Doctors share diverse views on whether gastric sleeve surgery is a viable option for the treatment of obesity during the annual meeting of the American Society for Metabolic and Bariatric Surgery.
The future of the gastric sleeve procedure was a topic of much debate during the third day of the American Society for Metabolic and Bariatric Surgery (ASMBS) annual meeting, currently underway in Grapevine, Texas. Although most of the presentations at the meeting focused on the gastric bypass and gastric banding procedures, which are the two most common weight loss surgery procedures in America, the gastric sleeve is quickly gaining traction among medical experts as a viable option in the surgical treatment of obesity. Still others are skeptical about long-term results, however, and question whether the sleeve is an improvement over the gastric bypass, which has a track record of success.
“New surgeries are always controversial because people are looking for things that will stand the test of time”, said Dr. John Coon, MD, FACS, a bariatric surgeon in Riverside, California. Although Dr. Coon specializes in Roux-en-Y gastric bypass surgery and the LAP-BAND® procedure, he admits to being intrigued by discussions of the gastric sleeve, also called the vertical sleeve gastrectomy (VSG).
During the procedure, the surgeon removes approximately 70-80 percent of the patient’s stomach, so that the remaining portion takes the shape of a tube or sleeve. Because the operation can be performed laparoscopically using a miniscule camera and special surgical instruments inserted through a series of small incisions, recovery time is kept to a minimum. In addition, the procedure restricts the amount of calories a person can consume by reducing the size of the stomach — thereby promoting weight loss — but does not cause many of the adverse side effects of gastric bypass surgery, because the outlet valve (pylorus) remains intact.
“Doctors are constantly concerned with durability. The gastric sleeve gained instant popularity because it is quick and easy to master, and is a less difficult operation than a bypass,” said Dr. Coon. However, he stressed the need for surgeons to learn all of the facts, perform extensive prep work, and communicate effectively with each patient before deciding whether the sleeve gastrectomy is appropriate.
“With new surgeries, outcome is always hard to predict,” he said. “If five years from now it still seems to be a good operation, then it probably will continue — and then again it might fail. Regardless, people will continue to promote it or disagree with it.”
-Erika Provost
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