Gastric sleeve

As with all weight loss surgery procedures, there is a 2-week pre-operative diet that must be adhered to, also known as a “liver shrinking” diet. This reduces the size of the liver, which needs to be moved out of the way, to enable the operation to be performed on the top part of the stomach. There are many variations of this diet, which all lead to the desired effect, so choose one that suits you following consultation with your provider.

A sleeve gastrectomy involves using a stapler gun to remove around 75-80% of your stomach. It’s accurately measured using a sizing tube that your consultant will use during the procedure. A sleeve gastrectomy is usually done laparoscopically; a minimally-invasive keyhole procedure. As a result, you’ll benefit from faster recovery and less time spent in hospital.

You’ll still have the operation under a general anaesthetic, and your consultant will discuss the details of your procedure with you, answering any questions you might have ahead of the surgery.

A sleeve gastrectomy reduces your stomach to around 20% of its previous size. Because of this you’ll feel fuller quicker, and won’t be able to eat as much as you used to.

You’ll also have a lower appetite because you’ll produce less “hunger hormone” called ghrelin, which sends signals to your brain, telling you you are hungry when your stomach is empty.

This combination of not wanting to eat and physically being unable to eat too much produces profound weight loss. The surgery is also a permanent option, and so longer term, more dramatic weight loss is likely with a gastric sleeve, rather than a band or balloon.

Picking the right weight loss surgery for you depends on a few different factors that work in combination. The first thing to consider is your BMI. A gastric sleeve is usually most appropriate for patients with a BMI of at least 35 and comorbidities such as diabetes.

The gastric sleeve isn’t advised for patients with a BMI of lower than 35 as it’s a drastic option for patients without so much weight to lose. It’s considered to be half way between a band and a bypass, and is usually suitable for patients with a high BMI that want a permanent option. A bypass is usually a preferred option for patients who have a very high BMI and have serious medical problems such as metabolic syndrome.

The best way to come to a decision about the right procedure for you, is to have a detailed and open conversation with your consultant. It’s also important to choose a surgeon that offers the full range of procedures, so that you can end up with the option that is right for you, and not just the option the surgeon wants to do.

As with any surgery, there are some risks. Whilst not common, complications such as bleeding, infection and blood clots are possible. Specifically to this procedure, a very small risk is leakage from the staples used to create the “sleeve”. If this rare event does occur, it will usually be within the first two days post-surgery, and a return to surgery will be needed to deal with the issue.

Your consultant will discuss all of the possible complications, side effects and other things to consider before you decide to have gastric sleeve surgery.

The principle of a gastric sleeve is to restrict how much you are eating by creating a long narrow sleeve of stomach. Stretching it with a balloon would not help weight loss. Bands can be placed to surround the stomach pouch of a gastric bypass to enhance the mechanical restriction, however the same effect has not be theorised to help weight loss with a sleeve gastrectomy. Sleeve gastrectomies can be converted to a mini-bypass or full bypass if weight loss has plateaued. It is best to discuss all these options with the team providing treatment.