Sleeve Gastrectomy is now the most popular procedure in Australia. It started as part of a procedure called the Duodenal Switch which is quite a complex procedure that has strong metabolic effect and side-effects. As a result very few surgeons around the world do the duodenal switch. But just the sleeve part of the duodenal switch was found to achieve good weight loss in the short-term and it has now become a stand-alone procedure.
The stomach is divided vertically using a stapling device. Most of the stomach, about 80%, is to the right of the staple line and is discarded. The stomach on the left is turned into a tube of stomach, which we call a sleeve, and which constitutes about 15% of the original stomach. It is always performed laparoscopically (key-hole surgery) and you are in hospital generally for one to two days afterwards.
The sleeve works as a weight loss procedure in two ways. First, you have less hunger as the “hunger” hormone, ghrelin has been reduced. This hormone comes almost totally from the stomach so removing 80% of the stomach removes 80% of the ghrelin. So, throughout the day, you are much less hungry. You don’t look for food, you don’t think about food, you don’t crave for food.
Secondly, the volume of the stomach is drastically reduced. Whereas it could easily accommodate one litre of more of food beforehand, it can now only accommodate about 100 ml. So, when you do eat, a small amount of food takes away any hunger quickly.