What is a gastric sleeve?: Q&A for Beginners

Gastric sleeve is known to be a popular solution for the treatment of obesity. But what is a gastric sleeve exactly? As the gastric sleeve is an obesity treatment, it will affect your metabolism and help you lose weight. 

Since the ’90s, this procedure has been a popular treatment and has four different types that can be performed. 

In this article, I will be explaining to you what it is, how it works on weight loss, what types of gastric sleeve there are, and if they are permanent.

Without further ado, let’s dive in!

What is gastric sleeve surgery?

So, let’s start. What is gastric sleeve surgery? Gastric sleeve surgery is a bariatric procedure, basically a weight loss surgery. It is done on patients who have above 40 body mass index (BMI). It can also be performed on patients with 35 and above BMI if they also have obesity-related medical conditions; such as type 2 diabetes, heart disease, high blood pressure, or sleep apnea.

With this procedure, approximately 80% of your stomach is extracted. The surgery takes about 40-70 minutes.

The cells on the removed part of your stomach produce hormones that are responsible for the feeling of hunger, also known as the ghrelin hormone. Since that part also goes away along with a big part of your stomach, you will not feel hungry and feel full after a few bites. So, your weight loss journey will be easier and faster. And your quality of life will be better than ever.

Is gastric sleeve permanent?

Yes, a gastric sleeve is permanent.

What is a gastric sleeve? Let’s refresh our memories. With this procedure, a big portion of the stomach is removed from the abdomen. There is no reversing the gastric surgery. It cannot be reattached. Once the cut part of the stomach is taken out, it is disposed of.

The results are also permanent, as long as you don’t return to your old habits. So, keep up the good work, eat well, and exercise regularly. You got this!

How does gastric sleeve help you lose weight?

With the gastric sleeve, we remove a big portion of the stomach. The part of the stomach we remove produces ghrelin and leptin hormones. These hormones are responsible for stimulating appetite, also referred to as hunger hormones. The cells producing these hormones do grow back in time. But not for at least 2 years.

Also, it is worth mentioning that first few months, you cannot even attempt to eat more than you are supposed to, or eat something that you are not allowed to; like solid food. Since your stomach is still healing and is weak, trying to digest those foods by turning and churning will be painful for both you and your stomach. Or worse, you could get a leak. This should be a good motivator to stick to your diet, no?

“Since the stomach cannot digest solid food yet, how are we supposed to feed ourselves? How can I function without adequate food?” The first 1 week to 10 days after your discharge will be the days you will be only consuming liquids (this is crucial for recovery). Your calorie intake will be very low. So your body will burn the stored excess fat for energy. This is also how gastric sleeve helps you lose weight.

How does gastric sleeve affect metabolism?

We know that ghrelin and leptin hormones trigger hunger. There is also another hormone that’s included in all of this: GLP-1. This hormone helps control hunger and helps the functioning of the gastrointestinal tract. After a gastric sleeve, this hormone’s production gets boosted, indirectly causing metabolism (breakdown of food) to also boost.

With the help of a boosted metabolism, you process food better. And that means healthy weight loss.

How much can you lose with gastric sleeve?

With a gastric sleeve, you will go through a dramatic weight loss. You will lose 55-75% of your excess weight.

You will lose most of your weight in the first 12 months after surgery. Your weight loss might slow down after some time. That is absolutely normal. Continue sticking to your diet and exercise, and you will be fine.

Is gastric sleeve inpatient or outpatient?

Gastric sleeve is an inpatient procedure. Even though it is minimally invasive, your stomach is reduced in size. So, it is actually a complicated procedure. You need to stay in the hospital for 1-2 nights after the surgery, in case there are any complications. 

You won’t be staying only for a chance of complication developing, of course. You will experience discomfort for the first few hours after the surgery. And to eliminate the risk of a leak, you will be given IV’s for both nutrition and to eliminate discomfort.

Regardless of the type of bariatric surgery, your stomach will be examined via endoscopy, which includes inflating your stomach with air. Also during the surgery, your stomach will be inflated to provide vision and accessibility for the surgeon. The remaining air inside the stomach will discomfort you, but it can be released with mobilization after surgery in the hospital.

You will not even drink water during your hospital stay. Since you will be provided IV fluids, you will not be dehydrated. Your lips may dry up and get chapped, though. To soothe chapped lips, moisten a napkin with water and press it lightly against your lips.

Oh, and on a side note, you can brush your teeth. Just be careful, do not swallow anything while you brush.

