A sleeve gastrectomy is a procedure that in effect drastically reduces the size of the stomach. A normal stomach can have a volume of around 2 litres, and after a sleeve gastrectomy this is reduced to less than 150 ml, with the remaining part of the stomach around the size of a banana - this is the 'sleeve'.
This procedure is effective for two reasons - firstly it significantly reduces the size of the stomach and secondly it removes the section of the stomach (called the 'fundus') which produces a hormone called ghrelin which is involved in the regulation of appetite and the creation of a feeling of hunger.
Sleeve gastrectomy used to be regarded as an initial procedure to prepare severely obese patients for a bilio-pancreatic bypass procedure by allowing them to lose some body weight, however the sleeve gastrectomy itself has proved to be a very efficient type of weight loss surgery in its own right, and is now the most common weight loss procedure in Australia.
The procedure
Sleeve gastrectomy is a laparoscopic procedure (i.e. 'keyhole' or 'minimally invasive' procedure) to remove the larger (fundus) section of the stomach, which is done by cutting away the section of stomach to be removed and using titanium surgical staples to seal the new sleeve.
Five small incisions are made to the abdomen and surgical instruments are inserted into the abdominal cavity. Once the stomach has been divided and the remaining section stapled, the part of the stomach that is no longer needed is removed.
After the procedure patients need to remain in hospital for 1-2 days and can generally return to work within 14 days of the procedure.
Before the procedure, patients must follow a very low-calorie meal replacement diet for at least two weeks prior to surgery. After the procedure patients follow a liquid only diet (e.g. water, tea, juice) until the remaining stomach sleeve is checked via x-ray to make sure everything is working correctly. Over the next 4-6 weeks patients are encouraged to gradually introduce other foods and increase the volume eaten.
Benefits of sleeve gastrectomy
The procedure is relatively straightforward compared to other surgical weight loss options, and weight loss is quicker than with lap band surgery (most patients lose around 60% of excess weight over 18-24 months). Also, unlike lap band surgery, there is no need for ongoing adjustments and a wider variety of food can be eaten than is possible with other procedures. Unlike lap band surgery, a sleeve gastrectomy is not reversible.
Download Sleeve Gastrectomy Nutritional Guidelines (PDF – 555Kb).