In this, the first Sleeve Pro blog, we explain why the sleeve has become the dominant weight loss surgery procedure in the NHS, in fact in the whole western world.
The sleeve has 3 main attractions that, when combined, make it hard to resist:
- A simple concept and relatively simple execution
- A low requirement for post op maintenance (by comparison to the band and bypass)
- Excellent weight loss results.
Patients say that the procedure encourages a significant reduction in appetite.
Weight loss results are comparable to those for gastric bypass, with most patients achieving excess weight loss in the region of 70% of their excess weight. This weight loss is usually achieved within 18-24 months too.
Patients can expect to spend little more than an hour in theatre and to go home after two nights in hospital. You'll be advised to allow a couple of weeks to recover but usually you'll be feeling much better before then.
Given the simplicity of the procedure it would beg the question why we still do the other procedures at all but there are downsides that need to be considered. The main ones are that a proportion of patients will experience reflux after surgery, and that the complications can take much longer to heal. Reflux occurs because the stomach is narrowed significantly after surgery. This causes higher pressure in the stomach and this can cause stomach acids to reflux up into the oesophagus. If you have a history of reflux, the sleeve is not a good option for you.
The complication that causes most concern is a leak from the staple line where the stomach is cut. This is a complication that occurs in approximately 1 in every 80 cases. It's particularly difficult to manage and will usually lead to a return to theatre to close the leak. In leaks that present later after surgery there can be damage to the stomach tissue that makes the leak very difficult to find and to close. Patients who experience a leak will usually need to allow for an extended stay in hospital of 2 months, although it can be longer. They will usually be transferred to an NHS hospital so that they receive the close attention required in the days after the leak is diagnosed. Leaks can also have consequences, such as difficulty in swallowing, that are hard to manage. So, although the risk is small, patients need to understand it and the the consequences for them before they go ahead.
We can expect sleeve numbers to continue to increase in the years ahead. It's a great procedure, very powerful and you can expect to lose weight quickly. Just make sure you understand the complication rates for your surgeon, and that you know how you would manage, for example with regard to your work and/or any child care arrangements you need to make, in the event you experience a complication.
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