Purpose of Gastric Sleeve Surgery

Gastric sleeve surgery is a type of weight loss procedure. During the surgery, a surgeon inserts small tools through multiple incisions (cuts) in the abdomen. The surgeon removes about 80% of your stomach, leaving a long tube-shaped stomach about the size of a banana.

Decreasing the size of the stomach limits the amount of food you can eat, which helps you lose weight quickly. The surgery may also lead to hormonal changes that make you feel hungry less often.

This article takes a closer look at the purpose of gastric sleeve surgery, the criteria you must meet to be eligible for it, and tests and labs to expect.

Diagnoses Related to Gastric Sleeve Surgery

The main goal of gastric sleeve surgery is to aid weight loss to prevent or improve medical conditions associated with obesity. Here are some examples of medical conditions that may be affected by obesity and weight:

• Cardiovascular diseases, like high blood pressure, coronary artery disease (blockages in arteries feeding the heart muscle), heart failure (heart unable to circulate blood effectively), atherosclerosis (buildup of deposits in the arteries)
• Lung disease, like obstructive sleep apnea (repeatedly stopping breathing while asleep due to airway obstruction) and obesity hypoventilation syndrome (not breathing deeply enough due to obesity)
• Venous conditions, like deep vein thrombosis (clot in a large vein) and pulmonary embolism (a clot that has lodged in the lung)
• Liver disease, like non-alcoholic fatty liver disease (buildup of fat in the liver that can lead to inflammation)
• Metabolic changes, like diabetes, high cholesterol, and high triglycerides
• Reproductive conditions, like fertility problems and polycystic ovary syndrome (PCOS) (hormonal system disorder with many cysts on the ovaries)
• Musculoskeletal conditions, like hernias, osteoarthritis (joint damage due to wear and tear), and back pain
• Gastrointestinal conditions, like gastroesophageal reflux disease (GERD) (chronic heartburn and regurgitation)
• Increased cancer risk with obesity for breast cancer, colorectal cancer, liver cancer, gallbladder cancer, stomach cancer, pancreatic cancer, uterine cancer, ovarian cancer, kidney cancer, multiple myeloma (a blood cancer), and adenocarcinoma of the esophagus

Weight loss surgeries are usually not the first-line treatment option for treating obesity and obesity-related conditions. It is considered major surgery and carries risks for both short- and long-term side effects.

Typically, weight loss surgery is recommended after failed weight loss attempts through diet and lifestyle changes.

Research suggests a weight loss of as little as 10% of total body weight may help improve health outcomes in overweight and obese individuals for many of these health conditions.

Criteria for Gastric Sleeve Surgery

There are specific criteria a patient is expected to meet to be considered a candidate for gastric sleeve surgery. Often, your healthcare team will want you to attempt weight loss through diet and exercise changes.

They use these failed attempts to determine whether surgery is necessary because it’s better to maintain a healthy weight without altering your gastrointestinal system if possible.

The classic criteria used to determine eligibility for bariatric surgery include:

• Body mass index (BMI) greater than or equal to 40 or BMI greater than or equal to 35 with at least one obesity-related health condition
• Unsuccessful weight loss attempts
• Passing mental health clearance
• No medical conditions that would interfere with surgery

Recently, the criteria have been updated to include patients with a BMI between 30 and 35 if they have uncontrollable type 2 diabetes or metabolic syndrome.

Some people may not be eligible for weight loss surgery if they have conditions such as:

• Severe psychiatric illness
• Uncontrolled blood clotting problems
• Barrett’s esophagus (changes to the lining of the food tube that increase risk of cancer)
• Severe gastroesophageal reflux disease

Tests and Labs

Before being approved for surgery, patients undergo several different tests and evaluations. These may begin weeks to months before receiving bariatric surgery. Healthcare professionals included as part of most bariatric surgery teams include:

• A bariatric physician or surgeon
• A registered dietitian or nutritionist
• A psychologist or psychiatrist

Some bariatric teams will include both physicians and surgeons to work with you before and after surgery. Both types are medical doctors. They just have different specializations. Both physicians and surgeons may help with pre-operative screenings like:

• Blood work including comprehensive metabolic panel, liver function tests, hemoglobin A1C, vitamin and mineral levels
• Overnight sleep study to test for obstructive sleep apnea
• Esophagogastroduodenoscopy (EGD) to evaluate for GERD and damage to the esophagus or stomach
• Electrocardiogram (ECG) and echocardiogram to assess your heart health
• Other imaging and tests, such as X-rays or an abdominal ultrasound

The dietitian or nutritionist will help you prepare for your new diet plan after surgery and help you along the stages of the bariatric diet. They will help answer any nutrition-related questions you have about eating a healthy diet.

The dietitian can also guide you through the stages of the post-bariatric surgery diet, such as clear liquid, full liquid, soft, and a balanced diet.

Another essential evaluation before and after weight loss surgery is the mental health screening done by a psychologist or psychiatrist. Eating can be connected with mental health, like stress, emotions, anxiety, depression, and other mental health conditions.

Talking with a mental health professional can help you feel ready to make changes to your diet and support you in the significant changes that happen with bariatric surgery.

Summary

The goal of gastric sleeve surgery is to make it easier for people to lose weight. It is usually done to prevent and improve obesity-related health conditions, like heart disease, diabetes, and metabolic syndrome.

To be considered a gastric sleeve surgery candidate, you must have a BMI over 40, pre-existing conditions, failed weight loss attempts, and pass a mental health screening.

Before your surgery is scheduled, a healthcare team will review your medical history, current health, and mental health and prepare you for the changes that develop after surgery.

A Word From Verywell

Weight loss surgery is a big decision and may help your overall health and well-being. Discuss all of the potential benefits and risks of bariatric surgery to learn if it is the best option for you. Weight can be an emotionally-charged subject. Stay kind to yourself and focus on the overall goal of improving your physical and mental health.