What are the types of gastric sleeve?

With the advancing technology and the people with lower BMI demanding this procedure, various types of gastric sleeve were developed. Some of them are outpatient, some of them are less invasive, and some of them are performed by a robot!

Let’s review.

Mini gastric sleeve

A mini gastric sleeve is basically a gastric sleeve surgery but on a smaller scale. Patients with a 29-35 BMI can have this procedure. It is called mini compared to the traditional gastric sleeve because, during mini gastric sleeve, 40-50% of the stomach is cut out.

Since less stomach tissue is being extracted, it grants faster recovery, less pain, and low complication risks.

Endoscopy gastric sleeve

Endoscopic gastric sleeve is the less invasive procedure among the types we are discussing. No abdominal incisions are made for this surgery. Instead of being cut, the stomach is narrowed by sutures.

It is done with an endoscope with a suturing device attached to it and a tiny camera attached to a tiny tube. The operator inserts the camera and the endoscope through the patient’s mouth and marks the stomach from the side of the stomach and the upper stomach. After the marks have been made, the operator begins stitching the stomach and narrows its size.

Laparoscopic gastric sleeve

This here is another simple answer to what is a gastric sleeve.

The laparoscopic gastric sleeve is the most common type of gastric sleeve. You may now refer to laparoscopic surgery as a traditional gastric sleeve. In the ’90s, gastric sleeve surgeries used to be performed openly. As technology advanced, the open surgery method was left behind.

A laparoscope –a surgical tool with a camera and light– is inserted in the belly through an incision to provide a vision of the inside of the abdomen. There will be additional incisions for the other tools as well, such as a liver retractor. With this surgery, approximately 80% of your stomach is removed. Your surgeon will divide, cut, and staple your stomach with a surgical stapler.

Robotic gastric sleeve

This technique gives the surgeon better vision and steadierhands” if you know what I mean. The surgeon controls the robotic platform to perform the procedure. 60-80% of the stomach is extracted with a robotic gastric sleeve. Since it grants better vision and dexterity for the surgeon, there are low complications risks, less pain, and quicker recovery.

Despite its good qualities, it is not a preferred type among surgeons. To use the robotic platform, you use your fingers. You have minimal movement throughout the procedure. And some even report that they do not feel like they have full control of the procedure. But, who knows? Maybe in a few years, it will be even more advanced and be one of the most preferred methods. We just have to wait and see. 

References:

(1) Brethauer SA. Sleeve Gastrectomy. Surgical Clinics of North America. 2011;91(6):1265-1279. doi:10.1016/j.suc.2011.08.012

https://pubmed.ncbi.nlm.nih.gov/22054153/

(2) Felsenreich DM, Bichler C, Langer FB, Gachabayov M, Prager G. Sleeve Gastrectomy: Surgical Technique, Outcomes, and Complications. Surgical Technology International. 2020;36:63-69. Accessed January 10, 2023. https://pubmed.ncbi.nlm.nih.gov/32359172/

(3) Popescu AL, Ioniţa-Radu F, Jinga M, Gavrilă AI, Săvulescu FA, Fierbinţeanu-Braticevici C. Laparoscopic sleeve gastrectomy and gastroesophageal reflux. Romanian Journal of Internal Medicine. 2018;56(4):227-232. doi:10.2478/rjim-2018-0019

https://pubmed.ncbi.nlm.nih.gov/30521478/

(4) Chung AY, Thompson R, Overby DW, Duke MC, Farrell TM. Sleeve Gastrectomy: Surgical Tips. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2018;28(8):930-937. doi:10.1089/lap.2018.0392

https://pubmed.ncbi.nlm.nih.gov/30004814/

(5) Cornejo-Pareja I, Clemente-Postigo M, Tinahones FJ. Metabolic and Endocrine Consequences of Bariatric Surgery. Frontiers in Endocrinology. 2019;10. doi:10.3389/fendo.2019.00626

https://pubmed.ncbi.nlm.nih.gov/31608009/

(6) Knop FK, Taylor R. Mechanism of Metabolic Advantages After Bariatric Surgery: It’s all gastrointestinal factors versus it’s all food restriction. Diabetes Care. 2013;36(Supplement_2):S287-S291. doi:10.2337/dcs13-2032

https://pubmed.ncbi.nlm.nih.gov/23882061/

Leave a Comment

Your email address will not be published. Required fields are marked *

Scroll to Top