UnityPoint Health - Des Moines

Scott's Story/Sleeve Gastrectomy

Weight loss surgeons at UnityPoint Clinic use a relatively new procedure called sleeve gastrectomy. It is a new, useful option for many patients considering weight loss surgery. 

Our bariatric surgeons have performed sleeve gastrectomies for several years. Dr. LaMasters was the first surgeon in Iowa to use the new procedure. "The advantages of this surgery include rapid weight loss, and lowering the risk of weight related diseases," said Dr. LaMasters.  "The procedure minimizes some of the long-term risks compared to the other surgical weight loss procedures."

Patients typically give the procedure high marks. One of our patients, Scott, had his surgery ten months before this article was written. "I knew that my high weight was exacerbating many related health problems for me - I was pre-diabetic, had bad varicose leg veins and sleep apnea - but it was when two of my physicians told me independently within two weeks that I was a likely candidate for a heart attack, that I knew I needed to do something," said Scott. "I needed a life-changing program." Scott researched the procedures and consulted with our physician, deciding together that the sleeve procedure would be best for him. "Ten months later, I've lost 100 pounds and am continuing to lose weight, as I am able to incorporate exercise more and more into my daily routine. I'm no longer pre-diabetic, I was able to discontinue the medication I was taking for that, and my blood pressure medicine dosage has been cut in half. My physician feels I'm close to being able to discontinue that completely very soon. I really love being able to walk with my wife again; being fitter makes me feel like I did back in high school."

In a sleeve gastrectomy procedure, a thin, vertical sleeve of stomach is created and approximately three quarters of the stomach is permanently removed.  The surgery is performed laparoscopically, which helps reduce recovery time for the patient; a number of small incisions are made in the abdomen. There is no intestinal bypass with this procedure, only a reduction in the size of the stomach. The lack of an intestinal bypass allows patients to avoid potential complications such as marginal ulcers, vitamin deficiencies and intestinal obstructions.

After surgery, the smaller stomach limits the amount of food that can be consumed, and people feel full sooner. The portion of the stomach which is removed is responsible for secreting Ghrelin, a hormone that is responsible for appetite and hunger. Low Ghrelin production promotes a reduction in one's appetite. Also, the removed section of the stomach is the portion that "stretches" the most.  "I do eat much smaller portions now," says Scott. "I still love food - I just eat less of it, and am much more aware of what I eat."

With sleeve gastrectomy, most patients' hospital stay averages 48 hours, and most return to normal activity in two weeks, achieving a full surgical recovery in three weeks. Patients can lose an average of 60 to 70 percent of excess body weight and can see significant improvements in their overall health.

 Advantages of Sleeve Gastrectomy:

  • Less food intolerance than with gastric banding.
  • Weight loss generally is faster.
  • There is no implantable band device, so slippage and erosion are not a risk.
  • The surgical risk is lower than with the Roux-en-Y gastric bypass procedure, but the weight loss is similar. In addition, our team can perform sleeve gastrectomy using minimally-invasive techniques that help speed recovery time.
  • No device that needs adjustment is inserted, so the follow-up regimen is not as intense as it would be with gastric banding.

Disadvantages of Sleeve Gastrectomy:

  • Since the sleeve gastrectomy is a newer procedure, it hasn't been tested as long as gastric banding or Roux-en-Y gastric bypass.
  • Sleeve gastrectomy is non-adjustable and non-reversible, unlike gastric banding. 
  • Early complication risks are slightly higher than with gastric banding (but long-term complication risks are actually lower).