Sleeve Gastrectomy

Sleeve Gastrectomy is a relatively more recent type of operation for morbid obesity. The biggest portion of the stomach is removed in a way that the remaining takes the shape of a tube (or a “sleeve”). The new tubular stomach not only does not accommodate much food, but it also makes it harder for the food to move through it, so patients are able to consume much lower quantities of food overall. In addition to the decreased quantity of food consumed, there is another mechanism that this operation exerts its beneficial results, which is that the portion of stomach removed is the site of production of a hormone called ghrellin, which increases the appetite. So, the absence of ghrellin leads to considerable decrease in appetite. This is extremely important because these patients are not as interested in food intake as before, so they do not “struggle” to abide by some diet regimen or stick to food restrictions. One can appreciate this when compared to a patient with a band. Such a patient does want to eat, does have a lot of appetite, but is not able to because of the forceful restriction to solids that the band exerts. This uninterrupted “drive to eat” is precisely why patients with a band eventually try to “cheat” the operation and they manage to do this by consuming high-calorie fluids and so they regain weight. Sleeve gastrectomy generally has very good long-term results in patients with BMI up to 45. It is performed laparoscopically and patients should eat blenderized food for a week. Then, there are no diet restrictions.