Obesity Surgery by Sleeve Gastrectomy
The sleeve gastrectomy is a technique of obesity surgery (bariatric surgery) which has for objective the weight loss of obese patients. It is a restrictive technique proposed to the hyperphagic patients who eat a lot during the meals.
Doubtless because of the gastric volume reduction, we feel very fast the satiety. Other mechanisms, hormonal order, intervene probably, as the decrease of the ghrelin (hormone stimulating the appetite and secreted especially in the part of the stomach removed).
Contrary to the bypass, there is no malabsorption, nor deficiency because there is no short food circuit. On the other hand, we protect the distal portion of the stomach, named gastric antrum or pyloric antrum, to keep its propellent capacities.
Sleeve Gastrectomy consists in transforming the stomach a kind of tube by means of a long stapling on all its
height. The objective is to eliminate a party of the gastric cells which secrete the ghrelin, a hormone stimulating the appetite. It is realized under coelioscopy, this complex intervention could last two hours and it is revaluated very painful (taken of antalgic drugs is necessary).
- the loss of weight is mechanical,
- We lose more weight (65 %), than with the Gastric Band,
- There is not an implantation of foreign body which can migrate.
- This surgery is irreversible and thus it is addressed for very motivated patients,
- Further to an inflammation due to staples, the stomach can shrink, where from difficulties to feed,
- The line of staples can distend, even tear, obliging to reintervene (in less than 1 % of the cases),
- Has a higher early complication rate than the Gastric Band.
The published data concerning Sleeve Gastrectomy show very interesting results at medium-term (3 years). The loss of overweight was superior to 65 % with a backward movement of three years. But, it is necessary to specify that the real value on the loss of weight after any bariatric surgery appreciates generally five years after the operation.