Gastric Sleeve Surgery

Compare this with Gastric Bands where the average number of consultations with the surgeon is 8 for the first year and then 1 or 2 per year, and Bypass 4 in the first year then annually. The reason we don’t need to see patients who have had a Sleeve Gastrectomy very often is there is very little that needs to be done. It is really quite easy to live with a Sleeve and there are no issues of malabsorption or excessive weight loss, and of course, there are no adjustments required. People find the weight loss is initially almost automatic in most cases. Some people experience eating squeezing for the first few months, which is difficulty eating most foods, but this settles by itself with time.

Because the eating style of Sleeve is so much like “normal eating”, you don’t have to change much to get it to work. Obviously, the more effort you put into losing weight and the better your diet is the more weight you will lose. But unlike the gastric Band where you need to follow a long list of simple eating rules the Sleeve is more straightforward. The eating rules with a band are easy for some people to follow and difficult for others. How much of your lifestyle are you willing and able to change to lose weight? What do you know from your previous attempts at weight loss? F you can make big lifestyle changes and maintain them, then the band is a reasonable choice. But if realistically, you will not change how and when you eat to make the band or Bypass work, then you should consider the Sleeve. This is because with a Sleeve Gastrectomy there are fewer rules to follow to avoid problems such as blockages and sabotage.

The Sleeve Gastrectomy will on average result in more weight loss than a Gastric Band. The difference between the 2 operations when it comes to weight loss is small, at 70% for the Sleeve, and 50 to 60% for the Band. But this difference is just statistics. The real difference we see clinically is that sweet eaters, high-calorie soft food eaters, and many other eating styles do better with a Sleeve because the volume of food is non-negotiable, whereas for a Gastric Band, if you eat a certain way you can eat more (see above).

When you eat something with the Sleeve Gastrectomy, food enters the stomach as normal (unlike the band where it is slowed up by the band) and leaves the stomach through the normal, natural passageway (the pylorus). So food travels normally through the part of the body the gives you fullness. So fullness feels normal, and eating feels normal. This is not the case for the band or the bypass. So how does that help? No matter what you are feeling like, no matter how distracted you are, no matter how hungry, food goes down normally and makes you feel full quickly. So imagine you are inclined to eat really large meals when you are very hungry, especially after a stressful day at work, and you quite like a bit of drive-through convenient, fast food. (Nothing wrong with that in general, by the way, but perhaps you tend to do it too often.)

With a Gastric Band you are likely to get a blockage and find it difficult to eat and eventually stop eating the takeaway and be less inclined to get it next time you feel like this. The Sleeve Gastrectomy will let you eat the take away normally, but only a much smaller amount, the meal ending when there is simply no room left in your stomach to eat anything more. So both the band and the Sleeve help with impulsively high calorie eating, but for the person with the Sleeve the feeling is more natural.

And if there is a moment or a period in your life when you are determined to eat your take away, and you have a Gastric Band, you might find some way to get the food down so you can keep on eating, because at that time you want to eat more, even though it will mess up your weight loss. With the Sleeve Gastrectomy, no matter how hard you try, you will still only eat a small meal. This durability gives people with a Sleeve the comfort that the weight control is going to persist, no matter how they are feeling, and is less subject to sabotage. Neither operations are effective at weight control unless you have a calorie controlled diet.

Once the Sleeve Gastrectomy operation is finished, if there is any adjustment required, you would have to have a further operation. Fortunately this is only rarely required, in less than 2%. And there is no way of returning the stomach to its original size and shape. So the operation is not reversible or adjustable, but it can be modified if required. The modifications that can be achieved are, however, quite limited, and seldom needed. This being the case, many patients are very pleased this is the case. Their weight problem was not temporary and was not reversible, so why should the solution be reversible? This can be comforting to some and concerning to others. You need o choose the operation that suits you best.