With obesity continuing to rise in the West weight loss surgery is becoming an everyday form of surgery in many medical facilities.
The sleeve gastrectomy is a restrictive form of weight loss surgery in which about 85% of the stomach is removed leaving a sleeve shaped stomach with a much reduced capacity ranging from about 60 to 150 cc. Unlike most other types of bariatric surgery, the outlet valve and the nerves to the stomach remain intact and, while the stomach is hugely reduced in volume, its function is unchanged. Again, unlike other types of weight loss surgery like the time honored Roux-en-Y gastric bypass the sleeve gastrectomy is not reversible.
As the newly created stomach functions normally there are far fewer restrictions on the foods which patients can eat following surgery, although the amount of food eaten will be very noticeably reduced. Many patients view this as being one of the great advantages of the vertical gastrectomy, as well as the fact that the removal of most of the stomach also causes the essential elimination of the hormones which are produced within the stomach and which stimulate hunger.
probably the greatest advantage of the vertical sleeve gastrectomy lies in the fact that it does not bypass the intestinal tract so that patients do not therefore encounter the complications of intestinal bypass such as anemia, intestinal obstruction, vitamin deficiency and protein deficiency. It also means that it is a fitting form of surgery for patients who already suffer from anemia, Crohn's disease and various other conditions which would place them at high risk for intestinal bypass surgery.
Finally, it is one of of only a few types of bariatric which can be carried out laparoscopically in patients who are particularly obese.
Probably the main disadvantage of the sleeve gastrectomy lies in the fact that it does not always create the weight loss which people would wish for and may even produce weight regain in the long term. This is of course true of any form of purely restrictive weight loss surgery although it is perhaps particularly true in the case of the vertical sleeve gastrectomy.
As the procedure requires the stomach to be stapled patients are at risk of leakage and other complications which are directly related to stapling. Furthermore, as is the case with any operation, patients are at risk from complications such as post-operative bleeding, small bowel obstruction, pneumonia and even death. The risk of experiencing any of these complications is nonetheless very small and is in the region of about 0.5 and 1%. Having said this, the risk of dying as a result of this form of operation at approximately 0 .25% is very small indeed.
As a general rule the vertical gastrectomy is most suitable for people who are either very overweight or whose health rules out other types of weight loss surgery. In the case of the first category of patient the vertical gastrectomy would usually form the first of a two-part plan of weight loss, with follow-up surgery being done once the individual's weight has fallen enough to permit other types of surgery to be done.
