Gastric Sleeve Surgery

Treatments

Gastric sleeve surgery is one of the newer treatment options for medical weight loss, and here at Beltline Health, we perform this procedure using minimally-invasive, robot-assisted technologies that are designed to help you feel better, faster.

To help you understand how this procedure works, we’ve prepared this summary of the most common questions our patients have about gastric sleeve surgery.

What is a Gastric Sleeve Procedure?

Gastric sleeve surgery, also called sleeve gastrectomy or vertical gastric sleeve, is a permanent, non-reversible procedure used to treat chronic obesity among patients who have a body mass index over 35.

During the operation, your surgeon seals off approximately 80 to 85 percent of your existing stomach with surgical staples and/or stitches placed with specialized surgical instruments and cameras inserted through tiny incisions in your abdomen. A long, narrow stomach sleeve is created, without the need to disrupt your digestive anatomy.

How Does Gastric Sleeve Work to Promote Weight Loss?

A sleeve gastrectomy is classified as a restrictive bariatric procedure – the operation restricts the amount of food your stomach can hold, helping you to consume fewer calories. When you take in fewer calories, you encourage your body to burn off excess fat as fuel.

Most patients achieve a loss of up to 70 percent of excess body weight within 2 years of having gastric sleeve surgery, with the most dramatic weight loss occurring in the first year following the procedure.*

A sleeve gastrectomy can also help patients feel less hungry, because the secretion of hunger-causing hormones is dramatically reduced when a large portion of the stomach is removed.

Who Qualifies for Gastric Sleeve Surgery?

As with all types of weight loss surgery, patients who are interested in gastric sleeve surgery need to meet specific preoperative criteria.

In general, a sleeve gastrectomy may be an option for patients who:

Have a body mass index (BMI) of 40 or greater, or over 35 with one or more comorbidities (serious medical conditions caused by obesity, such as sleep apnea, heart disease, or Type 2 diabetes)
Have been unable to achieve and maintain a healthy body weight through diet and exercise
Are committed to following a strict, lifelong diet and exercise program
Are healthy enough to undergo surgery using a general anesthesia
Understand the potential risks and complications of any type of surgical procedure
Have a realistic expectation of the likely outcomes from gastric sleeve surgery

How Safe is Gastric Sleeve Surgery?

Gastric sleeve surgery has been used to treat obesity both here in the United States and throughout Canada, Mexico, and Europe since the procedure was first developed in 1988. As with all surgical procedures, there are risks involved with the use of general anesthesia. Complication rates from sleeve gastrectomy surgery are relatively low when compared to other types of weight loss surgery. In most cases, complications can be prevented by choosing a skilled bariatric surgeon and following post-operative care instructions carefully.

Minimally-Invasive Options for Gastric Sleeve Surgery

While gastric sleeve surgeries can be performed in a traditional open manner, most patients experience better results from laparoscopic procedures. A surgical technique that uses several small incisions to access the stomach rather than one large one, laparoscopic surgery allows for the same basic outcome with fewer risks and expedited healing times. In these kinds of procedures, small holes known as keyholes are strategically placed to allow access with a laparoscope or a tube outfitted with a camera and surgical tools.

What To Expect After Gastric Sleeve Surgery

Following a sleeve gastrectomy, you will need to follow a special post-surgical diet that begins with a clear liquid phase, followed by full liquids then pureed foods. This special diet is designed to promote post-operative healing and help minimize the risk of complications.

Once your new stomach is fully healed, you will begin to consume regular foods again, however, the portion sizes will be dramatically smaller than you were eating before your gastric sleeve surgery.

Our nutritional experts here at Beltline will provide you with all the ongoing support you need to understand your new diet, address any concerns you might have, and help you achieve your weight loss goals.

Will Insurance Cover Gastric Sleeve Surgery?

Many insurance providers offer coverage for gastric sleeve surgery.

As with all weight loss procedures, there are strict requirements in order to qualify for insurance coverage for a sleeve gastrectomy. Your insurance provider may require you to undergo psychological assessments, medical testing, and proof of previous, failed attempts to achieve and maintain a healthy body mass index (BMI) through lifestyle modification (diet and exercise).

Here at Beltline, many of our patients choose to self-pay for weight loss procedures like gastric sleeve surgery, in order to expedite their weight loss journey.

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Gastric sleeve surgery, also called sleeve gastrectomy, is the most common bariatric surgery procedure in the United States that is usually performed laparoscopically. In this procedure, a bariatric surgeon removes around 80 to 85% of the stomach and shapes the remaining stomach portions into a tube or “sleeve”.

This restrictive bariatric surgery procedure helps patients reduce their food intake by limiting the capacity of the stomach. It also decreases their appetite as it removes the portion of the stomach that secretes the most hunger hormones. With reduced appetite and lower food intake, the gastric sleeve procedure can significantly contribute to a healthy weight loss.

Who is considered for gastric sleeve surgery?

In general, gastric sleeve surgery is a good option for patients with:

a body mass index (BMI) of 40 or higher (morbid obesity)
a BMI of 35 to 39.9, and have severe obesity-related health problems like type 2 diabetes, sleep apnea, hypertension, and heart disease.

Dr. Charles Procter, one of the nation’s top bariatric surgeons and a founding member of Beltline Health, recommends sleeve gastrectomy surgery for patients who want to lose weight with a BMI of 35 to maybe in the high 40s, especially if they have a pretty clean medical history.

