Sleeve stomach • Filled up faster through surgery

The formation of a stomach tube is said to help obese people lose weight effectively. What happens during this stomach reduction procedure, how the surgical procedure is carried out and what needs to be considered.

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What is a sleeve stomach?

Sleeve gastrectomy (SG; also called sleeve resection or sleeve gastrectomy) is a procedure used in bariatric surgery or metabolic surgery. These are surgical treatment methods for severe obesity or difficult-to-control type 2 diabetes mellitus. The formation of a sleeve stomach is intended to reduce weight, improve obesity-related accompanying and secondary diseases and improve quality of life.

The volume of the stomach is reduced with a sleeve stomach formation, so that a tubular looking part remains. This is a restrictive method of making the stomach smaller, with additional hormonal effects. As a result of the procedure, only smaller amounts of food can be consumed, as the reduced stomach fills up very quickly and the feeling of satiety occurs quickly. In addition, the feeling of hunger decreases after the operation, as the part of the stomach (gastric fundus) in which the hunger hormone ghrelin is produced is removed.

Procedure: what happens during a gastric sleeve operation?

The gastric sleeve surgery is performed laparoscopically. This means that only small incisions are necessary for the operation. Because it is a minimally invasive procedure (keyhole surgery) of a laparoscopy. The procedure is performed under general anesthesia and usually takes about an hour.

During the operation, the left-hand part of the stomach is severed and removed using a stapler (recessed stomach) and a tubular residual stomach with a stomach volume of around 100 to 120 milliliters is formed. For comparison: if the stomach is moderately full, it normally has a volume of 1.2 to 1.6 liters. In the case of overweight people, the volume is usually greatly increased, which is why saturation is no longer achieved when normal amounts of food are consumed.

The gastric sleeve formation is not only used as an independent surgical method for stomach reduction, but is often part of so-called step-by-step concepts. In such cases, a sleeve stomach is formed as a first-step operation; in a further step, it can be converted into a gastric bypass, for example. In this way it is possible to wait for the weight reduction in very obese people after a sleeve stomach formation before another operation is carried out.

Success: What is the weight loss with a sleeve stomach?

According to the guidelines of the German Society for General and Visceral Surgery, weight loss with a sleeve stomach is around 50 percent after five years.

In addition, the operation leads to a significant improvement in comorbidities such as type 2 diabetes mellitus or high blood pressure.

Risks: how dangerous is gastric sleeve surgery?

If the gastric sleeve formation is carried out by an experienced team, it is considered a safe operation. According to the German Society for General and Visceral Surgery, the probability of dying during the operation is far below one percent.

As with any operation, complications are also possible with the formation of a tubular stomach, but the complication rate is classified as low. The most common surgery-specific complications are staple fistulas, abscesses or (secondary) bleeding.

Advantages and disadvantages of a gastric sleeve

Whether the gastric sleeve formation is the most suitable surgical method has to be weighed up by a doctor in the individual case. There is no generally recommended surgical treatment for obesity. The decision is based on factors such as body mass index (BMI), age or concomitant diseases, among other things. For example, if you have reflux disease, gastric bypass may be considered a more appropriate method.

Possible advantages of a gastric sleeve:


  • The operation is also possible with a very high BMI of over 60.

  • The sleeve stomach offers many options if follow-up operations are necessary.

  • The so-called dumping risk is low. It is the risk of a fall emptying after stomach reduction, which can be accompanied by symptoms such as nausea, vomiting or diarrhea,

  • It is a restrictive procedure that does not lead to a reduced absorption of nutrients (malabsorption).

Possible disadvantages of a gastric sleeve:

  • Wound healing disorders of the long suture on the stomach are possible.

  • Heartburn may occur after the operation.

  • Weight gain is possible after two to five years.

Sleeve stomach: requirements, costs & Co.

Anyone interested in a stomach reduction, such as a sleeve stomach, should consider the following:

  • Requirements for a sleeve stomach: Surgical therapies to reduce the size of the stomach come into question if certain prerequisites are met. Among other things, the conservative therapies in the form of nutrition, exercise and behavioral therapies must be exhausted and the operation must be considered medically necessary due to a correspondingly high BMI or concomitant diseases. Read here what the specific requirements are.

  • Cost of a sleeve stomach: If the prerequisites for a surgical procedure are met, the health insurance company can cover the costs of a gastric sleeve upon request. Please inquire at the cash desk which documents are required for the application. Most clinics offer help with submitting an application.

  • Obesity centers: The procedure should be carried out by a reputable provider. Certified reference centers can, for example, via the German Society for General and Visceral Surgery can be found.

  • Hospital stay: An inpatient stay is required for gastric sleeve surgery. Depending on the individual situation, it can be around a week. Some clinics have special rooms for extremely obese people. After discharge, you are usually on sick leave for a certain period of time.

  • Diet change: Before and after the operation, a change in diet is necessary. How exactly this looks like must be clarified by a doctor in the individual case. After the operation it is necessary to supplement certain nutrients with food supplements.

  • Lifelong aftercare: In order to ensure the success of the therapy, careful follow-up care must take place throughout your life. In addition to regular medical check-ups, this also includes a change in lifestyle, if necessary psychological or psychiatric care and participation in a self-help group.

Long-term experience with a sleeve stomach

The effectiveness of obesity surgical measures such as a sleeve stomach has been proven by studies in extreme obesity. Studies on long-term success are only available sporadically.

How successful the weight loss is in the long run also depends on the active cooperation of the people concerned. Because after a few years with a sleeve stomach there is an increase in weight again. It is therefore particularly important that after the operation you learn how to make life healthier from now on and how to prevent future obesity. A permanent change in diet and the establishment of new exercise habits are crucial for lasting therapeutic success.

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Source: Lifeline | Das Gesundheitsportal by www.lifeline.de.

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