Gastric Sleeve Surgery Guidelines

Gastric sleeve bariatric surgery, also known as Vertical Sleeve Gastrectomy (VSG), is an effective weight loss surgery option. Countless studies by the Obesity Society, the American Society for Metabolic & Bariatric Surgery, and the American Association of Clinical Endocrinologists have been published on the success of the surgery. These studies depict how sleeve gastrectomy is comparable to bariatric surgery types such as gastric bypass and gastric banding.

Typically the surgery is used for patients who are too high risk for gastric bypass surgery. However, recent studies have found that the surgery is effective for all types of candidates. The guidelines for this surgery have been updated to include a large variety of individuals who may benefit from the surgical procedure. These guidelines, however, do not name one surgery over another as more beneficial for those seeking to lose weight with surgery.

In terms of candidates for gastric sleeve surgery, surgeons look at patients with a body mass index (BMI) greater than 40 without coexisting medical problems or patients with a BMI of over 35 with one or more co-morbidities such as high cholesterol, high blood pressure, fatty liver disease, kidney disease or failure, acid reflux, asthma, sleep apnea, urinary incontinence, arthritis, impaired quality of life or venous stasis disease, to name a few. Also, patients with a BMI of 30-34.9 with metabolic syndrome or Type II Diabetes may be offered this procedure as many studies show how it benefits these conditions.

When preparing for surgery and determining whether or not a candidate is eligible, a complete blood count, red blood cell count, white blood cell count, platelets, hematocrit, and hemoglobin test must be done. A lipid profile, fasting blood glucose, thyroid test, and serum chemistry (to test for liver and kidney function) also are recommended. One’s lifestyle with drugs, alcohol, and nicotine, as well as their age and gender, also determine whether or not someone is an ideal candidate for sleeve gastrectomy.

Oftentimes the laparoscopic sleeve gastrectomy is used as a first-stage procedure before a gastric bypass, or duodenal switch surgery is used in high-risk patients. Many studies have shown that this procedure, used in this way, reduces comorbidities, weight, and operative risk overall at the time of the second weight loss surgery. Data demonstrates that this procedure can provide substantial weight loss and resolution or improvement of comorbidities 3-5 years follow up.

Other factors leading to whether or not someone is a candidate are the same for all types of weight loss surgery. For instance, a candidate must consult with a nutritionist and accept the lifestyle change at hand, recognizing this is a journey and surgery isn’t the solution to their weight problem. Candidates are typically at least 80 pounds overweight and between the ages of 14 and 75. They have a history of failed attempts with diets and must demonstrate a failure at losing weight naturally before having weight loss surgery, no matter what type.