What is Gastric Sleeve Surgery?

The gastric sleeve is most recently approved by the FDA but is still more than ten years old.

During gastric sleeve surgery, Dr. LeGrand removes 80% to 85% of the stomach and staples the remaining portion of the stomach together. This restrictive procedure limits the amount of food the patient can consume.

Gastric Sleeve Surgery

(Before and After)

How does gastric sleeve surgery help people lose weight?

The vertical gastric sleeve is a metabolic surgery. By removing part of the stomach, Dr. LeGrand dramatically alters the neuro-hormonal pathways that control the sensation of hunger and the way your body manages the calories that we put in. There is a hormone called ghrelin that is made primarily in the part of the stomach that we remove. It is the primary driver in the hunger pathway. With the dramatic drops in the ghrelin levels seen after the procedure, there is a commensurate decrease in hunger. Gastric sleeve surgery also leads to an up-regulation of a hormone called GLP1, which is involved with our body’s control of glucose. In fact, many newer diabetes treatment mediations are designed to up-regulate GLP1. The gastric sleeve surgery does this without medication, and in this way, can cause remission of diabetes and metabolic disease quite rapidly.

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What are the advantages of gastric sleeve surgery?

Reduced Hunger

May reduce hunger, since less of the hunger-inducing hormone ghrelin is produced following the procedure.

No Maintenance

No adjustments are needed, unlike gastric bands, and no foreign objects are left in the body.

Fewer Side Effects

No “dumping syndrome” with unpleasant side effect that can be associated with gastric bypass surgery.

Simpler Operation

Simpler, shorter operation than a gastric bypass since gastric sleeve weight-loss surgery doesn’t reroute the intestines.

Better Results

Significant weight loss is the norm, and weight loss is usually maintained.

What are the side effects and disadvantages of gastric sleeve surgery?

Blood Clots

Blood thinners are administered to reduce this risk.

Perforation of the stomach or intestines.

Side Effects

Some side effects include gall stones and hernia.

Who makes a good candidate for gastric sleeve surgery?

Body Mass Index (BMI)

  • Individuals with a body mass index (BMI) of at least 40, meaning at least 100 pounds overweight
  • Individuals with a BMI of 35 with a chronic weight-related health condition such as type 2 diabetes, high blood pressure or sleep apnea
  • Inability to achieve healthy weight loss sustained for a period of time through prior weigh loss efforts
  • Depending on BMI, patients that are too heavy for gastric bypass surgery could still be good candidates for another weight loss procedure. Dr. LeGrand will discuss those other options.

Overall Health

If you’re considering gastric bypass surgery, you may also have weight-related health issues; however, you’ll need to be able to withstand the physical stress of surgery. Dr. LeGrand will review your medical history and current health. Additional tests may be needed to ensure you’re able to physically handle the surgery and recovery.

Commitment to Diet Maintenance

Our dieticians can help you follow a plan that meets your dietary requirements and maximizes nutrition. Following a plan will help you avoid eating more than you should in the long term. If you do overeat, it’s possible to stretch your new, smaller stomach and regain weight. You’ll learn some important guidelines and will need to follow them strictly including:

  • Chew everything well before swallowing. Begin this practice even before surgery. You will become a more mindful eater through this healthy habit.
  • Consume your food and drink separately. Extra fluid with food will make you feel full too fast and prevent you from getting proper nutrition.
  • Drink a liquid 30 minutes before each meal. Hydration is vital to good health. You would normally get a substantial amount of liquid from the foods you eat. Since you won’t be able to eat as much following surgery, you still need to be mindful about getting adequate water for healthy kidneys, liver, skin and every part of your body.
  • Avoid calorie-packed foods and drinks that have little nutritional value. You’ll be eating less food after surgery, so you need to ensure the foods you do eat will deliver the nutrition your body needs. You won’t have much room for anything else.

Moderators vs. Abstainers

Moderators are able to very occasionally and selectively have junk food. If you have trouble moderating, you should become an abstainer. You will be more successful abstaining completely because once you get a taste of foods low in nutritional value, you will have trouble stopping. Make a commitment to yourself and your health. Avoid buying things you shouldn’t eat or drink. Start these techniques before surgery to keep your weight loss commitment.

