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How Safe Is Gastric Sleeve Surgery?

Is Gastric Sleeve Safe?

Obesity is one of the biggest health challenges in today’s society. While it has genetic, socioeconomic, psychological, and medical components, it is largely due to poor diet and a lack of physical activity.

People spend a lot of time sitting in front of computers, and processed foods containing lots of fats and sugar are often cheaper and more easily accessible than healthy foods.

Most attempts to lose weight start with changing one’s diet and getting more exercise. However,  this isn’t enough to get some people to reach a healthy weight and reduce comorbid conditions. This is where weight loss surgery comes in.

There are several procedures available but gastric sleeve surgery is one of the newest and most effective options with patients losing up to 62.3% of their excess weight at five years.

Naturally, people considering gastric sleeve surgery wonder if it is safe. Every surgery carries risks but before we get into this, let’s first look at the dangers of obesity.

Risk Factors Associated with Obesity and Benefits of Sleeve Gastrectomy

Obesity and morbid obesity are associated with a range of health challenges and a lower quality of life.

According to the Centers for Disease Control and Prevention, obesity is a key risk factor for hypertension, heart disease, diabetes, and various types of cancer. Therefore, it is one of the leading causes of death. Also, Fontaine et al. found that obesity appeared to significantly reduce life expectancy, especially in younger adults.

Sleeve gastrectomy has become increasingly popular because the procedure involves fewer steps than gastric bypass and is less likely to result in complications. It works by removing up to 80 percent of the stomach to significantly limit the amount the patient can eat.

Gastric sleeve surgery also involves the removal of the part of the stomach that produces ghrelin which is also known as the hunger hormone. Therefore, the patient feels less hungry.

Along with causing weight loss, sleeve gastrectomy also helps to resolve the other conditions associated with obesity and therefore, helps to prolong life. Any potential risks of gastric sleeve surgery must be balanced against the risks of obesity and the benefits of the procedure.

Risks of Gastric Sleeve Surgery

Sleeve gastrectomy presents the same risks that are associated with any type of surgery such as having a negative reaction to anesthesia and causing additional stress to the heart and body in general.

There are both short-term and long-term potential complications of gastric sleeve procedures. Short-term risks include:

  • Post-operative bleeding
  • Staple line leakage
  • Wound infection
  • Pneumonia
  • Nausea and vomiting
  • Blood clots

Meanwhile, long-term risks can include

  • Dumping Syndrome
  • Nutrient deficiencies
  • Bowel obstruction
  • Hernias
  • Acid reflux
  • Low blood sugar
  • Gallstones

What Research Shows About Sleeve Gastrectomy Outcomes

Numerous studies have been conducted on the effectiveness and safety of gastric sleeve procedures. One carried out by Barzin et al. compared the safety of gastric sleeve with that of gastric bypass.

The researchers found that the durations of both operation and anesthesia were shorter for gastric sleeve patients and the rate of early complications was lower.

Meanwhile, Smith et al. reviewed the outcomes of bariatric procedures in ten centers over five years and came to the conclusion that sleeve gastrectomy was safe. The study covered 6, 118 patients who had their bariatric surgery for the first time.

While 18 deaths were recorded within 30 days after surgery, only two were in patients who had gastric sleeve surgery.

Another study looked at the five-year outcomes of 156 patients who underwent laparoscopic sleeve gastrectomy.  No deaths were recorded but eight of the individuals experienced side effects such as pneumonia, wound infection, rash, or staple line leakage or bleeding.

Late-term complications were more common and these were mostly gallstones and acid reflux.

Meanwhile, patients recorded an average of 82% excess body weight lost in the first year, 86% in the second year, and 76% and 73% in years three and four, respectively. The study also revealed a 75% remission rate for diabetes and a 71.7% remission rate for high blood pressure.

How to Reduce Your Risk of Developing Complications

The skill of the surgeon is, of course, important. However, patients also play a role in minimizing the risks they face following surgery. It’s a good idea to reduce your BMI as much as possible ahead of surgery, start moving more, and stop smoking if you’re a smoker.

