Gastric Sleeve Surgery

Gastric sleeve surgery, also known as sleeve gastrectomy, is a popular bariatric surgery procedure for weight loss. The operation involves removing a large portion of the stomach, leaving behind a slender, tube-like stomach, resembling the shape of a banana. This significantly reduces the stomach’s capacity, which leads to a feeling of fullness after eating only a small amount of food.

The primary goal of gastric sleeve surgery is to help people with obesity lose weight, which can then reduce the risk of other health problems like heart disease, high blood pressure, type-2 diabetes, and certain cancers.

The decision to undertake gastric sleeve surgery is usually thought about only after other options have been tried, such as dieting, exercise and other therapies.

Patient Selection:

Patients with a BMI score of 30 of over may be candidates for surgery. A wide range of lifestyle and psychological factors are reviewed prior to surgery, including prior attempts at dieting and losing weight, whether you have an underlying obesity-related medical condition that is increasing your risks of mortality, and whether you have sought psychological care and assessment in relation to your obesity.

Mechanism of Action:

Gastric sleeve surgery involves permanently altering the stomach.  The surgery is performed laparoscopically (“keyhole” surgery), meaning it is minimally-invasive with a few small incisions in the abdomen.

During gastric sleeve surgery:

  • Stomach Size Reduction: About 75-80% of the stomach is removed, leaving a smaller, ‘banana-shaped’ stomach pouch. This reduces the amount of food that can be physically consumed, meaning you feel ‘full’ with less food.
  • Hormonal Changes: The procedure also results in changes to gut hormones that regulate appetite, leading to reduced feelings of hunger.

Due to the reduced stomach size, patients may need to make dietary adjustments to ensure they are getting all the necessary nutrients. It is crucial to work closely with a nutritionist or dietitian.

  • Hormonal Changes: The surgery affects hormonal signals related to hunger and fullness.
  • Significant Weight Loss: Gastric sleeve surgery typically results in substantial weight loss, often achieving 60-70% excess weight loss within the first year.
  • Improvement of Obesity-Related Conditions: Many individuals experience improvements or remission of obesity-related conditions like type-2 diabetes, hypertension, and sleep apnoea.
  • Enhanced Quality of Life: Weight loss and improved health can lead to a better quality of life, increased energy, and improved mobility and a reduction in joint pain.
  • Long-Term Effectiveness: Gastric sleeve surgery is often effective in the long-term, especially when combined with lifestyle changes.
  • Lowered Risk of Obesity-Related Mortality: Reduced obesity-related health risks can extend life expectancy.

Due to the reduced stomach size, patients may need to make dietary adjustments to ensure they are getting all the necessary nutrients. It is crucial to work closely with a nutritionist or dietitian after surgery.

It is important to note that gastric sleeve surgery is not without risks and complications. Potential complications include:

  • Leaking from the site where the stomach was cut
  • Infection
  • Blood clots
  • Nutritional deficiencies
  • Acid reflux
  • Weight regain or insufficient weight loss

The decision to undergo this surgery should be made in consultation with a healthcare provider and a thorough evaluation of the risks and benefits. Additionally, post-surgery, individuals must commit to significant dietary and lifestyle changes to maximise the benefits and maintain weight loss.

Dr Devesh Kaushal is a Specialist General Surgeon and a Fellow of the Royal Australian College of Surgeons (FRACS).

Dr Kaushal offers 15+ years of experience and holds a Master of Surgery Degree, as well as being fully certified in gastroscopy and colonoscopy by the Gastroenterology Society of Australia (GESA).

Dr Kaushal takes an empathetic, warm-hearted and friendly approach to patient care and is completely dedicated to patient outcomes.

He consults and operates across Souther-Western Sydney.