When surgeons first proposed the gastric sleeve as the first step of a 2-step surgery, they did so for two reasons: it was safer, and it was simpler. On the safety side, it was correctly assumed that high-risk patients could undergo the sleeve procedure with far less risk than the gastric bypass. On the simplicity side, the instrumentation had already been developed that allowed surgeons to trim off a portion of the stomach without difficulty.
As the patients who had the sleeve procedure continued to surpass expectations of weight loss and health improvements, researchers began to ask whether the sleeve might work well enough all by itself, and not as the start of a 2-stage surgical intervention. Each year, weight-loss results paralleled those of the more invasive gastric bypass procedure (but without the complications), and the rates of diabetes resolution appeared nearly equal. And each year, researchers asked why the sleeve worked better than most experts had expected.
The answer appears to lie in the new understanding of body weight metabolism and the body weight set point. Elegant research from labs around the world has demonstrated that a key feature in the body’s defense of higher body weight comes right from the cells of the stomach lining, right in the part of the stomach being removed with the sleeve. In the normal stomach, contact on the gastric lining from ingested food stimulates hormonal responses that ultimately make us heavier and hungrier. With the sleeve that portion of the stomach is removed, and the hormonal responses are blunted. Combined with the significant shrinkage of the size of the stomach, this change in gastric hormones appears to account for the complete loss of hunger and the permanent weight loss that most people experience after the sleeve.
We are now about ten years into our worldwide experience with the gastric sleeve, and the data appears as convincing as ever. The safer, simpler surgery has proven to be safer and simpler, and the results have exceeded expectations. Most people maintain their healthier, lower body weight and enjoy the improvements in health and quality of life that result from a more normal body weight.
Too see if you are a candidate for the gastric sleeve please call us at 775-829-7999.