Commitment to Exercise

Exercise is important to achieving post-surgery success. Exercising three or more times per week is highly recommended. Find various activities you enjoy so you remain engaged. You will notice exercise and all activities will get easier as you lose weight.

Willingness to Take Nutritional Supplements

Taking multiple vitamin and mineral supplements the rest of your life will become necessary as your new, smaller stomach will hold less food, even nutrient dense foods. Recommended supplements include a multi-vitamin, calcium and vitamin B12.

Psychological Readiness and Support

Physical changes aren’t the only effects you will experience after gastric sleeve surgery. You will notice psychological effects, too. For example, if overeating was your common response to stress, continuing to do so after surgery could stretch your stomach and regain the weight you’ve worked so hard to lose. Your relationships might change, too. Surround yourself with people who support you in making your health a priority.

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How is the gastric sleeve procedure performed?

Dr. LeGrand performs the procedure laparoscopically, a minimally invasive approach, in about an hour. General anesthetic will be used to put you to sleep. Several small incisions will be made in your abdomen. Dr. LeGrand will insert narrow tubes in the incision that contain cameras and small surgical tools.

Dr. LeGrand will see the inside of your abdomen and safely make surgical adjustments to your stomach. Pieces of your stomach will be removed until it is about three-fourth of its original mass. Scarring, surgical risks and recovery time are minimized using this method. Only a few stitches will be needed to close the small incisions.

What should I expect post-op following gastric sleeve weight loss surgery?

You may stay in the hospital for one or two nights. Your first goals after surgery are to walk frequently and do breathing exercises with a tool called an incentive spirometer. You will be given blood-thinning medications to prevent blood clots. Patients are typically allowed to sip liquids a few hours after surgery.

Day 1 | Post Op

Transition completely from IV fluids and medications to oral intake and liquid pain medications.

Day 2 | Discharge

Most patients are discharged, but everyone is different. You should be completely comfortable before going home, which may require an extra hospitalization day.

Post-Hospital Recovery

Your post-op regimen begins. Your smaller stomach will extremely limit what you can eat. After one to two months, you will revisit the healthy eating and lifestyle habits you began adopting before surgery, including exercise.

What type of weight loss can be expected following gastric sleeve surgery?

Individual results vary, but people who have had gastric sleeve surgery, and comply with our guidelines, lose about 60% of their excess weight within 12 to 18 months. Proper diet and exercise can expedite your weight loss.

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How is gastric sleeve surgery different from gastric bypass surgery?

In gastric bypass, Dr. LeGrand makes a small pouch that bypasses the lower part of your stomach. Food is redirected to the top of the stomach straight into the small intestines. The gastric sleeve is similar, but the shape and size of the stomach after the procedure is more like that of a banana or hockey stick making the functional stomach more like a tube than a bag.

Gastric bypass can be dangerous for people who have over 100 pounds to lose, which makes the gastric sleeve a safer alternative.

Gastric Bypass Surgery

(Before and After)

Gastric Sleeve

Weight Loss Surgery (Before and After)

How do I prepare for my surgery date?

Leading up to surgery, you’ll complete several evaluations and education preparing you for post-op success. You’ll practice new, healthy lifestyle skills early on because it takes time to develop new habits. Your results and success completely depend on your ability to permanently adopt healthy habits.

You may experience weight loss even before surgery because of your lifestyle changes. You should be encouraged by this weight loss and gain confidence in your long-term success. The gastric sleeve surgery, as well as support from your medical and personal teams, will help you remain successful.

When will my new diet begin?

Two weeks before surgery, you’ll begin a very strict diet. Calories and carbohydrates will be restricted while your intake of lean proteins will be increased. These dietary changes will help shrink the liver and prepare your body for a smooth transition to a new lifestyle. An oversized liver could compromise your success and make the surgery more dangerous.

Two days before surgery, you will switch to a liquid diet that may include broth and protein shakes. You may also be able to drink decaffeinated coffee and tea and eat Jell-O. Avoid caffeine as it could impact your procedure. No two patients are alike, so Dr. LeGrand’s orders may vary.

Considering Gastric Sleeve Surgery to help achieve your lifestyle goals?