Download PDF The Sleeved Life: A Patient-to-Patient Guide on Vertical Sleeve Gastrectomy Weight Loss Surgery

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How would the gastric sleeve procedure effect me? Can I take a prescription or over the counter appetite suppressant before bariatric surgery? I'm scheduled to have gastric sleeve surgery in 10 days and want to make sure that it's…. I have been enjoying your site so far, thank you for all the info it really helps! But, I was hoping to find a little more information on how bariatric…. Large Group Plans — Coverage depends on whether your employer has chosen to add it to your policy. If your policy covers it and you meet the qualification requirements, your plan will likely include 4 procedures:.

You will start losing weight fast after any bariatric surgery procedure, but the total amount lost varies based on:. Click here to learn more. The other types of bariatric surgery are less likely to be covered, although you may be able to get insurance to pay for some of the costs. See our Insurance Tool to find out if your plan covers it. NOTE: Some surgeons offer each procedure for as low as half of the national average.


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How competitive your surgeon and hospital fees are — there is often a substantial difference in costs between different doctors and hospitals, even within the same town. Whether you qualify for tax write-offs — Bariatric surgery is tax deductible, which can have a big impact on the total cost of surgery. See our Tax Tool to find out if your bariatric procedure will be tax deductible. If you pay for the procedure without insurance, total costs will depend on how you pay. For example, your surgeon may offer a discount if you pay the full amount up front, and you can make the costs more affordable by applying for bariatric surgery financing.

Weight loss surgery is tax deductible, which can have a big impact on the total cost of surgery. Money in one of the following special savings accounts or even your IRA may also be a way to pay for part of surgery tax-free:. Below is a brief explanation of how each bariatric surgery procedure works. Tap the icons for more information. Select your health conditions in the tool, then click the Submit button to find out the impact a procedure like gastric sleeve can have.

Fill out the below form for a free insurance check performed in partnership with your local bariatric surgeon. Qualification Requirements. Back to Table of Contents. How the Gastric Sleeve Works. Calculate Your Weight Loss. Health Benefits to Expect. Compare Other Weight Loss Procedures. Take the Gastric Sleeve Knowledge Quiz. Gastric Sleeve: Test Your Knowledge Well-educated patients are more likely to be successful over the long-term. Enter a title Ask your question or share your experiences here! Close Help Do you have some pictures or graphics to add?

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Apply for Loan Ad. Tax Write-Offs. Best Procedure Quiz. Find a Bariatric Surgeon. Find a Bariatric Surgeon Back to Page. Back to Page Back to Tools. Do You Qualify for a Bariatric Procedure? Does hunger come back? Can the sleeve get stretched out? How do you deal with weight loss stalls? How many vitamins do you take every day? How much weight should I expect to lose with the sleeve? What does a maintenance diet look like? Help Centre. My Wishlist Sign In Join.

Be the first to write a review. Add to Wishlist. In Stock. Unable to Load Delivery Dates. Enter an Australian post code for delivery estimate. One patient suffered from intractable diabetes, despite sufficient post-LSG weight loss RYGB was adopted as a revisional procedure in all patients and all revisional procedures were successfully performed laparoscopically.

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This study included a relatively large number of Korean patients who underwent LSG at a single specialized center and demonstrated outcomes after up to 4 years of follow-up. Since bariatric surgery in Asian countries is relatively new, there are only a few literatures available that evaluated the medium-term outcomes of LSG in obese patients from Far East Asia [ 12 ]. We believe that this study would provide valuable information on the efficacy of LSG in Asian obese patients.

Since LSG has become a stand-alone procedure for weight loss, the number of annual LSG procedures performed, world-wide, has exponentially increased over the last few years [ 13 ]. This can be mostly attributed to the decrease the in number of adjustable gastric banding procedures, which are associated with frequent long-term complications.

Buchwald and Oien [ 13 ] also speculated that the global popularity of LSG might be faddism, with surgeons gravitating towards the latest surgical option. Several reasons may account for this enthusiasm, particularly in Asian countries. Because the incidence of morbid obesity is much lower in Asian countries than in Western countries, surgeons are less experienced with bariatric procedures. Therefore, this less aggressive approach has been widely advocated in Asian countries. Further, Asian patients seem to have relatively low BMI values; hence, stand-alone LSG is considered to be sufficient to achieve satisfactory weight loss outcomes.

Furthermore, the high incidence of gastric cancer in Asian countries makes surgeons and patients hesitate to choose RYGB because regular endoscopic surveillance of the excluded stomach would be impossible following RYGB.


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The patients enrolled in the current study chose to undergo LSG for various reasons, including as part of a staged operation in superobese patients or as a stand-alone procedure in relatively low BMI patients. In contrast, a family history of gastric cancer, a fear of gastric cancer, liver cirrhosis in hepatitis virus carriers who might be eligible for liver transplantation, and other reasons were stated by patients not choosing LSG. As mentioned above, regional characteristics have a large influence on the selection of LSG. Surgical complications occurred in Among these, severe complications requiring invasive intervention comprised 1.

