gastrectomy is a "restrictive" procedure that limits the amount of food you eat by reducing the size of your stomach. During this procedure, a thin vertical sleeve of stomach is created using a surgical stapling device via keyhole surgery. This sleeve will typically hold between 50-150ml which is about the size of a banana. The rest of the stomach is removed. The newly created gastric sleeve is able to hold approximately 1/10th of what the stomach was able to hold before.

The stomach sleeve restricts the amount of food you can eat and makes you feel full with a small meal. It also reduces hunger.

Weight loss is very good – generally more than 60% of excess weight.

As with the gastric band procedure, you need to eat slowly and chew well but the sleeve gastrectomy is perhaps a little less demanding in this regard in the long run, although initially (first 6 weeks) it can be quite difficult.

Risks of Surgery

The main risk of this surgery is leakage from the staple line. Although not common (1%), it can be a serious complication. As with any other surgery, bleeding and infection as well as general medical complications are possible but infrequent.

Reflux (heartburn / "indigestion") is a common side effect after surgery and may require medication. This usually settles after 6 months.

Again, risks will be discussed in more detail by the surgeon.

Advantages

• Limits the amount of food that is eaten at a meal
• Food passes through the digestive tract in the usual order, allowing vitamins and nutrients to be fully absorbed into the body
• No post-operative adjustments are required
• 60-70 % EWL

Disadvantages

• Irreversible changes to anatomy
• Longer operating time and hospital stay (3-4 nights)
• Complications may include a leak from sleeve staple line (1%) which would prolong hospital stay and may require further intervention

Dietetic requirements

• A healthy, balanced eating plan is recommended with focus on portion control
• Nutritional significance of this procedure is greater than the gastric band, with a greater risk of thiamine, iron, folate, B12 and zinc deficiencies due to the smaller volume of food tolerated
• Possibly less food intolerances than that experienced with the gastric band and regurgitation is rare
• At least 6-12 monthly review of nutritional adequacy (including annual blood tests) to ensure maintenance of adequate nutritional health