Sleeve gastrectomy, also called a vertical sleeve gastrectomy, is a surgical weight-loss procedure. This procedure is typically performed laparoscopically, which involves inserting small instruments through multiple small incisions in the upper abdomen. During sleeve gastrectomy, about 80 percent of the stomach is removed, a tube-shaped stomach about the size and shape of a banana.

Limiting the size of your stomach restricts the amount of food you are able to consume. In addition, the procedure triggers the hormonal changes that assist with weight loss. The same hormonal changes also help relieve conditions  being overweight, such as high blood pressure or heart disease.

Why it’s done

Sleeve gastrectomy is done to help you lose excess weight and reduce your risk of potentially life-threatening weight-related health problems, including:

• Gastroesophageal reflux disease
• Heart disease
• High blood pressure
• High cholesterol
• Obstructive sleep apnea
• Type 2 diabetes
• Stroke
• Infertility

Sleeve gastrectomy is typically done only after you’ve tried to lose weight by improving your diet and exercise habits.

In general, sleeve gastrectomy surgery could be an option for you if:

• Your body mass index (BMI) is 40 or higher (extreme obesity).
• Your BMI is 35 to 39.9 (obesity), and you have a serious weight-related health problem, such as type 2 diabetes, high blood pressure or severe sleep apnea. In some cases, you may qualify for certain types of weight-loss surgery if your BMI is 30 to 34 and you have serious weight-related health problems.

You must also be willing to make permanent changes to lead a healthier lifestyle. You may be required to participate in long-term follow-up plans that include monitoring your nutrition, your lifestyle and behaviour, and your medical conditions.

As with any major surgery, sleeve gastrectomy poses potential health risks, both in the short term and long term. Risks associated with the sleeve gastrectomy can include:

• Excessive bleeding
• Infection
• Adverse reactions to anaesthesia
• Blood clots
• Lung or breathing problems
• Leaks from the cut edge of the stomach

Longer term risks and complications of sleeve gastrectomy surgery can include:

• Gastrointestinal obstruction
• Hernias
• Gastrointestinal reflux
• Low blood sugar (hypoglycemia)
• Malnutrition
• Vomiting

Very rarely, complications of sleeve gastrectomy can be fatal.

 

Food and medications

Before your surgery, give your doctor a list of all medicines, vitamins, minerals, and herbal or dietary supplements you take. You may have restrictions on eating and drinking and which medications you can take.

If you take blood-thinning medications, talk with your doctor before your surgery. Because these medications affect clotting and bleeding, your blood-thinning medication routine may need to be changed.

If you have diabetes, talk with the doctor who manages your insulin or other diabetes medications for specific instructions on taking or adjusting them after surgery.

Other precautions

You’ll be required to start a physical activity program.

You’ll be required to stop any tobacco use 12 weeks before surgery and may be tested for nicotine prior to your surgery.

You may also need to prepare by planning ahead for your recovery after surgery. For instance, arrange for help at home if you think you’ll need it. People who have a sleeve gastrectomy are typically off work for four weeks.

Results

Sleeve gastrectomy can provide long-term weight loss. The amount of weight you lose depends on your change in lifestyle habits. It is possible to lose approximately 60 percent, or even more, of your excess weight within two years.

In addition to weight loss, sleeve gastrectomy may improve or resolve conditions related to being overweight, including:

• Heart disease
• High blood pressure
• High cholesterol
• Obstructive sleep apnea
• Type 2 diabetes
• Stroke
• Infertility

Sleeve gastrectomy surgery can also improve your ability to perform routine daily activities, and can help improve your quality of life.