HEALTH+WELLNESS
Sleeve Gastrectomy:
The Way Forward?
YOU HAVE PROBABLY HEARD
ABOUT OR KNOW SOMEONE
WHO HAS HAD A GASTRIC BAND
OR A BYPASS; WHAT IS A GASTRIC
SLEEVE THEN? IT IS CONSIDERED
BY MANY TO COMBINE THE
ADVANTAGES OF BOTH BAND
AND BYPASS PROCEDURES.
Weight loss surgery has become the most
effective weight loss intervention that is currently
available to treat obesity. Over the past few years
two developments – namely keyhole surgery and
a solid safety record – have made this surgery
an appealing way to treat weight problems. The
first weight loss operations were performed more
than 50 years ago and were a result of the weight
loss observed in patients having gastric surgery
for other conditions. One could argue that gastric
bypass in its many forms was one of the earliest
operations performed for weight loss. The concept
of an implantable and adjustable ring (gastric
band) to partition the stomach into an hourglass
came later.
The sleeve gastrectomy arrived much later, when
in 1988 a surgeon performed this procedure
through open surgery as the first stage of a more
radical intervention known as a duodenal switch.
The concept of the sleeve is simple: remove a
large portion of the stomach, sizing the remaining
part into a long sleeve that empties naturally into
the bowel as it should do.
The advantages of this procedure are multiple,
starting with the restrictive effect which is very
much similar to the way a gastric band works;
however no band adjustments are required which
can sometimes delay weight loss with a gastric
band. On the other hand the nutritional defects
of a gastric bypass are avoided because food
will travel in exactly the same way as before albeit
in smaller quantities. A sleeve gastrectomy leads
to loss of 50-70% of the excess weight carried
by the individual and in some cases even more.
The effect is sustained over a period of time,
however some slight stretch of the sleeve is
expected but never to the original volume.
The procedure was first performed through
keyhole surgery in 2000 and has gained popularity
ever since, due to its high safety profile, quick
recovery and good outcomes. Although there is
no fixed rule for the choice of surgery, sleeve has
become increasingly recognised as offering an
alternative to gastric bypass surgery at high BMIs
(40 or above), as well as an alternative to bands
to avoid frequent adjustments in individuals with
busy lifestyles.
of the surgery and your expectations with the
team well in advance. There is never a need to
rush anything and the best outcomes are achieved
when your medical history, lifestyle and needs
are taken into consideration for a tailored
approach.
Research has shown that chemical messengers
from the gut travel to the brain and are responsible
for our sensation of craving and appetite. The
better known messengers are Ghrelin, PPY and
GLP-1. It is theorised that they are secreted from
certain points in the gut which are affected by
sleeve