According to the University of Maryland Medical Center, the gastric sleeve (laparoscopic sleeve gastrectomy or “vertical sleeve”) is a bariatric (weight loss) procedure that reduces the size of the stomach by approximately 85 percent. The excess portion of the stomach is removed, leaving a vertical tube or “sleeve” that considerably limits the patient’s food intake. The procedure was developed as the first stage of a more extensive operation that involves rerouting the digestive system as well as removing most of the stomach. The gastric sleeve may also be used as a stand-alone procedure in high risk patients, including those with a complicated medical or surgical history, or a very high body mass index (BMI). As with any surgery, gastric sleeve patients are at risk for certain complications.
Early Complications
The surgeon performs the gastric sleeve laparoscopically using an instrument with a tiny camera that is introduced into the belly through several small incisions. Although this is a minimally invasive procedure compared to one that is performed through an abdominal incision, any surgical procedure involves some risks. According to the Institute of Diabetes and Digestive and Kidney Diseases, early complications may include hemorrhage (bleeding), blood clots, leaking at the surgical site, or infection. Possible anesthesia complications could include breathing problems and allergic reactions. There is also some risk of damage to the stomach, intestines or other organs, internal scarring or leaking from the surgical site.
Nutritional Deficiencies
In gastric sleeve patients, the digestive system remains intact except for the reduced size of the stomach, so many of the complications of gastric bypass procedures are avoided. According to a 2009 position paper from the American Society of Metabolic and Bariatric Surgeons, however, gastric sleeve patients may experience long-term nutritional deficiencies of certain nutrients, including vitamin B12 and iron, because so much of the stomach is removed.
Unsatisfactory Weight Loss
According to the National Institutes of Health, gastric sleeve patients generally do not lose as much weight as gastric bypass patients lose, and the rate of loss is slower. If the weight loss is inadequate, it may be necessary to perform a second operation to aid weight loss. According to a 2009 position statement by the American Society of Metabolic and Bariatric Surgeons, it is an approved bariatric procedure but more follow-up data is needed to determine if it is effective as a stand-alone procedure.
