An important shift is occurring in our practice. Patients appear to be requesting the gastric sleeve operation more frequently than any other operation. We are much less likely to be requested to perform an adjustable gastric band than a coup;e of years ago.
In my opinion a gastric sleeve is a great operation for many patients. However, a gastric bypass is usually the best operation if you have significant type 2 diabetes or severe gastroesophageal reflux.
A gastric sleeve operation does not change the small intestine and therefore supplemental vitamins and calcium may not be medically necessary.
Also the circular muscle at the outlet of the stomach functions somewhat as the gastric band. In a way this operation is the best a gastric bypass and a band without some of the potential problems of either.
I have now had the privilege of performing over 200 laparoscopic gastric sleeve operations and I have found patients are generally very pleased with their results. In our practice our patients lose about 20 lbs. a month for about three months and they lose an average of 78% of their excess weight at one year after surgery. This is similar to the 80% excess weight loss a year after a gastric bypass in our practice.
