Treatments

The surgery is usually done laparoscopically, commonly known as keyhole surgery. This means that you will be up and about soon after surgery and should make a speedy recovery. Although you will have some pain after surgery this is usually easily controlled by taking pain killers regularly.
The operation involves removing approximately 75 per cent of your stomach, leaving behind a narrow tube (sleeve) which becomes your new stomach. After the surgery food will follow the normal route into the smaller stomach and then on into the small intestine.
The operation also alters some of the hormone signals from the stomach and intestine to parts of the brain that control body weight.
Following this operation, many patients report that they feel less like eating and feel fuller sooner and for longer after a meal. As the size of your stomach has been reduced, the size of your meals will need to be reduced to be appropriate for your new small stomach. Your reduced portion size combined with low fat, low sugar choices will help you to lose weight. A sleeve gastrectomy is permanent and is not a reversible procedure. You may need to take vitamin supplements after the operation.

During the laparoscopic gastric sleeve the nerves of the stomach and the outlet valve (pylorus) are not altered, preserving the function of the stomach. Other advantages:

• The rest of the gastrointestinal tract anatomy is not altered, so the food ingested follows the normal course. This results in less chance of developing lack of vitamins and minerals and eliminates dumping syndrome.
• The procedure decreases significantly the hunger by removing the part of the stomach that produces the main stimulating hormones.
• Minimize the chance of developing ulcers.
• Fewer office visits that the Lap Band, since there is no need for band size adjustments.

In the laparoscopic sleeve gastrectomy the stomach is divided along its vertical length in order to create a slender pouch. The excess stomach is removed. The purpose is to limit the amount of food ingested at any give time (restrictive operation), without altering the normal absorption of the vitamins and minerals.

The procedure is particularly indicated for patients who are at high medical risk for bypass procedures, have very high BMI, or complex surgical history. Patients interested in the gastric banding procedure may also want to consider the sleeve gastrectomy to avoid the potential risks of a foreign body.

You can expect to lose between 50 and 70 per cent of your excess weight in the first 12 to 18 months following surgery. The amount of weight you are able to lose and keep off after surgery will depend also on the lifestyle changes that you make, such as increasing the amount of exercise you take and eating a healthy diet. It is important to remember that the operation will not stop from you from craving certain foods or eating what you fancy.

As with all major surgery, sleeve gastrectomy has some risks. These risks vary according to your age and any other illnesses you may have.

Complications that can occur soon after surgery:

• Wound infection: This can be treated with a course of antibiotics.
• Bleeding: You will be monitored carefully for signs of bleeding; a few patients will need a blood transfusion. Usually this will not be a problem but in the worst case scenario the surgeon will take you back to theatre and stop the bleeding (may involve an ‘open’ operation where the stomach has to be opened up with an incision).
• Embolism

Long term problems are uncommon but can include:

• Hernias of the abdominal wall.
• Narrowing of the new stomach which can cause problems with eating and drinking. This will usually settle on its own although sometimes it will need to be stretched under a local anaesthetic.
• Hair loss or thinning in the first six months; this will re-grow.

It is important for you to know that the procedure recommended is based on your specific medical history and dietary history.
Other options we offer include:

• Gastric Band.
• Gastric Bypass.
• Intensive Weight Control Programme (non-surgical pathway).

Please feel free to discuss your options with your surgeon

Your surgeon may talk to you about LSG as an option if you have a BMI over 60 or significant medical problems that increase your risk for undergoing anesthesia or gastric bypass. Laparoscopic Sleeve Gastrectomy may also be offered as part of a clinical investigation if you have a lower BMI and diabetes.

You should discuss all of the available surgical procedures with your surgeon and determine which procedure is best for you.