Sleeve Gastrectomy (SG)
What is a Sleeve Gastrectomy?
The sleeve gastrectomy is a surgical procedure that removes about 75-80% of your stomach, leaving you with a thin, narrow, tubular ‘sleeve’ that is about the size of a banana. It is performed either robotically or laparoscopically (keyhole surgery), leaving you with approximately five small incisions (cuts) in your abdomen.
How does a Sleeve Gastrectomy help you?
Your stomach holds approximately 1500ml. A sleeve gastrectomy reduces the stomach’s capacity to approximately 150ml. Reducing the size of your stomach restricts the amount of food that you can eat in one sitting, which leaves you feeling fuller faster. You will also experience a reduced appetite as the amount of hunger hormone (ghrelin) that your stomach can produce decreases and this affects your metabolism. Together, the restricted size of your stomach and the reduced hunger signals can help you restrict calorie intake to achieve effective weight loss and better blood sugar control.
Advantages of the Sleeve Gastrectomy
- Less complex than any of the bypasses (no involvement of bowel)
- Approximately 1 hour to complete
- May reduce your excess weight by 60-70%
- Can improve obesity related conditions such as type 2 diabetes, high blood pressure, high cholesterol and sleep apnoea.
- Safest operation for patients with high risk medical conditions.
- No bowel involvement, therefore no increased risk of bowel obstruction.
- Lower risk of nutritional deficiencies compared to the bypasses
- A simpler procedure than the bypasses when performed by an experienced surgeon.
- Less risk of stomach ulcers than a bypass (particularly for those needing use anti-inflammatory drugs).
Disadvantages of the Sleeve Gastrectomy
- Non-reversible procedure
- May worsen reflux if you already have it or cause new onset of reflux in approximately 30% of patients.
- Less impact on your metabolism than the gastric bypasses.
- Higher incidence of weight regain for patients with a sweet tooth – will allow for ‘cheating’ in diet
- Potential for Vitamin B12 or iron deficiency in the long-term in a small number of patients.
Risks and Complications of the Sleeve Gastrectomy
Risk of the Sleeve Gastrectomy in the Short-Term
(common to most surgical procedures)
- Bleeding during or after the operation
- Damage to organs
- Wound infections
- Chest infections
- Deep vein thrombosis (blood clots in your legs)
- Pulmonary emboli (blood clots in the lungs)
- Leakage and bleeding at the stomach staple line
- Death (very rare)
- Anaesthetic risks (please see this section for more info).
Risks of the Sleeve Gastrectomy in the Long-Term
- Adhesions or scar tissue within the abdomen (which can occur in any abdominal procedure) – may require surgery to release.
- Hernia formation at the site of the wound closure – may require surgery to repair.
- Development of reflux after surgery – may need medication or revision surgery.
- Occasional nutritional deficiencies – this can be avoided with good diet and vitamin/mineral supplementation