At Beltline Health, our goal is to provide you with all the information you need to determine if weight loss surgery is right for you. Our team is dedicated to helping you decide which procedure best fits your needs to achieve a healthy and sustainable weight.

How is gastric sleeve surgery different from gastric bypass surgery?

In Roux-en-Y Gastric Bypass (RYGB) or simply gastric bypass, the bariatric surgeon divides the stomach into a small upper portion called the pouch. It bypasses the lower, larger portion of the stomach which can no longer store or digest food.

Instead of removing a large portion of the stomach, the newly created stomach pouch is connected to the lower portion of the small intestine to allow for complete digestion. However, these bariatric surgery procedures both aim to limit food intake, reduce hunger, and promote healthy weight loss.

Stout adult woman with measuring tape at home. Weight loss concept

What to expect before sleeve gastrectomy?

As with other bariatric surgery procedures, patients are encouraged to lose as much excess weight as they can before the surgery. Specifically, a special pre-surgical diet should be followed to “shrink” your liver. It is assumed for obese patients that their liver has accumulated plenty of fat cells which needs to be reduced. It would also be easier during the surgery to have a normal-sized liver since it’s right next to the stomach.

Weeks prior to surgery, patients will be required to eat mainly lean protein, vegetables, low-sugar fruits, and low-calorie beverages. It’s best to avoid fatty meats, oily foods, whole milk products, high-carb and sugar foods, and high-calorie drinks to lose weight before the surgery.

There are also certain medications that must be discontinued prior to surgery such as NSAIDs (including aspirin alternatives), arthritis medications, herbal supplements, and blood thinners. You may ask your bariatric surgeon for more information about these.

What happens during sleeve gastrectomy?

The surgery, which takes around one to two hours, almost always uses minimally invasive techniques. During the laparoscopic sleeve gastrectomy surgery, the bariatric surgeon will start by making five to six small incisions in the abdominal area. The surgical instruments and a camera will be inserted into these small incisions to access the stomach.

Using surgical staplers, a larger portion of the stomach is removed to leave a narrow gastric tube or “gastric sleeve” in the shape of a banana, that is naturally connected to the small intestine. It doesn’t bypass any part of the intestine, unlike gastric bypass surgery.

What to expect after sleeve gastrectomy?

Following gastric sleeve surgery, patients typically spend a night or two in the hospital. Patients should be able to walk and do light daily activities a few hours after the procedure.

Patients will also need to follow a special post-surgical diet that starts with a clear liquid diet, followed by full liquids and pureed foods. After around four to five weeks, patients will be able to consume regular solid foods again once your new stomach is fully healed.

Since a portion of the stomach is removed, patients will also need to reduce your food intake and adjust the portion sizes compared to what you’re used to before the surgery. Patients should eat slowly and chew thoroughly, and it’s important to stop eating when you’re starting to feel full.

Since most gastric sleeve procedures are performed laparoscopically, the complication rates from sleeve gastrectomy are relatively low. Many patients return to their normal daily routine after two to four weeks. While fatigue is common for the first two weeks due to low-calorie intake, the energy level of patients significantly improves after introducing soft foods.

After around four weeks, depending on the situation, patients are encouraged to begin with their normal exercise routine. It takes around two months at most for patients to recover from gastric sleeve surgery. During that time, they are called into the clinic for regular check-ups and weight loss monitoring.

Our team at Beltline Health will provide you with personalized support to address your health concerns and dietary needs before and after your weight loss surgery.

What are the advantages of sleeve gastrectomy?

Compared to other weight loss surgery procedures, sleeve gastrectomy is a simple and less invasive procedure with shorter surgery time, faster healing time, and extremely rare post-surgery complications.

Other advantages are:

may be a suitable bariatric surgery procedure for patients with severe obesity
may be performed in certain patients with high-risk and complicated medical conditions
may lead to improvements in weight-related conditions like high blood pressure, type 2 diabetes, sleep apnea, and fatty liver disease
lower chances for nutrient deficiencies
removes the gland that secretes the hunger hormone ghrelin
does not affect the small intestine
does not require to place a foreign object inside the body
no risk for “dumping syndrome” (rapid gastric emptying)

What are the disadvantages of sleeve gastrectomy?

Even as a less invasive procedure, sleeve gastrectomy is a non-reversible procedure since the larger portion of the stomach is removed from the body. Without bypassing the small intestine, it might have less impact on metabolism which may slow down weight loss.

Other disadvantages are:

stapling can increase risks for leaks and other complications
may worsen or cause acid reflux and heartburn
the body can still tolerate carb-rich and high-fat foods

Is gastric sleeve surgery safe?

Gastric sleeve surgery is one of the safest and most effective weight loss surgery procedures. It is also the most commonly performed bariatric surgery procedure in the United States.

Many studies have confirmed its efficacy and safety in terms of weight loss and risks, particularly in patients with a BMI lower than 40. On average, gastric sleeve patients lose around 60 to 80% of their excess weight after 5 years when maintaining a proper diet.

If you’re interested in weight loss surgery, register for our free weight loss seminar to get started. Our team of experienced health professionals will guide you through the weight loss surgery process in detail, as well as the lifestyle habits you would need to adopt if you decide to undergo the procedure.

To know more about bariatric surgery, check our article on the different types of bariatric procedures we offer. For questions and concerns, head on to our website to message us or call us at (470) 419-4380.