This procedure works by several mechanisms. First, the new stomach pouch holds a considerably smaller volume than the normal stomach and helps to significantly reduce the amount of food (and thus calories) that can be consumed. The greater impact, however, seems to be the effect the surgery has on gut hormones that impact a number of factors including hunger, satiety, and blood sugar control.
The procedure only takes around one to two hours to perform. During the surgery, patients are placed under general anesthesia. Several very small incisions are created in the upper abdomen. Through these, a section of the stomach is removed, and then a sleeve is created through vertical stapling of the remaining stomach. Incisions are closed with stitches, medical tape, or medical glue.
Short term studies show that the sleeve is as effective as the roux-en-Y gastric bypass in terms of weight loss and improvement or remission of diabetes. There is also evidence that suggest the sleeve, similar to the gastric bypass, is effective in improving type 2 diabetes independent of the weight loss. The complication rates of the sleeve fall between those of the adjustable gastric band and the roux-en-y gastric bypass.
The Recovery Process
After a Laparoscopic Sleeve Gastrectomy, a short stay at the hospital is necessary (typically only 2 days). Pain medication will be prescribed to address any pain and should be taken as prescribed. Diet will change gradually, starting with cups of ice immediately after the procedure and moving to clear liquids. Soft foods will eventually be permissible, and solid food will be permissible after 8 weeks.
Patients should avoid physically strenuous activities for 4 to 6 weeks. However, walking is encouraged and will get easier with time. Patients should be gentle with their body while it is healing and will have decreased energy levels.
Patients must take time off from work, usually 3 to 4 weeks, to rest and recover. Regular follow-up appointments will be required to ensure that healing is going as expected. The full recovery process typically takes around 6 to 8 weeks.
- Restricts the amount of food the stomach can hold
- Induces rapid and significant weight loss that comparative studies find similar to that of the Roux-en-Y gastric bypass. Weight loss of >50% for 3-5+ year data, and weight loss comparable to that of the bypass with maintenance of >50%
- Requires no foreign objects (AGB), and no bypass or re-routing of the food stream (RYGB)
- Involves a relatively short hospital stay of approximately 2 days
- Causes favorable changes in gut hormones that suppress hunger, reduce appetite and improve satiety
- Is a non-reversible procedure
- Has the potential for long-term vitamin deficiencies
- Has a higher early complication rate than the AGB