Sleeve Gastrectomy...

Sep 23, 2009

Sleeve Gastrectomy…

What is it? This is a relatively new form of restrictive weight loss surgery. In the operation, which is usually done with a laparoscope, about 75% of the stomach is removed. What remains of the stomach is a narrow tube or sleeve, which connects to the intestines.

Usually, a sleeve gastrectomy is a first step in a sequence of weight loss surgeries. It's typically followed up by gastric bypass or biliopancreatic diversion, which will result in greater weight loss. However, in some cases, it might be the only surgery you need.

·                         The Pros. For people who are very obese or sick, standard gastric bypass or biliopancreatic diversion may be too risky. A sleeve gastrectomy is a simpler operation that allows them a lower-risk way to start losing weight. Afterwards, once they've lost weight and their health has improved -- usually after 12-18 months -- they can go on to have a second surgery, such as gastric bypass. In people with high BMIs, sleeve gastrectomies result in an average weight loss of 40% to 50% of excess weight after three years. People with lower BMIs tend to lose even more of their excess weight. The preliminary evidence suggests that sleeve gastrectomy works about as well as adjustable gastric banding

Because the intestines aren't affected, a sleeve gastrectomy doesn't affect the absorption of food, so nutritional deficiencies are not a problem.

·                         The Cons. Since a sleeve gastrectomy is often just the first step in weight loss surgery, you will probably face further operations later on. Unlike gastric banding procedures, a sleeve gastrectomy is irreversible. Most importantly, since it's relatively new, the long-term benefits and risks aren't yet known.
www.WebMD.com is where I got the top part

 

This is from Anthem website

Medical Policy

 

Subject:

Surgery for Clinically Severe Obesity

Policy #:  

SURG.00024

Current Effective Date: 

04/22/2009

Status:

Reviewed

Last Review Date: 

02/26/2009

Sleeve Gastrectomy…

This alternative surgical approach to gastrectomy involves resection of the greater curvature of the stomach resulting in a stomach remnant shaped like a tube or "sleeve."  It can be performed by open or laparoscopic technique and can be done as a stand-alone procedure or as the first in a two-stage procedure subsequently followed by a malabsorptive procedure, such as biliopancreatic diversion with duodenal switch. It has been proposed by some surgeons for very high risk patients where weight loss following sleeve gastrectomy may improve a patient's overall medical status and reduce risk for subsequent more extensive malabsorptive procedures.

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