Treatment and Causes of Sleeve Gastrectomy

Sleeve gastrectomy is a widely performed and effective bariatric surgery designed to help individuals struggling with obesity achieve sustainable weight loss. As the prevalence of obesity continues to rise globally, more people are turning to surgical options like sleeve gastrectomy to improve their health and quality of life.

This is where bariatric surgery and more specifically, sleeve gastrectomy comes into play. Sleeve gastrectomy has rapidly emerged as one of the most effective and commonly performed weight loss surgeries worldwide. It provides a permanent solution by reducing the size of the stomach, limiting food intake, and influencing hunger regulating hormones. More than just a weight loss tool, this surgery can lead to dramatic improvements in overall health, energy levels, mobility, and quality of life.

What is Sleeve Gastrectomy?

Sleeve gastrectomy, also known as vertical sleeve gastrectomy (VSG), is a type of weight loss surgery that involves removing about 75–80% of the stomach. This procedure transforms the stomach into a tube like or sleeve shaped organ, which significantly limits the amount of food one can consume.

Unlike gastric bypass, sleeve gastrectomy does not involve rerouting the intestines. It primarily works through restriction and hormonal changes, making patients feel full sooner and reducing hunger by affecting the production of the hunger hormone, ghrelin.

Why is Sleeve Gastrectomy Performed?

Sleeve gastrectomy is typically recommended for individuals who are severely obese and have been unable to lose weight through diet, exercise, or medications. It is often advised for patients with a body mass index (BMI) of 40 or higher, or for those with a BMI of 35 or more who also suffer from obesity related health conditions such as type 2 diabetes, high blood pressure, or sleep apnea.

In addition to weight loss, the surgery offers significant improvements in overall health, reducing the risk of chronic diseases and increasing life expectancy. It is also chosen for being less complex than gastric bypass, with fewer complications and a shorter hospital stay.

Treatment and Causes of Sleeve Gastrectomy

Common Causes Leading to the Need for Sleeve Gastrectomy :- There are several underlying causes that can lead individuals to consider sleeve gastrectomy. These include :-

1. Obesity and Genetic Factors :- Genetics often play a crucial role in the development of obesity. If a person has a family history of obesity, they are more likely to struggle with weight gain, even if they lead a relatively healthy lifestyle. Metabolic rate, appetite regulation, and fat storage are influenced by inherited traits, making weight loss particularly difficult without medical intervention.
2. Sedentary Lifestyle :- Modern sedentary lifestyles contribute significantly to obesity. Long hours of desk work, minimal physical activity, and the widespread use of electronic devices lead to calorie imbalance, resulting in excessive fat accumulation.
3. Poor Dietary Habits :- Frequent consumption of high calorie, processed foods and sugary beverages can lead to rapid weight gain. Emotional eating, binge eating, and a lack of portion control further exacerbate the issue, making it hard to maintain a healthy weight.
4. Medical Conditions and Medications :- Certain medical conditions, such as hypothyroidism, polycystic ovarian syndrome (PCOS), and Cushing’s syndrome, can cause or worsen obesity. Additionally, some medications like antidepressants, corticosteroids, and antipsychotics can lead to weight gain.
5. Psychological Factors :- Mental health issues such as depression, anxiety, and chronic stress often contribute to unhealthy eating patterns. Individuals may turn to food for comfort, leading to compulsive overeating and eventual obesity.

Pre operative Preparation for Sleeve Gastrectomy

Before undergoing sleeve gastrectomy, patients go through a thorough evaluation process that includes physical examinations, lab tests, and consultations with nutritionists and psychologists. The goal is to assess the patient’s readiness for surgery and their ability to commit to long-term lifestyle changes.

Patients are usually placed on a low calorie diet for a few weeks before surgery to reduce liver size and fat in the abdominal area, which helps ensure a safer procedure. Smoking cessation, managing comorbid conditions like diabetes or hypertension, and achieving a modest amount of weight loss are also encouraged prior to surgery.

The Sleeve Gastrectomy Procedure

The surgery is typically performed laparoscopically, which involves making small incisions in the abdomen and using a camera and surgical instruments to carry out the procedure. This minimally invasive approach results in reduced pain, shorter hospital stays, and quicker recovery times.

During the operation, approximately 75–80% of the stomach is removed, leaving a narrow sleeve. The remaining stomach is stapled shut using surgical staples. Since the part of the stomach that produces ghrelin is removed, patients experience decreased hunger levels after surgery.

The procedure generally lasts between 60 to 90 minutes and requires an overnight hospital stay for monitoring.

Recovery After Sleeve Gastrectomy

The recovery period varies from person to person, but most patients can resume light activities within a few days. A gradual dietary progression is essential, starting with clear liquids, followed by pureed foods, soft foods, and eventually regular healthy meals.

Most patients return to work within two to four weeks, depending on the nature of their job. Regular follow-up appointments are crucial to monitor nutritional intake, weight loss progress, and overall health.

Vitamin supplementation is often necessary to prevent nutritional deficiencies. Patients are advised to take multivitamins, vitamin B12, iron, and calcium supplements as prescribed by their healthcare provider.

Long Term Treatment and Lifestyle Changes

Sleeve gastrectomy is not a quick fix; it is a tool that requires long term commitment to lifestyle changes. Successful weight loss and maintenance depend heavily on healthy eating, regular exercise, behavioral therapy, and consistent follow up with medical professionals.

Patients are encouraged to :-

1. Eat small, nutrient rich meals

2. Avoid sugary and high fat foods

3. Stay hydrated

4. Engage in physical activity regularly

5. Attend support groups or counseling sessions if needed

It’s also important to monitor for potential complications, such as acid reflux, vitamin deficiencies, or weight regain, which can occur if dietary guidelines are not followed.

Effectiveness of Sleeve Gastrectomy

Sleeve gastrectomy has proven to be highly effective in promoting significant and sustainable weight loss. Most patients lose 50–70% of their excess body weight within 12 to 18 months following surgery. The procedure also helps in the remission or improvement of many obesity-related conditions such as :-

1. Type 2 diabetes

2. High blood pressure

3. Sleep apnea

4. High cholesterol

5. Joint pain

6. Fatty liver disease

These health improvements contribute to a better quality of life, increased mobility, and enhanced self confidence.

Conclusion

Sleeve gastrectomy offers a powerful solution for individuals struggling with severe obesity and its associated health problems. While the decision to undergo bariatric surgery is a significant one, it can be life changing when combined with dedication to healthier habits. Understanding the causes that lead to this surgical choice, along with the treatment process and post-operative requirements, is essential for long term success.