Did you know that sleeve gastrectomy, also known as gastric sleeve surgery, is the most frequently performed bariatric procedure in the U.S.? It’s an option many of our patients at Birmingham Minimally Invasive Surgery choose as well. 

To qualify for weight loss surgery, your body mass index (BMI) must be greater than or equal to 40 or between 30 and 40 with other medical problems, such as diabetes, sleep apnea, heart disease, or high blood pressure. In addition to these requirements, gastric sleeve and alternatives are options for those who have not been successful losing weight through diet and exercise alone. These procedures, along with lifestyle modifications, such as the right proportion of healthy food and exercise, can help improve your overall health and quality of life.

So gastric sleeve surgery is a great solution for many, but there are other choices. Why should you choose one over the other? We will explore three common procedures in this blog post to help you learn more, and as always, our surgeon and staff will be happy to discuss with you more.

Gastric sleeve surgery explained 

Gastric sleeve surgery works by changing the structure and reducing the size of your stomach. About two-thirds of your stomach is surgically removed during this procedure. You benefit from a smaller stomach which fills up more quickly. This limits the quantity of food you eat and the amount of calories absorbed by your body. The surgery results in a stomach that functions normally and enables you to eat most foods, just in smaller amounts.

Gastric sleeve surgery is a simpler procedure and helps avoid the associated risks of an intestinal bypass. It typically takes only about 30 to 45 minutes and  is performed laparoscopically. This means we avoid the need for large abdominal incisions, which typically results in less pain, shorter hospital stays, and faster recovery.

Considerations for gastric sleeve surgery: 

• Stomach tube may stretch over time, leading to late weight regain
• If weight is regained, a second stage operation known as duodenal switch or Roux-en-Y gastric bypass can be performed
• The procedure is not reversible
• There is no malabsorption of nutrients
• Not an option for patients with severe reflux disease

Gastric sleeve surgery alternative #1: LAP-BAND

In the LAP-BAND procedure, a hollow band made of special material is placed around the stomach near its upper end, creating a small pouch and a narrow passage into the larger remainder of the stomach. The band is then inflated with a salt solution. It can be tightened or loosened over time to change the size of the passage by increasing or decreasing the amount of salt solution. The entire procedure is done laparoscopically as well and induces weight loss by reducing the capacity of the stomach. This restricts the amount of food that can be consumed.

LAP-BAND is usually performed in the outpatient surgery center, and you are usually discharged the same day of the procedure.

Considerations for LAP-BAND:

• Least invasive surgical option
• No intestinal re-routing
• No cutting or stapling of the stomach wall or bowel
• Reduced pain, hospital length-of-stay, and recovery period
• Lower mortality risk than other obesity surgery procedures
• Low risk of nutritional deficiencies associated with gastric bypass
• Reduced risk of hair loss
• No “dumping syndrome” related to dietary intake restrictions

The lap band procedure is also adjustable and reversible. It allows for an individualized degree of restriction for ideal, long-term weight loss, and adjustments can be made without additional surgery. The band can also be removed, allowing the stomach and other anatomy to be restored to their original forms and functions.

While there are many benefits to LAP-BAND, it isn’t an overnight fix. We often have to work with patients to find their “happy place.” This involves finding the right fit so that you can eat freely but also maintain smaller portion sizes. This is where band adjustments come into play, which could be a process that takes a little time to perfect.

Gastric sleeve surgery alternative #2: Gastric bypass

Gastric bypass has the longest track record in the U.S., having been performed since 1967. It combines “restriction” and “malabsorption.” With restriction, we are creating a stomach pouch that holds 1 to 2 ounces. It is very effective in obtaining and maintaining long-term weight loss.

During the laparoscopic procedure, a small stomach pouch is created to restrict food intake. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum (the first segment of the small intestine), and the first portion of the jejunum (the second segment of the small intestine). This bypass reduces the absorption of nutrients and thereby reduces calorie intake.

Gastric bypass is an inpatient procedure requiring a hospital stay of 1 to 2 nights. The surgery takes about 60 to 120 minutes.

Considerations for gastric bypass:

• Rapid weight loss in the first six months
• Best operation to cure diabetes, high blood pressure, and sleep apnea
• Tend to lose more weight than patients after gastric band or gastric sleeve
• Longer recovery time
• Not considered reversible, but could be reversed if medically necessary
• Staple line can leak after surgery
• Minor late weight regain (10-20%) after 2 to 5 yrs
• Nutritional/mineral supplements required for life

As you can see, there are advantages and disadvantages to each option, and which one is best for you will depend greatly on your individual situation. The good news is that you don’t have to figure it out alone! Our surgeon, Dr. Jay Long, is extremely experienced in working with each patient to consider their needs and issues to find the right option.

Contact us to learn more about gastric sleeve and other weight loss surgery options.

Birmingham Minimally Invasive Surgery is a caring group of professionals who specialize in all types of bariatric surgery.  Our surgeon Dr. Jay Long has highly specialized training in bariatric surgery, having completed a fellowship in minimally invasive and bariatric surgery at The Methodist Hospital in Houston, Texas, where he focused on taking care of patients that are morbidly obese.  And we are so proud of our pricing that we publish the costs right on the front page of our website!  Insurance won’t pay?  We have a variety of financing options we can offer you so that you are able to get the healthy body you’ve wanted for years.  Visit us today at http://www.bmisurgery.com/ or give us a call to set up a consultation at 205-833-6907.