Subtotal vertical gastrectomy, also known as gastric sleeve, is a surgical treatment for morbid obesity. It consists of removal of 80% of the stomach, resulting in the restriction of food intake, bringing about weight loss in the patient.
MECHANISMS OF THE GASTRIC SLEEVE
Reduction of gastric volume.
Reduction of ghrelin, a hormone that stimulates the appetite, since removal of the gastric fundus through the gastric sleeve procedure eliminates the site of greatest production of this hormone.
RESULTS OF THE GASTRIC SLEEVE
Various studies have shown a loss in excess weight with this procedure of between 70 and 90% on average in the first year after surgery, which can be carried out with minimally invasive (laparoscopic) techniques that lessen both recovery time and the risk of complications, with a considerable and sustained loss of weight. The average duration of the surgery is about one hour, with return to normal activities in about seven days.
ADVANTAGES OF THE GASTRIC SLEEVE
Small incisions, minimal scarring, reduction in hospitalization time and recovery period; the digestive process is not altered and therefore there are no nutritional deficiencies. A significant loss of weight has been observed, as well as substantial improvements in health and better control of diseases such as diabetes, hypertension, degenerative joint disease and others.
FREQUENTLY ASKED QUESTIONS ABOUT THE GASTRIC SLEEVE
WHAT IS THE GASTRIC SLEEVE?
The gastric sleeve is a surgical procedure for the treatment of obesity, in which stomach capacity is surgically reduced by 80%.
HOW DOES THE GASTRIC SLEEVE WORK?
The gastric sleeve restricts the capacity of the stomach, similarly decreasing its capacity for receiving food in each meal.Additionally, it inhibits the secretion of a hormone called ghrelin, which stimulates the appetite.
WHO IS A CANDIDATE FOR THE GASTRIC SLEEVE?
Candidates for this procedure are those patients with a body mass index (BMI) of 35 kg/m2with associated diseases, or of 40 kg/m2with no associated diseases.
WHAT IS THE BODY MASS INDEX (BMI)?
BMI is the relationship that exists between the patient's weight and height, the latter squared.
WHAT ARE SOME OF THE DISEASES ASSOCIATED WITH OBESITY?
Associated diseases are systemic arterial hypertension, diabetes mellitus type 2, hypercholesterolemia or alterations of the lipids, obstructive sleep apnea syndrome, joint diseases (hips, knees and ankles), peripheral venous insufficiency (varicose veins classes III and IV) or depression, among others.
ARE ANY ADDITIONAL STUDIES REQUIRED FOR THE GASTRIC SLEEVE?
In addition to having the BMI indicated above, the candidate should submit to a study protocol prior to surgery which consists of assessments by the bariatric surgeon, as well as by specialists in endocrinology, psychiatry, internal medicine and nutrition. Once the protocol is completed, the gastric sleeve can be performed.
HOW IS THE GASTRIC SLEEVE PERFORMED?
The gastric sleeve procedure is performed by minimally invasive surgery under general anesthesia. It consists of making six small incisions in the abdomen where working ports are placed for introduction of the instruments needed for the cutting and removal of the stomach.
WHAT DOES FOLLOW-UP AFTER SURGERY CONSIST OF?
Checkups are done by all the specialists on a regular basis, until the patient has changed their eating habits and can continue with the care of their gastric sleeve surgery on their own.
WHAT ARE THE ADVANTAGES OF HAVING THE GASTRIC SLEEVE?
It is a safe and effective, recently developed procedure based on national and international studies, with better weight loss results than the gastric band and the intragastric balloon, similar to the results of the gastric bypass, but with fewer complications if it is carried out by specialists and qualified professionals.
HOW MUCH TIME WILL I BE HOSPITALIZED AND WHEN CAN I RESUME MY DAY-TO-DAY ACTIVITIES IF I HAVE THE GASTRIC SLEEVE?
Most patients remain hospitalized for an average of two days after gastric sleeve surgery. Patients can return to their customary work activities after seven days. They can begin aerobic exercise within two weeks of surgery.
WHAT IS THE SUCCESS RATE FOR GASTRIC SLEEVE SURGERY?
Most patients can expect a 70 to 80% loss of excess weight in a period of 12 months. However, the majority of patients with severe obesity (BMI greater than 50) may experience a 70% loss of excess weight after four years of follow-up.
AT WHAT POINT IS PLASTIC SURGERY RECOMMENDED AFTER WEIGHT LOSS?
One year after surgery is recommended, with prior appraisal and indication by the attending physician, because if the patient has plastic surgery while still losing weight, the result will not be adequate.
HOW MUCH PROTEIN SHOULD I TAKE IN PER DAY IF I HAD THE GASTRIC SLEEVE?
This is a matter for the attending physician's consideration, to insure that with weight loss the body's own protein, such as from muscles, etc., is not consumed.