Houston Gastric Sleeve Surgery (also known as Sleeve Gastrectomy)
Overview:
Overall, this is Dr. Ferrari’s preferred procedure for most patients, except for patients suffering with severe GERD. Patients with significant reflux symptoms have to be evaluated carefully, because the LSG may worsen those symptoms after surgery.
Gastric Sleeve Surgery
The Sleeve Gastrectomy is the most common bariatric surgery performed in the United States and in the world. This is a restrictive operation with some metabolic component with consistent weight loss effective at any range of morbid obesity from a lower BMI of severe obesity to a high BMI of super obesity. This operation has an excellent safety profile with very few complication and rapid recovery. Current minimally invasive robotic techniques and anesthesia advances increase the safety profile to the point where this procedure can be performed outpatient basis in some cases. This procedure is a tool to obtain rapid satiety and with metabolic component can improve many comorbidities including diabetes and hypertension. This procedure doesn’t have the complications of other metabolic surgery such as the RNY Gastric Bypass and Duodenal Switch such as anemia, vitamin deficiency, diarrhea, malnutrition, and bowel obstruction. The quality of life after surgery is not affected significantly. For all these reasons, this procedure is my preferred for the treatment of morbid obesity.
Technically, the Sleeve is a much simpler surgery. The operating time for the sleeve surgery is usually 40-70 minutes, while bypass surgery takes approximately 2-3 hours to complete. There is a much lower chance for nutrient or vitamin deficiency with the Sleeve procedure. In addition, there is no mal-absorption for Sleeve patients as well as no bowel obstruction, marginal ulcer, and internal hernias that would otherwise occur with a bypass. The chances of Sleeve patients developing these complications are exceedingly rare.
The operation involves the removal of the large part of the stomach and converting the remaining part into a long, tubular structure, resembling the shape of a banana. Weight loss is similar to the RNY procedure, but its metabolic effect is milder. Unlike the RNY procedure, there is no malabsorption; therefore, nutritional and vitamin deficiencies are rare. The LSG takes about 1 hour and requires a 24-hour stay in the hospital.
Before and After
