What is the Gastric Sleeve (Sleeve Gastrectomy) Surgery?
Gastric sleeve surgery is one of the most commonly performed obesity surgeries worldwide. The surgery is performed under general anesthesia, using either laparoscopic (minimally invasive) or robotic surgical methods, with only 4-5 small incisions made to access the abdominal cavity. In suitable patients, it is also possible to perform the surgery through a single incision (single port).
The main goal of gastric sleeve surgery is to reduce the size of the stomach. For this, approximately 80-85% of the stomach is removed vertically. After this removal, 150-200 ml of space remains in the stomach, which helps the patient consume less food and liquid. Gastric sleeve surgery is classified as a restrictive surgery.
How Does the Weight Loss Mechanism Work?
Weight loss occurs through two mechanisms in this procedure:
- Restrictive Effect
- Endocrine Effect
Restrictive Effect
The reduction in stomach volume leads to mechanical restriction and weight loss due to decreased stomach movements.
Endocrine Effect
A decrease in the level of the hormone GHRELIN, which is secreted from the portion of the stomach that is removed, helps create a feeling of fullness. Ghrelin is a peptide protein secreted by cells in the fundus (upper part) of the stomach. It is a powerful stimulant for the appetite-regulating area in the brain. In gastric sleeve surgery, since the portion of the stomach that produces Ghrelin is removed, appetite is reduced, contributing to weight loss.
What Are the Risks of Gastric Sleeve Surgery?
Complications such as bleeding, organ injury, respiratory problems, and embolism, which apply to all surgeries, can occur at very low rates. A specific complication of gastric sleeve surgery is leaks (leakage) that may occur from the stapler line (the part where the stomach is cut and sutured), which may sometimes require a second intervention.
Am I a Candidate for Gastric Sleeve Surgery?
If your BMI > 35 kg/m2 or if your BMI is between 30-35 kg/m2 with obesity-related medical problems (such as type 2 diabetes, hypertension, sleep apnea, etc.), you may be a candidate for this surgery. Patients who undergo gastric sleeve surgery have typically tried conventional weight loss methods but were unsuccessful. Even if you meet these general criteria, an assessment of your medical, nutritional, and behavioral suitability for the surgery is required.
How Long Will I Stay in the Hospital?
You are expected to stay in the hospital for 2-3 days; however, the duration may be extended if there are issues arising during pre-surgery evaluation or post-surgery recovery.
Is Vitamin/Mineral Supplementation Necessary After Gastric Sleeve Surgery?
Since this procedure is restrictive, there are no issues with nutrient absorption in the intestines. However, iron absorption requires stomach acid secreted by parietal cells, and vitamin B12 absorption requires intrinsic factor. Therefore, patients need to take iron and B12 vitamin supplements after surgery. For most patients, lifelong supplementation is not necessary, and adjustments will be made during follow-ups by your doctor and nutritionist.
How Much Weight Will I Lose After Gastric Sleeve Surgery?
Patients who undergo gastric sleeve surgery typically lose 60-70% of their excess weight in 1-2 years. In patients who follow a regular follow-up and adhere to nutrition guidelines, this rate can rise to 80-90%. Studies have also shown that the amount of excess weight lost after 3 years is similar to the weight loss achieved with Gastric Bypass surgery.
Is Success Guaranteed After Gastric Sleeve Surgery? Will I Gain Weight Again?
After gastric sleeve surgery, some weight regain may occur if the stomach tube gradually enlarges over time or if unhealthy eating habits continue. The primary effect of the gastric sleeve surgery is restrictive, meaning reducing food intake is the fundamental purpose. However, if the diet consists of liquids and high-calorie foods, weight loss may be minimal. In such cases, it is possible to transition to another obesity surgery, such as Gastric Bypass or Duodenal Switch, which can also be performed laparoscopically.
I’m Afraid of Leaks (Leaks) After Gastric Sleeve Surgery, How Can I Minimize the Risk?
The rate of leaks after gastric sleeve surgery is typically around 1%. The most important factors in reducing the risk of leaks include having the surgery performed by an experienced surgeon, using high-quality surgical materials (stapling machines and laser cutters), and employing supportive products (tissue adhesives) along the stapler line.
In our gastric sleeve surgeries, we routinely use FDA-approved devices from Johnson & Johnson / Medtronic. Additionally, we routinely use FDA-approved tissue-supportive products from Baxter. You can access our article in internationally highly referenced journals related to our surgeries below.
