Sleeve Gastrectomy

The Gastric Sleeve operation is an operative procedure that combines the reliable weight loss and low maintenance of the gastric bypass with the simplicity of gastric banding.

For patients with a BMI of over 60kg/m² (super obese) complex surgery such as gastric bypass or duodenal switch can pose additional risks due to the duration of surgery. For these patients surgery can be considered in two stages to reduce the risk; initially a sleeve gastrectomy followed at a later date by a second operation to convert it to either a gastric bypass or to a duodenal switch. However, some patients will lose enough weight with a sleeve gastrectomy alone, so that the second stage of the operation is not required.

The sleeve gastrectomy reduces the size of the stomach by about 75%. It is divided vertically from top to bottom leaving a banana shaped stomach along the inside curve. This means that although smaller, the stomach function remains unaltered.

The stomach can hold about 60 – 100cc at any one time. This may reduce total weight by 15-25% (excess weight by about 30 - 50%) in the first year. For obese people with not that high BMI (eg: 35-40), this alone may be enough without any further procedure.

Who is it suitable for?

It is a suitable form of surgery for patients who are already suffering from anaemia, Crohn's disease and a variety of other conditions that would place them at high risk for surgery involving intestinal bypass
It is one of the few forms of surgery which can be performed laparoscopically in patients who are extremely overweight and this accounts for the rising popularity of the laparoscopic sleeve gastrectomy in some patients with a BMI over 55-60
The Sleeve does appear to create reliable weight loss, though a bit less than a gastric bypass. Thus, the Sleeve is also gaining acceptance as an operation for patients on the lighter end of the weight scale, even down to a BMI of 30 in other countries
The Sleeve is commonly utilized as a conversion procedure in cases where the gastric band is not working

What are the advantages?

The surgery does not involve diverting intestines like the Gastric Bypass
The Sleeve surgery does not create any changes in nutrient absorption, though supplements and regular follow up care are strongly recommended because of the dramatically lower food intake
In comparison to the Gastric Band, there is no plastic device in the body and there is not any requirement for frequent follow up and Band adjustment
Unlike many other forms of Bariatric Surgery, the outlet valve and the nerves to the stomach remain intact and, while the stomach is drastically reduced in size, its function is preserved
Because the new stomach continues to function normally there are far fewer restrictions on the foods which patients can consume after surgery, albeit that the quantity of food eaten will be considerably reduced. This is seen by many patients as being one of the great advantages
The removal of the majority of the stomach also results in the virtual elimination of hormones produced within the stomach which stimulate hunger
Patients do not suffer the complications of intestinal bypass such as intestinal obstruction, anaemia, osteoporosis, vitamin deficiency and protein deficiency
Patients can experience resolution rates for type 2 diabetes, high blood pressure, high cholesterol, and obstructive sleep apnoea that are similar to resolution rates for other restrictive procedures such as gastric banding

What are the drawbacks?

The Sleeve Gastrectomy is not reversible. It should be remembered though that the Sleeve Gastrectomy can be extended at a later date if required by performing additional bypass surgery
It does not always produce the reduction in weight which people would wish for and, in the longer term, can result in weight regain. This is indeed true of any form of purely restrictive surgery, but is perhaps especially true in the case of the Sleeve Gastrectomy
Because the procedure requires stapling of the stomach patients do run the risk of leakage and of other complications directly related to stapling

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BMI calculator

The body mass index (BMI) is a statistical measurement which compares a person's weight and height. Though it does not actually measure the percentage of body fat, it may be a useful tool to estimate a healthy body weight based on how tall a person is. Due to its ease of measurement and calculation, it is the most widely used diagnostic tool to identify weight problems within a population, usually whether individuals are underweight, overweight or obese. Body mass index is defined as the individual's body weight divided by the square of his or her height. The formulae universally used in medicine produce a unit of measure of kg/m2. BMI can also be determined using a BMI chart, which displays BMI as a function of weight (horizontal axis) and height (vertical axis) using contour lines for different values of BMI or colours for different BMI categories.

Gastric Band

A laparoscopic adjustable gastric band also known as a Lap-Band, is an inflatable silicone device that is placed around the top portion of the stomach, via laparoscopic surgery, in order to treat obesity. Adjustable gastric band surgery is an example of bariatric surgery designed for obese patients with a body mass index (BMI) of 40 or greater—or between 35–40 in cases of patients with certain co-morbidities that are known to improve with weight loss, such as sleep apnea, diabetes, osteoarthritis, GERD, Hypertension (high blood pressure), or metabolic syndrome, among others.

Gastric Band Surgery

This involves the placement of an adjustable gastric band (made from silicone) that is placed around the upper part of the stomach. It creates a new smaller stomach pouch, with a small opening that leads to the larger part of the stomach below the band. Food pools in the small stomach pouch and creates a feeling of fullness.

The gastric band creates an opening between the smaller and larger stomach. The size of the opening controls the flow rate of food from the two areas. This means the band can be adjusted. To change the size of the opening, the inner surface of the band can be inflated with saline via a port. This is called a fill.

An ideal fill is tight enough to allow a reduction in hunger, increased fullness and cause steady weight loss whilst allowing adequate amounts of food to pass through the band to meet your baseline nutritional needs. People usually require several fills as the band needs very fine tuning to obtain optimum restriction.

Gastric Bypass Surgery

The gastric bypass is a surgical operation that results in enhanced satiety after a small meal. There is a marked reduction in the size of the stomach to a small stomach pouch. None of the stomach is actually removed. The food then passes through the intestine, but the lower part of the intestine is in contact with food much earlier than usual, because as the initial half meter of the intestine has been bypassed.

A side effect of the gastric bypass operation is what is called ‘dumping’, which gives you a light-headed feeling, nausea and occasionally diarrhoea. This happens in response to overeating very sweet foods such as chocolate.

The gastric bypass operation is generally suitable for all patients and achieves excellent results. It is starting to become a surgical ‘treatment of choice’.

Obesity surgery

Obesity surgery, is performed on the stomach and intestine of people who are dangerously obese, for the purpose of losing weight. The two most common procedures are the Roux-en-Y or Gastric Bypass, which closes off a portion of the stomach and bypasses part of the intestine; and gastric banding, which places a band around the stomach. In long-term studies, the procedures cause a significant long-term loss of weight, recovery from diabetes, improvement in cardiovascular risk factors, and a reduction in mortality of 23% to 40%.

Weight loss clinics

Vita Weight Management Clinics are designed to offer the best possible environment to cater for the sensitive needs of those people who are experiencing weight issues. We will be developing clinics in other locations (both NHS and private). If you want to see if we're locating a clinic in your region contact us for further information.
Current clinics:

Birmingham weight management clinic
London weight management clinic
Manchester weight management clinic
Belfast weight management clinic
Ballykelly weight management clinic

Weight loss surgery

Weight loss surgery, is performed on the stomach and intestine of people who are dangerously obese, for the purpose of losing weight.
The two most common procedures are the Roux-en-Y or Gastric Bypass, which closes off a portion of the stomach and bypasses part of the intestine; and gastric banding, which places a band around the stomach. In long-term studies, the procedures cause a significant long-term loss of weight, recovery from diabetes, improvement in cardiovascular risk factors, and a reduction in mortality of 23% to 40%.