What are the advantages of gastric sleeve surgery?
1.Most of your stomach is removed from your body resulting in smaller portion sizes and decreased hunger. Weight loss gets much easier.
2.Ghrelin is the primary hormone that stimulates hunger and is produced by the upper portion (called “fundus”) of the stomach. Since fundus is eliminated by the gastric sleeve operation, your appetite often lessens.
3.Compared to other surgical operations such as gastric bypass, gastric sleeve is an easier operation and its duration is shorter.
4.The positions of the intestines are not changed.
5. Dumping syndrome is a condition that occurs when food, especially sugar, moves from your stomach into your small bowel too quickly causing light-headedness, sweating, nausea, abdominal cramping and it is not a desired condition for patients. Symptoms of dumping syndrome are not very common since the gastric exit door (pylorus) remains intact after the gastric sleeve operation hence the food does not leave the stomach immediately.
6.No tube is placed in the stomach in this surgery. The stomach is reconstructed in the form of a thin tube.
7.Weight loss after the operation continues for approximately 1-1.5 years.
8.Patients who regain weight in the long run have always a chance to undergo another surgical operation. In other surgeries such as gastric bypass, revision (having another weight loss operation) is quite difficult for patients who regain weight after the operation.
Why do surgeons recommend gastric sleeve surgery?
As of 2018, gastric sleeve operations account for 60% of all obesity surgery operations in the United States. In Turkey, the mentioned rate is over 80% and the rate of gastric bypass operations falls gradually. There are several reasons for this:
The primary reason is that your organs are not displaced in gastric sleeve surgery. What is solely done is to reduce the capacity of your stomach. Gastric sleeve surgery is technically easier to perform and less complex in the short and long terms. Vitamin and mineral deficiency in patients is less common in gastric sleeve surgery. Gastric sleeve and gastric bypass surgeries have a similar effect on patients in terms of getting rid of comorbid diseases such as blood pressure, diabetes, sleep apnea caused by obesity and weight loss performance in the five-year period following the surgery.
Although, in the long term, the risk of regaining weight after gastric sleeve surgery is slightly higher than gastric bypass method, it is not possible to know precisely which specific type of operation will yield better results for a patient in advance. By combining their motivations provided by effective weight loss after surgery with adopting the relevant changes in their lifestyles, some patients may be successful far beyond expectations.
After gastric bypass surgery, internal herniation may be life-threatening and lead to bowel obstruction. Also, ulcers causing bleeding or perforation and dumping syndrome can be seen in the area of junction where stomach meets intestines. Studies involving the 10-year follow-up period after surgery have shown that percentage of regaining weight after gastric bypass surgery reaches considerable figures (more than 20%). In some patients, diabetes may also reappear due to postoperative weight gain and other factors. This is an extremely difficult situation for bariatric surgeons who encounter patients that need revision surgery in the long term. Options for revision (having a second surgical operation) after gastric bypass surgery are limited and really difficult. However, patients who need revision in the long term after gastric sleeve surgery can undergo any type of surgical operation, including second gastric sleeve operation. This is itself a very important advantage compared to gastric bypass. Those who oppose to gastric sleeve surgery claim that rates of reversal and elimination of diabetes as a result of gastric sleeve surgery are not as high and risk of regaining weight after the surgery is quite high in the long term. Inıtially, gastric sleeve surgery was the first stage of duodenal switch surgery. Those who oppose to gastric sleeve surgery ignore the fact that other surgical methods can easily be performed in case of regaining weight or getting diabetes again in the future. Hence with certain exceptions, laparoscopic sleeve gastrectomy is the best choice for most patients and advanced results will yield with the ever-growing experience of surgeons in sleeve gastrectomy over time.