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Sleeve Gastrectomy

Sleeve Gastrectomy Videos & Overview

Sleeve Gastrectomy – Introduction Video

 

Sleeve Gastrectomy – Surgery Video

 

 

Laparoscopic sleeve gastrectomy is a relatively new surgical procedure utilised since 2003. It is also called sleeve gastrectomy. It is a keyhole laparoscopic procedure which involves stapling off and completely removing of the stomach leaving a small tube remaining with a capacity of approximately 200ml. It is irreversible and therefore more radical than laparoscopic band surgery but it has its own advantages and disadvantages.

Tube gastrectomy is relatively straightforward to perform, usually with five 1cm keyhole laparoscopic incisions. We use an array of staples to create the tube and then remove a substantial portion of the stomach as shown in the diagram. The procedure takes 1-2 hours and patients usually stay in hospital for 3 nights and would be able to return to work in 1-2 weeks.

The sleeve gastrectomy is very much a set and forget procedure. Unlike the gastric band it does not involve any adjustments or concerns about long term issues such as band slippage or erosion. The weight loss appears to be better than the gastric band in the short to medium term with most patients losing roughly 65% of their excess weight at 12 months.

It appears to be as good as the band procedure in terms of resolving Type 2 diabetes and sleep apnoea. The dietary restriction is also less for tube patients. Unlike band patients most tube patients can still eat meats and bread afterwards.

The sleeve gastrectomy is, however, a more radical irreversible procedure and does have slightly higher initial postoperative risks associated with it. There is a 1-2% risk of having either a leak or a bleed from the staple line.

A leak from the join would require re-operative surgery either via keyhole surgery or possibly a larger incision and could involve a long stay in hospital and perhaps further operations later on. A bleed from the staple line might require blood transfusions or re-operation, usually via a keyhole approach.
Patients who have had a sleeve gastrectomy can develop reflux or heartburn symptoms in the first few weeks but this usually settles quickly.

As the tube procedure has only been performed for 6 years we do not know how it will perform in the long run i.e 10-20 years down the line. There is the possibility of putting on weight in the future if the stomach tube were to dilate up with the passage of time. Also the stomach absorbs vitamin B12, calcium and iron and with a smaller, thinner, stomach we might see some deficiencies in these vitamins and minerals in the future.

Laparoscopic sleeve gastrectomy does have attractions for patients who live in a regional setting in Western Australia as it does not require as intensive follow up as for band patients who would need band adjustments on a fairly regular basis in the first year after surgery.

The choice to have surgery in the first place, and then between a band or tube procedure is made on a case by case basis and will involve several consultations between your surgeon and also the dietician. It is not a decision that should be rushed into. We would aim to tailor the surgery to your particular circumstances and needs.

Please contact Advance Surgical on 9386 2634 or via email.

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