Gastric Sleeve

Bariatric Surgery at Memorial Hospital

If you are very overweight and have serious health problems because of it, and you have unsuccessfully tried other methods, you may benefit from a type of weight loss surgery called the vertical sleeve gastrectomy, also known as the gastric sleeve.

Gastric sleeve is shown to be a highly effective treatment for obesity, and the surgery is available at Memorial Hospital.

How Gastric Sleeves Work

• Your smaller stomach produces much less of the hormone that causes the sensation of hunger, so you feel less hungry.
• You often eat only very small amounts of food at a time, stay full longer, and cut down on portion sizes.
• Your overall health improves. Diabetes may be eliminated altogether and blood pressure brought down to normal levels.

Advantages of Gastric Sleeve Surgery

If you follow specific dietary, exercise, and vitamin instructions, this procedure can greatly benefit your overall health. It can be especially helpful if you have type II diabetes. The less body mass you have, the less insulin you need, so you may be able to produce enough insulin on your own for your smaller body mass, and as a result, have normal blood sugar. In some instances, it has been shown to eliminate diabetes altogether. The surgery has also helped to bring blood pressure back to normal levels.

• Decrease risk of diabetes
• Lower blood pressure
• Improve cholesterol levels
• Decrease risk of heart disease
• Decrease risk of certain cancers
• Improve mobility
• Improve sleep apnea
• Decrease joint pain
• Improve blood sugar levels

Are You a Candidate for Weight Loss Surgery?

To help determine who is a good candidate for bariatric (weight loss) surgery, Memorial uses the following criteria for the surgical treatment of severe obesity:

Weight

• Body Mass Index (BMI) greater than 40
• BMI greater or equal to 35, with one or more significant obesity-related health conditions

Age

• 18 to 70 years
• 70 to 75 years on a case-by-case evaluation

History

• Multiple failed attempts with diet plans, behavior changes, and medical therapy

Mindset

• Realistic expectations and motivation
• Ability to understand the procedure and its implications, and to accept the operative risk
• Commitment to post-surgery diet, vitamin supplementation, exercise program, health, and weight-maintenance follow-up

Improving Your Health if You Don’t Qualify for Weight Loss Surgery

At Memorial, we understand the toll that obesity takes on your quality of life. Not everyone is an ideal bariatric surgery candidate; even so, Memorial offers ways to help you achieve a healthier state:

• Nutritional counseling
• Creation of a custom diet and exercise plan for your individual needs

Two Ways the Process Works

A sleeve gastrectomy is an inpatient procedure performed under anesthetic, and it requires you to stay in the hospital. Weight loss is achieved via the resulting physical and chemical changes of your stomach’s shape and size physical alteration, and you eat less at each meal.

It also produces chemical changes in the signals your stomach sends to your brain. This controls your blood sugar levels, causes you to feel more full (thereby decreasing hunger), and affects how your body processes and stores calories from the food you eat.

Following the procedure, medications are provided to help manage the post-surgical pain, which can be moderate to severe, particularly when you move your torso. The pain should stop within one to two weeks after you are discharged from the hospital. During your recovery time, if you experience fever, vomiting, or pain in areas not related to the surgical site, notify your doctor immediately.

Although at least one week of post-surgical recovery time is to be expected, you may need up to four weeks before you may feel comfortable with returning to work. This will depend on the nature of your job and how well you feel.

You should see results from your weight loss surgery within a few months, and you should lose 60% to 70% of your excess body weight within 12 to 18 months.

Your Decision: Other Things to Consider About Weight Loss Surgery

Qualifying is the first step. The decision to undergo bariatric surgery is complex and intensely personal, with many factors to take into account, including:

• Benefits versus risks: If you’re not morbidly obese, the risks of bariatric surgery outweigh the benefits of weight loss
• Finances and insurance: Many insurance carriers do not cover weight loss surgery. Check your plan for coverage requirements and out-of-pocket expenses. Our staff can explain your financial obligations and answer questions.

Advantages of Weight Loss Surgery

• Food passes through the digestive tract in the usual order, allowing vitamins and nutrients to be fully absorbed into the body.
• In clinical studies, patients lost an average of 66% of their excess weight.
• Shown to help resolve high blood pressure (49%), obstructive sleep apnea (60%), and to help improve type 2 diabetes (45-58%) and high cholesterol* (77%)^1,2,3,4

Risks of Weight Loss Surgery

In addition to the general risks that are possible with any type of surgery, weight loss surgery can lead to:

• Complications due to stomach stapling, such as stapled or stitched stomach tissue becoming separated, as well as leaks from staple lines
• Gastric leakage
• Ulcers
• Dyspepsia—a vague discomfort in the upper abdomen that feels like gas, fullness, gnawing or burning
• Esophageal dysmotility—problems with food in the esophagus; for example, acid reflux
• Nonreversible since part of the stomach is removed

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¹[45% to 68% achieved partial or complete remission of diabetes (diabetes resolution based on HbA1c ≤7.0).] Schauer PR, Sangeeta KR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012 Apr 26;366(17):1567-76

² [EES weighted analysis of data summarized in table 4 of] Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Rel Dis. 2009; 5:469-475.

³ [EES summary of data contained in] Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Rel Dis. 2009; 5:469-475.

⁴Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery. A systematic review and meta-analysis. JAMA. 2004;292(14):172–37