The Gastric Sleeve is an operation that seems to have taken the country by storm. What it is removing about 90% of the stomach. That includes the part of the stomach that produces a lot of ghrelin, or appetite hormone. So it works to quell obesity in two manners. One is by restricting the amount that you can intake, and the other is by reducing your appetite. It works really well. A lot of people don’t know that we were the first ones to introduce Gastric Sleeve as a stand alone operation in Arizona in 2002. So we have a lot of experience with Gastric Sleeve surgery. We think it’s a great weight loss operation. You might ask, “Dr. Simpson, why are you standing in a kitchen instead of the operating room?” Here’s why – because we know that if you have any weight loss operation, your success doesn’t start in the operating room. It starts in the kitchen. And we think that your lifestyle changes are the most important changes you have to make, not for a year after a procedure, but five years after a procedure. An that’s what we have seen in our patients. So come join our journey. Learn about this operation. We want to show you a new place in your house that may not have been used so much before – the kitchen.
Did you know that Dr. Simpson was the first surgeon in Arizona to offer the gastric sleeve as a stand-alone procedure? We have a long experience with the gastric sleeve as a stand-alone operation for weight loss. It wasn’t “approved” unless part of a study, and so for a number of years we focused on the Lap-Band. Now the sleeve has been approved as a procedure for weight loss with most insurance companies we wanted to give an alternative to the Lap-Band so it was natural that we returned to doing a procedure that we pioneered. What has changed in the last few years about this operation (a) the staples are better (b) it can often be done as an outpatient procedure.
Some people know right off the bat that the Lap-band is not for them
Some people just want to get their weight loss operation and then forget it. While that can never fully be realized as all weight loss surgeries require lifestyle changes, The Gastric Sleeve does not require physical maintenance such as the Lap-band’s adjustments. We have also had a very few patients reject Lap-band surgery just because they knew themselves – they knew that Lap-band adjustments were not for them. A few of those people had aversions to needles and while a Lap-band adjustment is a whole lot easier to take than it appears, some just don’t deal well with the concept of injections.
Lap-band to Gastric Sleeve surgery
We have also found some people don’t tolerate the Lap-Band and wish to have an alternative procedure. Gastric Sleeve surgery can be used as a replacement weight loss procedure for the Lap-band. If the Lap-band has not slipped out of position, Dr. Simpson can do the Gastric Sleeve procedure at the same time he removes the Lap-band. If the Lap-band has slipped out of position, Dr. Simpson may have to let the stomach rest for a couple of months before doing another weight loss surgery.
Some people need weight loss surgery to save their lives
Those with a BMI over thirty who have health problems associated with obesity sometimes are on the verge of death. Almost every obese person has Type 2 Diabetes and the majority of them can get rid of the disease merely through permanent weight loss. Diseases caused by diabetes include cardiovascular disease including destruction of arteries and blood vessels in the heart and throughout the body. Capillaries can be destroyed causing loss of vision. Kidneys can be destroyed resulting in the need for dialysis. The nervous system can become damaged causing reduced brain function. Nerve damage and vascular disease can cause limbs to atrophy and require amputation. Diabetes combined with the heart issues directly caused by obesity guarantee a much shorter lifespan. If an overweight person is caught in time while they are healthy enough to have a weight loss operation, they can avoid impending death. They can live decades longer. We are offering the Gastric Sleeve to make certain there are no barriers to having weight loss surgery for those who are at risk and can’t lose weight any other way.
The Gastric Sleeve is a very good weight loss operation using stomach transection
If you are going to have a weight loss procedure requiring removal of a portion of your stomach, Gastric Sleeve is a good choice. Why is that? Because in effect your stomach remains in tact. Only the side of it is removed. The other most popular weight loss procedures using stomach transection is the Roux-en-Y Bypass. This operation cuts the stomach horizontally transecting (but not removing) the lower half. The lower half of your stomach is removed from your digestive tract but remains dormant within you. The lower half of your stomach is a miracle of nature. The valve structure at the exit of your stomach is critical to normal digestion. Without it, food enters your system in a much rawer state. This more often than not causes terrible gas and diarrhea. Food cannot be fully digested and nutritional deficiencies result. The Gastric Sleeve leaves your lower stomach in tact. Figuratively speaking It just closes a few lanes of your digestive highway. Everything works exactly the way it did before the operation.
