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Gastric Sleeve

Sleeve gastrectomy is a relatively new bariatric operation, and currently comprises 10-20 percent of bariatric operations performed in the US: This number is expected to rise in coming years. Sleeve gastrectomy is a safe and effective operation. Your surgeon will help you decide if this is the right operation for you.

Sleeve gastrectomy involves removal of the majority of the stomach, leaving a narrow “sleeve” of stomach that limits food intake much like a gastric pouch, but without the need to rearrange intestinal anatomy. Sleeve gastrectomy thus restricts the amount of food a person can eat and provides a feeling of fullness.

Weight loss after sleeve gastrectomy ranges from 50-60 percent of excess weight in most patients, similar to gastric bypass. More than 80 percent of patients will experience marked improvement in related diseases such as diabetes, sleep apnea, high blood pressure, fatty liver disease, osteoarthritis, and other diseases

  • 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 significantly decreases hunger sensations by removing the part of the stomach that produces the main stimulating hormones.
  • It minimizes the chance of developing ulcers.
  • There are normally fewer office visits than with gastric banding, since there is no need for adjustment of the size of the band.

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Gastric Band

The adjustable gastric band is made of soft silicone and is equipped with a firmly attached inflatable balloon. This balloon is connected by a tube to an access port.

The band is positioned around the upper part of the stomach by keyhole (or laparoscopic) surgery so as to create a small pouch. This small pouch lies above the band and has a capacity of 15-20mL. The remaining stomach lies below the band. The band helps patients reduce weight by 2 mechanisms:

  • By reducing the amount of food that an individual wants to eat by inducing a feeling of fullness after only half a cup of food; and
  • By slowing down the emptying from the pouch above the band, thereby prolonging the feeling of fullness

The size of the pouch outlet is adjusted by adjusting the volume of fluid in the balloon through the access port. The access port is situated under the skin usually in the upper abdomen and is easily accessible by the treating doctor with a special needle.

Since the insertion of the adjustable gastric band does not involve any stapling, resection or shortening of any part of the stomach or intestines, the function of the digestive system remains intact. All ingested food will still be absorbed by the body the same way that it was before the operation. Weight loss is achieved by helping induce early feeling of satiety after eating considerably smaller amounts of food than before the surgery. It is most important to avoid foods of high caloric content, such as ice cream, custards and chocolates.

The Operation

Insertion of the adjustable gastric band is usually done via laparoscopic approach.

Five or six small incisions are made in the abdomen to introduce a camera and instruments and the adjustable gastric band is positioned at the upper end of the stomach.

Once the band is placed in position, the connecting tube and access port are inserted and secured to the upper abdominal wall.

All incisions are finally closed using absorbable sutures which do not need to be removed.

How much weight can you expect to lose?

The weight will be lost gradually and should commence immediately after surgery. The amount of weight loss will depend partly on the amount of fluid injected into the balloon to provide a feeling of satiety. More importantly, the amount of weight loss in the long term will depend on the patient, i.e. on how carefully the patient follows the recommendations regarding eating habits, diet and exercise. The recommended rate of weight loss we would like to see is 0.5 – 1.0 kg per week. On average it is expected that 50-60% excess weight will be lost long term.

This also means a long-term commitment to follow up by your bariatric clinic as data clearly shows the importance of follow up for successful weight loss.

We recommend that you follow the dietary instructions from our dietician and if necessary take a multivitamin supplement






Discover a new you




Discover a new you