Type of Surgery
Information
Last updated: 11/24/2009
The stomach acts as a basin for ingested food prior to subsequent digestion. Over years of overeating it stretches and grows to accommodate increasingly larger meals. The goal of vertical sleeve gastrectomy is to remove this enlarged receptacle...
for food and leave a region of stomach that does not permit much stretching or growth. With this large pouch gone, the stomach becomes a simple tub to connect the esophagus to the duodenum.
for food and leave a region of stomach that does not permit much stretching or growth. With this large pouch gone, the stomach becomes a simple tub to connect the esophagus to the duodenum.
One of the benefits of sleeve gastrectomy is that it is almost always performed as a laparoscopic procedure. A laparoscopic procedure is one in which a series of small hole are made through the skin and fascia rather than using a scalpel to open the entire area. This approach speeds recovery times considerably.
As with all bariatric surgeries, sleeve gastrectomy is performed under general anesthesia. Laparoscopic vertical sleeve gastrectomy involves making three to four small incisions in the abdomen through which a small camera and specially designed surgical instruments are passed. The stomach, esophagus and duodenum are identified and the greater curvature of the stomach is isolated. A vertical strip of staples is made across the stomach thereby separating the majority of the stomach from the rest of the gastrointestinal tract. The esophagus remains attached to the duodenum via the lesser curvature of the stomach. The tube that remains is only about 15 percent of the volume of the stomach in its former state. The portion of the stomach that was cut away is removed through the largest of the laparoscopic incisions.
One important features of vertical sleeve gastrectomy is that the pyloric sphincter is preserved in the surgery. The pyloric sphincter is a small, circular muscle that can completely close off the exit to the stomach. Thus when food is ingested, it can be kept in the stomach until the pyloric sphincter allows a small bolus to be released into the first part of the small intestine (duodenum). Many bariatric surgeries remove or circumvent this sphincter leading to an unfortunate consequence called “dumping syndrome”. Dumping syndrome occurs when ingested food rapidly enters the intestines causing severe nausea, cramps and bloating. Since the pyloric Dumping sphincter is preserved in vertical sleeve gastrectomy, dumping syndrome does not occur.
Another important advantage to vertical sleeve gastrectomy is that the portion of stomach that “stretches,” or enlarges to accommodate progressively larger meals, has been removed. The small portion of stomach that remains will not “stretch” to any appreciable degree thus forcing the patient to consume smaller meals. The permanence of sleeve gastrectomy helps the patient achieve and maintain a healthy weight.
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The video provides a detailed look at the bariatric surgery known as sleeve gastrectomy. The narrator explains how sleeve gastrectomy leads to weight loss for the bariatric patient.
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Other Information
Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach, following the major curve. The open edges are then attached together (often with surgical staples) to form a sleeve or tube with a banana shape. The procedure permanently reduces the size of the stomach. The procedure is performed laparoscopically and is not reversible.
Sleeve gastrectomy is usually performed on extremely obese patients, with a body mass index of 40 or more, where the risk of performing a gastric bypass or duodenal switch procedure may be too large. A two-stage procedure is performed: the first is a sleeve gastrectomy, and the second is a conversion into a gastric bypass or duodenal switch. Patients usually lose a large quantity of their excess weight after the first sleeve gastrectomy procedure alone, but if weight loss ceases the second step is performed.
Other Information
The number of Gastric Bypass surgeries climbed more than 600% from 1993 to 2003.
From: Bariatric-Surgery.info
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