The “official” Gastric Sleeve surgery as we know it today was not the first manifestation of the operation. The first Duodenal Switch, as it was called at the time, was done in the 1980’s by Dr. Tom R. Demeester. His operation did not originate as a weight loss procedure. It was designed to treat bile gastritis. Most importantly, Dr. Demeester’s operation did not include a bypass. So even though it was called a Duodenal Switch, in actuality it was the first Gastric Sleeve surgery.
Gastric Sleeve surgery and the Plication work in a similar way
Both surgeries reduce your stomach to the size of a banana. For some reason, the Plication is more effective than any other restrictive procedure. Being a newer operation, the cause of this phenomena is not understood. Time will reveal why the Plication is so effective. But the Gastric Sleeve has proven to be a very capable weight loss surgery and will serve you well if you eat the right foods and go to support meetings.
Gastric Sleeve surgery requires the largest transection of all weight loss procedures
The plication requires no transection. Your stomach is reduced by being folded into itself and stitched (sutured) in place. The horizontal transection of RNY bypass is considerably smaller than the Gastric Sleeve and that may be the reason for the existence of that procedure. Because of the size of the Gastric Sleeve Transection, an experienced surgeon can greatly limit surgical risk. It is interesting to note that both the Plication and Gastric Sleeve require excellence in a surgeon’s stitching (or suturing) skills. This requires the surgeon to have high natural dexterity along with acquired precision that can only be developed through forethought and practice. Dr. Simpson is the most experienced weight loss surgeon in Arizona.
Before the Lap-band, Dr. Simpson’s procedure of choice was Duodenal Switch
The Duodenal switch is the Gastric Sleeve with a bypass. Just a few years ago, the RNY bypass was the most popular operation by a large margin. It’s what everybody got. Dr. Simpson realized the extreme damage the RNY bypass does to a person’s stomach and overall digestive capability. So he chose Duodenal Switch despite mainstream preference for the RNY bypass. He knew that retaining the lower stomach resulted in a much healthier operation and better lifestyle. Most surgeons doing the Gastric Sleeve now did the RNY bypass back when it was popular. While those other doctors were doing the RNY, Dr. Simpson was perfecting Gastric Sleeve surgery (which is half of the Duodenal Switch). So when we say Dr. Simpson is the most experienced Gastric Sleeve surgeon in Arizona, it is by a very large margin. Doctor Simpson was the first to do the surgery (without a bypass) in Arizona. Dr. Simpson was the first to do the surgery laparoscopically (with minimal scars) in Arizona.
Why did Dr. Terry Simpson do bypass surgery in the first place? Because bypassing a large portion of intestine limits the amount of calories that can be metabolized and results in radical weight loss. Over time it was discovered how badly it reduced overall nutrition. Dr. Simpson was the first surgeon to do Lap-band surgery in Arizona because he realized how detrimental bypass surgery is. Bypass surgery should only be considered as a last ditch effort for super morbidly obese people when all options have failed.
Gastric Sleeve surgery is not reversible…
…and up until this point we have been touting reversible operations. You have to admit in life it is good to be able to go back and undo things, the decisions we make. The reality is this. People who get weight loss surgery do not have it reversed. They got it in the first place because they need it. It’s a rare, rare thing to reverse a weight loss procedure. Once people get the nerve up to have the operation, they want to keep it – keep the benefits. Think about it. If weight loss surgery works for you, would you want to reverse it? Our support groups have evolved into what we call Weight Loss Festivals. You can come to one of these for free and eat, learn and be entertained. This is an open environment with a lot of people who have had weight loss surgery. You can ask them yourself how likely they would be to reverse their surgeries. Virtually no one will tell you that they would reverse their operation – they know they need it.
Is there an advantage for Gastric Sleeve over Plication?
It’s main advantage is that it is clean. What we mean by clean is that the portion of your stomach that is transected is removed giving lots of space for healing. Once it heals, that is your stomach – no devices, no maintenance, no folds. The Plication requires two folds of the stomach that are held by stitching (sutures). Gastric Imbrication (Plication) has been done for over a decade in the middle east and is being done all the time in America. So folding the stomach has been proven safe. But some people might like the idea of having no folds – no stress, no possibility of hidden crevices.