What is a "Gastric Sleeve"?

The Gastric Sleeve – often called sleeve gastrectomy or vertical sleeve gastrectomy (VSG) is an operation which facilitates weight loss by permanently reducing the size of the stomach. During this procedure the left side of the stomach is surgically removed. Hunger is controlled because a portion of the stomach that produces the hunger hormone Ghrelin is removed. Stomach stapling is then used to create a gastric sleeve. This results in a new stomach which is roughly the size and shape of a banana. Since this operation does not involve any re-routing or reconnecting of the intestines, it is a simpler and reportedly safer operation than the gastric bypass. Gastric Sleeve surgery does not bypass any part of the stomach or small intestine and allows the digestive system to function normally. Unlike the LAP-BAND procedure, the sleeve gastrectomy does not require the implantation of an artificial device inside the abdomen and adjustments or fills are not required. Gastric Sleeve or Sleeve Gastrectomy is a restrictive procedure, not a malabsorptive procedure.

Bariatric Surgeons have been performing VSG for quite some time as the first part of a two step process. For patients who were severely obese (BMI over 60) and who were too ill to undergo the more complicated gastric bypass surgery, doctors would perform VSG first, let the patient lose weight and recover, then complete the more risky bypass procedure. In recent years, the procedure has become a stand-alone procedure with results similar to the LAP-BAND.

How much will I lose?

Short term results show that Gastric Sleeve patients who have had the stand-alone procedure can expect to achieve a 60 to 70% excess weight loss at 2 years.

Advantages of the Gastric Sleeve

• It does not require disconnecting or reconnecting the intestines
• There is no malabsorption of nutrients therefore avoiding anemia, osteoporosis, protein deficiency and vitamin deficiency.
• It is technically a much simpler, and thus much safer, operation than the gastric bypass.
• There is no foreign body implanted.
• It does not need adjustments or fills (LAP-BAND® patients must come back for fills).
• Preserves the pyloric valve (most patients should not get dumping syndrome).
• It may be a safer operation for patients with a body mass index (BMI) more than 60. It may be used as the first stage of a 2-stage operation.

Disadvantages of the Gastric Sleeve

• The procedure is not reversible.
• The procedure is slightly riskier than the Gastric Banding procedure.
• The most common complaint is some leakage immediately after surgery which may require the use of a temporary drain – this has been reported to happen in approximately 1 in 100 cases.

Insurance Coverage

Recent changes have been made by Aetna and United Healthcare supporting the Sleeve Gastrectomy procedure. Contact your health insurance carrier for more information.