Like a lot of surgical procedures, bariatric surgery has evolved over the decades, and it continues to change and improve today. With over 75 years of history, the procedures have come a long way. So, what is the most popular bariatric surgery today?
The Most Popular Bariatric Surgery
The short answer is the laparoscopic sleeve gastrectomy. But what is the sleeve procedure, and why has it become the most popular? Let me start by noting that the name “sleeve” is a lousy name for an operation — especially one that does not involve implanting anything within the body, no sleeve, no sock, no band, no device whatsoever.
A deeper dive into the history of surgical procedures will lead one to realize that most of them have been given names derived either from the surgeon who popularized or invented them, or a shorthand or slang term within the surgical community. In this case, many decades ago when surgeons needed to remove part of the stomach to treat a tumor or a large ulcer for example, the surgeon faced a choice of a horizontal cut to remove part of the stomach, or a vertical cut. When the surgeon chose a vertical cut, he or she removed the outer part of the stomach tissue. What remained was more like a banana-shaped stomach, more slender or tube-like. And if you are wearing a long jacket and look at your arm, you see a long slender tube that looks like the sleeve of your jacket. Voila, vertical sleeve gastrectomy.
But why is it so popular? This has a lot to do with both the effectiveness and safety of the procedure.
Efficacy
We know from decades of data that the long-term success of weight-loss surgery depends upon changing the family of hormones that regulates the body weight setpoint. We know now that there is a group of important hormones that collectively determine our metabolic rate and establish a body weight set point — like the flight plan of an aircraft. That is to say, it is impossible to veer off that setpoint or flight plan without changing the underlying control panel, which in this case is the hormone family.
Bypassing the stomach and some of the intestine creates a shift in the family of hormones. So it is with removing the outer part of the stomach tissue with vertical sleeve gastrectomy. The sleeve gastrectomy has proven to be extremely effective at reducing body weight for the long-haul and reducing stored fat, liver dysfunction, blood sugar, and diabetes.
Safety
But the real reason sleeve gastrectomy overtook all the other contenders in the last 15 years has more to do with its safety record. The sleeve procedure has proven to be the simplest, safest, least invasive procedure among all the candidates. It is even safer than the lap band by virtue of the fact that there is no device which can cause erosion, pain, infection, or vomiting. Likewise, there is no bypass or rerouting of the intestines, so that means there are no blockages, and very little in the way of other complications on the laundry list of side effects from bypass procedures such as low blood sugar episodes, hot flash dumping syndromes, diarrhea, hair loss, and vitamin deficiencies.
There are some people for whom a bypass type of procedure is undoubtedly the best solution. It is often a great choice as a revision or a second bite at the apple years later if the sleeve was not successful. And there is good data that over the long term, the bypass type procedures do a better job at keeping diabetes in remission. Plus, the list of side effects is certainly manageable in those cases. Like with any needed procedure that has side effects, one needs to reckon with them and keep them in mind, learn ways of preventing them.
In most cases the sleeve gastrectomy can be performed very safely with four or five small Band-Aids in less than an hour, with an overnight stay and a two-week recovery time. It has become one of the safest of all the procedures performed on a regular basis throughout the United States. It has its downsides like all procedures, including rare complications, long term scar tissue stenoses, acid reflux and some (usually mild) vitamin deficiencies. For most individuals, the sleeve creates a much healthier body weight setpoint, reverses diabetes, and improves health with a minimally invasive procedure.
The safety record in fact it is so good, that the statistics bear out an interesting fact: undergoing the 45-minute sleeve procedure for anyone overweight enough to consider it, is significantly safer than not undergoing the procedure. Food for thought.
If you’re considering weight-loss surgery, it’s normal to have questions. Contact the Nevada Surgical team today for more information about these procedures and whether you might be a candidate.
