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procedures
Gastric Sleeve
Gastric sleeve, also known as sleeve gastrectomy, involves reducing the size of the stomach by removing a portion, which helps limit the amount of food consumed and promotes weight loss.
Quick Facts
| Weight loss | 60-70% of excess body weight is lost within 12 to 18 months. |
| Surgery time | Approximately one hour. |
| Hospital stay: | 2 days |
| Recovery time: | 2-4 weeks. |
Find answers to your questions
Consult our Frequently Asked Questions to obtain detailed information and clarify your doubts. We are here to help you make informed decisions.
Introduction
Obesity is a growing problem worldwide, affecting both the physical and emotional health of those who suffer from it. In recent years, the gastric sleeve procedure has gained popularity as an effective and safe option to treat obesity and improve patients' quality of life (Angrisani et al., 2019). This article reviews the gastric sleeve procedure, its indications, contraindications, and long-term results.
Gastric Sleeve Procedure
Gastric sleeve, also known as sleeve gastrectomy or vertical gastrectomy, is a restrictive bariatric procedure that involves the removal of approximately 75-80% of the stomach, leaving a tubular sleeve-like structure (Rosenthal, 2012). This procedure is less invasive than other bariatric methods, such as gastric bypass, and has fewer short- and long-term complications (Gagner, 2016).
Indications
The gastric sleeve procedure is mainly indicated in morbidly obese patients, who have a body mass index (BMI) greater than 35 kg/m² or a BMI of 30 kg/m² with associated comorbidities, such as type 2 diabetes, arterial hypertension, sleep apnea, non-alcoholic fatty liver disease, among others (ASMBS, 2020). It is also considered an option for patients who have failed to lose weight with conservative methods, such as diet, exercise and medications (Colquitt et al., 2014).
Contraindications
The gastric sleeve procedure is contraindicated in patients with chronic gastrointestinal disorders, advanced liver disease, chronic kidney disease, coagulation disorders, uncontrolled eating disorders, or those who cannot commit to long-term medical and nutritional follow-up (ASMBS, 2020).
Long-Term Results
Numerous studies have demonstrated the effectiveness of gastric sleeve in weight loss and improvement of comorbidities associated with obesity. According to a meta-analysis study, the average weight loss after gastric sleeve surgery is 58% to 65% of excess weight after five years (Clapp et al., 2018). In addition, significant improvement in comorbidities, such as type 2 diabetes, high blood pressure, and sleep apnea, among others, has been observed (Brethauer et al., 2013).
Complications and Risks
Although the gastric sleeve procedure is generally safe and effective, there are potential complications, such as bleeding, infections, gastric leaks, strictures, and deep vein thrombosis (Buchwald et al., 2014). Despite these risks, the rate of serious complications is low, around 2-5% (Gagner, 2016). It is important that patients are aware of these risks and discuss concerns with their medical team before undergoing the procedure.
Monitoring and Lifestyle Changes
Medical and nutritional follow-up is critical to ensure the long-term success of the gastric sleeve. Patients must be committed to lifestyle changes, such as adopting a healthy and balanced diet, engaging in regular physical activity, and maintaining psychological and emotional support (Courcoulas et al., 2014). In addition, vitamin and mineral supplementation is essential to prevent nutritional deficiencies, as nutrient absorption can be affected by the reduced size of the stomach (Parrott et al., 2017).
Conclusion
The gastric sleeve procedure is an effective and safe option for the treatment of morbid obesity and improvement of associated comorbidities. Although there are risks and complications, these are generally low compared to other bariatric procedures. The patient's commitment to medical and nutritional follow-up, as well as to adopting a healthy lifestyle, is critical to ensure the long-term success of the surgery.
References
Angrisani, L., Santonicola, A., Iovino, P., Vitiello, A., & Higa, K. (2019). Bariatric surgery and endoluminal procedures: IFSO Worldwide Survey 2018. Obesity Surgery, 29(12), 3783-3794. https://doi.org/10.1007/s11695-019-04107-x.
ASMBS (2020). ASMBS updated position statement on bariatric surgery in class I obesity (BMI 30-35 kg/m²). Surgery for Obesity and Related Diseases, 16(7), 825-831. https://doi.org/10.1016/j.soard.2020.04.010
Brethauer, S. A., Aminian, A., Romero-Talamás, H., Batayyah, E., Mackey, J., Kennedy, L., ... & Schauer, P. R. (2013). Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus. Annals of Surgery, 258(4), 628-637. https://doi.org/10.1097/SLA.0b013e3182a5034b.
Buchwald, H., Oien, D. M., & Schauer, P. R. (2014). Laparoscopic gastric bypass versus laparoscopic adjustable gastric banding: A systematic review and meta-analysis of bariatric surgery. JAMA Surgery, 149(12), 1279-1287. https://doi.org/10.1001/jamasurg.2014.1674.
Clapp, B., Wynn, M., Martyn, C., Foster, C., O'Dell, M., & Tyroch, A. (2018). Long-term outcomes of laparoscopic sleeve gastrectomy-a single-center, retrospective study. Surgery for Obesity and Related Diseases, 14(1), 88-93. https://doi.org/10.1016/j.soard.2017.09.521.
Colquitt, J. L., Pickett, K., Loveman, E., & Frampton, G. K. (2014). Surgery for weight loss in adults. Cochrane Database of Systematic Reviews, 8, CD003641. https://doi.org/10.1002/14651858.CD003641.pub4.
Courcoulas, A. P., Christian, N. J., Belle, S. H., Berk, P. D., Flum, D. R., Garcia, L., ... & Mitchell, J. E. (2014). Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA, 310(22), 2416-2425. https://doi.org/10.1001/jama.2013.280928
Gagner, M. (2016). Bariatric surgery tourism hidden costs? How Canada is not doing its part in covering bariatric surgery under the Canada Health Act. Canadian Journal of Surgery, 59(4), 271-273. https://doi.org/10.1503/cjs.007616
Parrott, J., Frank, L., Rabena, R., Craggs-Dino, L., Isom, K. A., & Greiman, L. (2017). American Society for Metabolic and Bariatric Surgery integrated health nutritional guidelines for the surgical weight loss patient 2016 update: Micronutrients. Surgery for Obesity and Related Diseases, 13(5), 727-741. https://doi.org/10.1016/j.soard.2016.12.018.
Rosenthal, R. J. (2012). International Sleeve Gastrectomy Expert Panel Consensus Statement: Best practice guidelines based on experience of>12,000 cases. Surgery for Obesity and Related Diseases, 8(1), 8-19. https://doi.org/10.1016/j.soard.2011.10.019. https://doi.org/10.1016/j.soard.2011.10.019
CONSULT
You may be a candidate for weight loss surgery.
You may be a candidate for weight loss surgery if you meet any of the following criteria:
Overweight
He weighs more than 20 kilos above his ideal body weight.
BMI
You have a Body Mass Index (BMI) greater than 30 kg/m².
Health
You suffer from obesity-related health problems, such as hypertension or diabetes.
Diets
You cannot achieve a healthy body weight, even with medically supervised diets.
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