These steps will help to prepare your body for the procedure and also help you to get the best results. Research shows that individuals with a lower BMI prior to surgery had higher rates of weight loss after the gastric sleeve procedure.

Therefore, it’s important to work with your medical team with a team of weight loss professionals who can help you to establish and maintain good dietary and exercise habits.

One study found that even though smoking has little or no effect on weight loss after bariatric surgery, smoking within a year before surgery was linked to significant postoperative morbidity. Meanwhile, Haskins found that smoking was associated with a range of complications including:

  • Prolonged intubation
  • Reintubation
  • Sepsis
  • Organ space infection
  • Pneumonia
  • Shock
  • Sepsis
  • Longer length of stay in hospital

If you are a smoker, and you want to reduce your risk of related complications, you should stop smoking as early as possible before surgery.

The Bottom Line on the Safety of Gastric Sleeve Surgery

Obesity itself is a risk factor for any surgery. However, gastric sleeve surgery presents minimal risks when compared to all the benefits. The potential complications, therefore, need to be viewed in relation to the risks associated with obesity and related chronic illnesses.

When you work with a team of experienced weight loss professionals and you follow their advice, you’re more likely to have a successful procedure and a successful weight loss journey.

If you’re finding it hard to lose weight, reach out to the weight-loss experts at Renew Bariatrics to learn if gastric sleeve surgery is right for you.

References

Chow, A., Neville, A., & Kolozsvari, N. (2021). Smoking in bariatric surgery: a systematic review. Surgical endoscopy, 35(6), 3047–3066. https://doi.org/10.1007/s00464-020-07669-3

Diamantis, T., Apostolou, K. G., Alexandrou, A., Griniatsos, J., Felekouras, E., & Tsigris, C. (2014). Review of long-term weight loss results after laparoscopic sleeve gastrectomy. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 10(1), 177–183. https://doi.org/10.1016/j.soard.2013.11.007

Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB. Years of Life Lost Due to Obesity. JAMA. 2003;289(2):187–193. doi:10.1001/jama.289.2.187

Haskins, I. N., Amdur, R., & Vaziri, K. (2014). The effect of smoking on bariatric surgical outcomes. Surgical endoscopy, 28(11), 3074–3080. https://doi.org/10.1007/s00464-014-3581-z

Hoyuela C. (2017). Five-year outcomes of laparoscopic sleeve gastrectomy as a primary procedure for morbid obesity: A prospective study. World journal of gastrointestinal surgery, 9(4), 109–117. https://doi.org/10.4240/wjgs.v9.i4.109

Sarkhosh, K., Birch, D. W., Sharma, A., & Karmali, S. (2013). Complications associated with laparoscopic sleeve gastrectomy for morbid obesity: a surgeon’s guide. Canadian journal of surgery. Journal canadien de chirurgie, 56(5), 347–352. https://doi.org/10.1503/cjs.033511

Smith, M. D., Patterson, E., Wahed, A. S., Belle, S. H., Berk, P. D., Courcoulas, A. P., Dakin, G. F., Flum, D. R., Machado, L., Mitchell, J. E., Pender, J., Pomp, A., Pories, W., Ramanathan, R., Schrope, B., Staten, M., Ude, A., & Wolfe, B. M. (2011). Thirty-day mortality after bariatric surgery: independently adjudicated causes of death in the longitudinal assessment of bariatric surgery. Obesity surgery, 21(11), 1687–1692. https://doi.org/10.1007/s11695-011-0497-8

Varban, O. A., Bonham, A. J., Finks, J. F., Telem, D. A., Obeid, N. R., & Ghaferi, A. A. (2020). Is it worth it? Determining the health benefits of sleeve gastrectomy in patients with a body mass index <35 kg/m2. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 16(2), 248–253. https://doi.org/10.1016/j.soard.2019.10.027

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This article is based on scientific evidence, written by experts and fact checked by experts.

Our editorial team strives to present both sides of the argument with in-depth analysis and links to resources.

This article contains scientific and health-related references. The numbers in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.