Background:
Sleeve gastrectomy (SG) is an alternative to gastric bypass and laparoscopic adjustable gastric banding (GB).
Methods:
From January 2004 to January 2006, a prospective follow-up study was conducted with 111 patients who had a follow-up longer than 24 months. Three treatment groups were defined: sleeve gastrectomy as the first procedure, sleeve gastrectomy after failure of GB.
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Dr. Van Wagner and Dr. Jay Snow, both bariatric surgeons in St. Louis, have observed a significant rise in the number of gastric sleeve procedures performed, according to the American Society for Metabolic and Bariatric Surgery (ASMBS). This surge is attributed to increased patient awareness and recognition of the effectiveness of gastric sleeve surgery for extreme obesity. The procedure is now widely acknowledged as one of the most successful options for achieving substantial weight loss.
Dr. Wagner and Dr. Snow from Heart of America Bariatrics have seen a notable surge in the popularity of gastric sleeve surgeries since 2009. These procedures now account for half of their overall surgical volume, representing a growth rate exceeding 200%. The doctors credit this increase to factors like enhanced patient education and advancements in techniques and technology associated with the procedure.
When it comes to the increasing demand for weight loss surgery, consulting a certified bariatric surgeon is essential. Surgeons stress the importance of conducting thorough research on available options and carefully contemplating the decision. Dr. Snow highlights that patients need to be ready for substantial lifestyle and dietary modifications since bariatric surgery necessitates lifelong commitment.
According to him, patients who engage in this behavior can greatly enhance their lives by addressing the issues associated with obesity. He also emphasizes that the staff at Heart of America Bariatrics is fully dedicated to ensuring that patients achieve optimal outcomes. The study utilized data from January 2004 to January 2006, consisting of a patient population of 326 individuals who underwent bariatric surgery. All procedures were performed by two surgeons (PV, AD), with consistent support from a medical team comprising endocrinologists, psychiatrists, and gastroenterologists.
The surgeon and patient reached a consensus on the bariatric surgery procedure. The waiting time for the surgery was around 6 months, during which occasional consultations with psychiatric and endocrinology specialists took place. Among the 111 patients who underwent restrictive surgery (SG, SG after GB, GB) and were monitored for over 2 years, the results of 59 patients who received SG have already been published in another series [5].
The validated form of bariatric surgery known as the SG technique involves collecting prospective data, which includes age, gender, initial BMI, comorbidities associated with obesity (such as dyspnoea, diabetes, arterial hypertension, and obstructive sleep apnoea syndrome), duration of the operation, early postoperative complications assessed using the Clavien score system, long-term complications, reoperations performed under general anesthesia. Additionally, BMI measurements at 6 months, 12 months and 24 months after surgery are recorded along with the percentage of excess weight loss (EWL) at these same time points. The percentage of excess BMI loss (EBMIL) is also measured at 6 months ,12 months and 24 months post-surgery. Furthermore, quality of life details are included in the data collection.
The outcomes of sleeve gastrectomy (SG) in this study were comparable to those of gastric bypass (GB), indicating that endoscopic sleeve gastroplasty (EWL) can be equally effective as GB. Additionally, SG performed after GB showed similar results to a successful GB procedure, suggesting the possibility of a second restrictive procedure following unsuccessful GB. Although complications occurred less frequently in the SG group, they tended to be more severe. The rate of reoperation under general anesthesia was lower in the SG group. Overall, there were no significant differences in quality of life among the three groups.
References 1: de Saint Pol T. Obesite et milieux sociaux en France: les inegalites augmentent.
Bull Epid Hebdo. 2008;20:175–9.
Ginter E, Simko V. Adult obesity at the beginning of the 21st century: epidemiology, pathophysiology and health risk. Bratisl Lek Listy. 2008;109:224–30.
This section contains information about Sleeve Gastrectomy. It is intended for general information only and should not be considered as medical advice on the part of Health-Tourism.com. Any decision on medical treatments, after-care or recovery should be done solely upon proper consultation and advice of a qualified physician.
Sleeve gastrectomy, a weight loss procedure, involves surgically removing a portion of the stomach to create a slender “sleeve”. This reduction in stomach size limits food intake and leads to weight loss. Sometimes, sleeve gastrectomy is followed by duodenal switch surgery or gastric bypass. The procedure utilizes a laparoscope and small instruments to vertically divide the stomach along its inner curve. Staples are used to connect the open edges of the stomach, forming a sleeve or banana-like shape.
This procedure decreases the size of the stomach by around 75%, mainly for obese patients, although extremely obese individuals may not qualify. The success rate is high, with many patients losing 30 to 50% of their weight within the first year after surgery. If there is inadequate weight loss, a duodenal switch surgery is performed.
The sleeve gastrectomy procedure typically lasts for about 1 hour and requires patients to stay in the hospital for 2 to 3 nights. General anesthesia is used during the surgery, and the recovery time is estimated to be around 2 to 3 weeks. There are several risks associated with this procedure, including infection, bleeding, adverse reactions to anesthesia, marginal ulcers, deep vein thrombosis, and malnutrition or other nutritional problems. Aftercare includes taking painkillers to address any abdominal pain or discomfort that may arise.
Compression pads or stockings should be worn after sleeve gastrectomy to prevent deep vein thrombosis. In the first 24 hours following the surgery, only water should be consumed, and then switch to a liquid diet for the next week. It is crucial to chew food slowly and eat small amounts when consuming meals. The size of your stomach post-surgery will vary depending on the surgeon, as they all use a tube as a guide while stapling the stomach.
The tube size used in this surgery can vary from 32 French Bougie (1-2 ounces) to 64 French Bougie (6-8 ounces), which is crucial as patients with bigger pouches may have lower weight loss. The removal of the stomach is a safe procedure that has been performed alongside the Duodenal Switch since the mid-1980s. It involves stapling, similar to gastric bypass, and carries comparable risks. Interestingly, patients do not ask for their stomach to be returned, but some wonder if it can be done.
