Laparoscopic vertical sleeve gastrectomy procedure is a relatively new procedure in the U.S. MSA has experienced great success with this procedure. Our patients have lost the weight they expected while staying healthy. In late 2012, this procedure became an option for Medicare patients following government approval.
This procedure works by several mechanisms. First, the new stomach pouch holds a considerably smaller volume than the normal stomach and helps to significantly reduce the amount of food (and thus calories) that can be consumed. The greater impact, however, seems to be the effect the surgery has on gut hormones that impact a number of factors including hunger, satiety, and blood sugar control.
Short term studies show that the sleeve is as effective as the roux-en-Y gastric bypass in terms of weight loss and improvement or remission of diabetes. There is also evidence that suggest the sleeve, similar to the gastric bypass, is effective in improving type 2 diabetes independent of the weight loss. The complication rates of the sleeve fall between those of the adjustable gastric band and the roux-en-y gastric bypass.
Advantages of the Sleeve Gastrectomy
The procedure is a satiety-inducing procedure because it reduces the “appetite hormone” ghrelin, and there is no bypassing of the small intestine therefore the risk of malnutrition is low. Long term the sleeve gastrectomy has less risk of bowel obstruction and stomach ulcers. Weight loss after the sleeve gastrectomy is similar to the weight loss after the gastric bypass.
Disadvantages of the Sleeve Gastrectomy
The procedure removes part of the stomach, is not reversible and is considered experimental by most insurance companies; therefore, it is typically not covered. United Healthcare and Blue Cross Federal now cover the procedure.