Gastric Sleeving Newest Technique for Weight Loss Surgery
Gastric sleeve surgery reduces the stomach so it resembles a small tube
With a new procedure being offered this fall, Scottsdale Healthcare is increasing the options for weight-loss surgery patients.
Sleeve gastrectomy can be part of a two-stage procedure for weight loss, but it is becoming more commonly offered as a stand-alone surgery.
“I think the sleeve is attractive to the obese person who wants a much lessened feeling of hunger,” said Robin Blackstone, MD, surgeon and medical director of the Scottsdale healthcare Bariatric Program.
“The patient requires good solid education, but the follow-up care can be more natural because there is no medical device to maintain. In terms of risk and benefit, this procedure fits nicely between gastric bypass and adjustable gastric band,” she said.
In gastric sleeve, the stomach is reduced so it looks like a small tube. The rest of the stomach is removed. Removing the remainder of the stomach also removes ghrelin-producing cells-ghrelin is the hormone that makes you feel hunger.
The slim tube shape of the new stomach pouch causes quick transport of food to the small intestine, which in turn engages the “ileal break”, a mechanism that creates a hormone called GLP-1.
“GLP-1 tells the brain that you are full relatively soon after eating,” Dr. Blackstone said. “That feeling of fullness decreases the amount of food you eat.”
Unlike other procedures, no devices are used in gastric sleeve and nothing is implanted. Patients initially will eat 600 to 800 calories per day, then they will self-monitor and learn to eat what they need to maintain their ideal weight.
“They’ll lose weight right away,” Dr Blackstone said. Previously, a gastric sleeve was a first stage procedure used with gastric bypass or duodenal switch. The American Association for Metabolic and Bariatric Surgery currently recognizes gastric sleeve only in this context, as a first-stage procedure.
Patients may elect to move on to a second stage (such as gastric bypass) if they do not demonstrate adequate weight loss and remission of medical problems such as diabetes within the first two years.
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