Overview

Laparoscopically Vertical Sleeve Gastrectomy Surgery

icon-2-d Laparoscopically Vertical Sleeve Gastrectomy Surgery

During a Vertical Sleeve Gastrectomy, the surgeon removes most of the stomach (about 80%), leaving only a banana-shaped section that is closed with staples. The new stomach pouch holds a considerably smaller volume than the normal stomach and helps to significantly reduce the amount of food that can be consumed. The greater impact, however, seems to be the effect the surgery has on gut hormones that impact a number of factors including hunger, satiety, and blood sugar control. There is evidence suggesting that the sleeve, similar to the gastric bypass, is effective in improving type 2 diabetes independent of the weight loss.

This type of surgery cannot be reversed because some of the stomach has been permanently removed.

Of the individuals that are overweight by 50 pounds or more, 90% fail to control weight through exercise and diet. This is not due to laziness or a lack of willpower, but to an increased metabolism that processes nutrients and minerals at a faster rate. These individuals will gain more calories than before when eating the same meals. When a change in lifestyle is insufficient, weight loss surgery becomes the most viable solution. However, a successful operation often requires an additional surgery to finalize improvements to health and weight.

Post-bariatric surgery is a very important part of rehabilitation and success. Follow up surgeries are typically performed about 12 to 18 months after surgery, when the patient has adapted to lifestyle changes, and weight loss has slowed down or even begin to reverse. By then, the body has likely compensated for the shift in diet by increasing the absorption of calories consumed. Often times, this happens prior to the patient achieving their desired results, and independent of anything the patient may have done wrong. This is why revisional surgery is often necessary to fine tune and solidify a patient’s overall progress. Failure to get a revisional surgery can lead to; difficulty maintaining dietary guidelines, minimized results, or even weeks of dieting undone. Some possible indications that it’s time for a revision include; incapacity to attain desired body mass, unexpected changes despite maintaining the same diet, slowed weight loss prior to achieving satisfactory IBM, greatly increased appetite, greater capacity to eat than expected, and more.

Furthermore, a revision may be necessary if there is cause for concern as described below.

When you come into our office, we will evaluate any developments since your previous weight loss surgery. We will take diagnostics, conduct X-rays, and run tests to determine the current state of your anatomy. Our surgeons will also consider other conditions that may affect your bariatric revision and will take into account your progress and goals. Your success is important to us.

A surgical revision is generally recommended to maintain improvements, but may even be necessary if symptoms or incidents become reason for concern. Here are a few possible revisions to help you get back on track:

  • Correction or Reversal of a Vertical Sleeve Gastrectomy:
    It is not uncommon for the size of the sleeve to double after 2 years. In this case, a surgeon can conduct an additional gastrectomy rather than a gastric bypass which consists of re-routing the intestines. Additionally, a more serious condition such as internal leakage or erosion could require surgery. A Sleeve Gastrectomy, however, is non-reversible due to part of the stomach having been permanently removed.
  • Conversion to an Adjustable Gastric Band or a Vertical Banded Gastroplasty:
    These surgeries are not easily executed following a sleeve gastrectomy because there may not be enough stomach to execute them. If the sleeve has doubled in size, it may be possible to attempt one of these. The results will not be as evident as with other options
  • Conversion to a Roux-en-Y Gastric Bypass or a Biliopancreatic Diversion:
    If you experience metabolic changes that cause your intestines to absorb more calories, promoting weight gain, our surgeons will recommend turning your previous procedure into a gastric bypass so that part of your intestines are skipped, thus absorbing less calories.

Generally, our surgeons can perform revision surgery laparoscopically. This is a minimally invasive surgery that uses small incisions with the aid of a camera to operate. This technology helps avoid large incisitions in your body that would make day-to-day life activities more difficult and take longer to heal. Our physicians use only the best technology to revise your bariatric surgery.

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