Short-term complications are relatively infrequent after LSG because of the procedure's technical simplicity, compared with RYGB or BPD, but risks of surgical complications involving the long stapler line remain. Most of all, leakage at the staple line near the esophagogastric junction, the so-called high leak, is very difficult to manage. One patient in our study developed a high leak in the early postoperative period and required two reoperations for primary repair with external drainage and repeated endoscopic stent insertions due to persistent leakage from the uppermost end of the stapler line.

The leakage was successfully controlled following approximately 3 months of in-hospital treatment, but the required prolonged fasting and parenteral nutrition resulted in a thiamine deficiency and subsequent long-term neurologic sequelae Wernicke syndrome. This patient's detailed clinical course is described elsewhere [ 18 ]. An endoscopically placed stent, which is reported to achieve successful outcomes in some carefully selected patients with leakage, was ineffective in this patient due to repeated migration.

If the migration issue can be overcome, stenting might provide the advantage of allowing patients to resume oral intake while the leak heals. Otherwise, patients benefit nutritionally from a surgically inserted feeding jejunostomy when lengthy fasting is anticipated [ 19 ]. Kinking of the gastric tube could be another staple line-associated problem that results in a functional distal obstruction. This presents as persistent dysphagia with nausea and vomiting associated with consumption of either solids or liquids.

In the current study, this functional obstruction in one patient eventually led to a delayed microleak from the proximal staple line. A bare staple line, adhering to the surrounding tissue, or an inadequately narrow lumen at the incisura could have resulted in angulation of the staple line. In the current study, the entire staple line of each patient was reinforced with continuous oversewing further to complications encountered in earlier patient series. However, recent studies suggest that oversewing, or buttressing, of the staple line does not have a clinically significant effect on postoperative complications [ 20 ].

Given the recent advancements in laparoscopic stapling instruments, the proper utilization of staplers becomes important, through the proper choice of staple height, ensuring good staple formation, allowing time for tissue compression, avoiding a stricture by not stapling too close to the incisura, and avoiding a high leak by stapling away from the gastroesophageal junction [ 16 , 21 ]. However, this table is based on several-decades-old data from North American populations and does not consider racial differences.

The WHO suggested that a lower cutoff value should be adopted for the diagnosis of obesity for the Asia-Pacific region [ 11 ].


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  6. The current study showed that patients who underwent LSG were susceptible to weight regain after more than 2 years, although the number of patients continuing in the follow-up study had decreased markedly, and became too small, by year 4, to draw definitive conclusions. However, this finding is consistent with those of previous studies on LSG or other purely restrictive procedures; most consistently report that weight regain might eventually be observed after LSG [ 23 , 24 ]. Himpens et al. Gradual loss of the "appetite suppression effect" following fundic resection has also been cited as being partly responsible for the delayed weight regain after LSG [ 25 ].

    The patients in the present study need to be followed up for much longer periods to determine whether a tendency to regain weight persists. Four of our patients 2. Two patients showed severe grade C or worse, based on the Los Angeles classification reflux esophagitis. Reduced pressure on the lower esophageal sphincter could be caused by excessive dissection around the angle of His.

    This could also result from reduced gastric compliance and increased gastric pressure [ 27 ]. Furthermore, crus repair was not routinely performed in the current study cohort. When LSG is planned as a stand-alone procedure, the possibility of new or recurrent reflux symptoms should be considered. Hiatal hernias should be identified intraoperatively and the crus should be appropriately closed to minimize de novo GERD-induced surgical failure [ 21 ]. Recently, numerous studies have demonstrated promising results for stand-alone LSG-derived EWL and resolution of comorbid conditions during the short to medium term [ 12 , 14 , 17 , 23 , 24 ].

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    The present study also demonstrated promising midterm outcomes in terms of both weight loss and comorbidity resolution. The associated revision rate of 4. In addition, Since the rate of weight loss markedly decreases and plateaus after 1 year, and given the possibility of weight regain after 2 years, this population might require revisional procedures for weight loss failure.

    A recently published systematic review also concluded that LSG results in satisfactory long-term weight loss, but the number of analyzed patients was small [ 28 ]. A larger cohort of patients is necessary to validate the effectiveness of LSG compared to other well established bariatric procedures, 10 or more years postoperatively. Whether the current popularity of LSG will endure or whether the procedure will be relegated to the status of a surgical fad remains to be seen.

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    In conclusion, LSG can be performed safely, with an acceptable risk of surgical complications, and provides effective weight loss and considerable comorbidity resolution at midterm follow-ups. However, longer follow-up periods are necessary to elucidate whether LSG achieves sustainable weight loss outcomes, comparable to those of more aggressive procedures.

    Min Ju Soh supported this study as a research coordinator. This research was supported by the Soonchunhyang University Research Fund. National Center for Biotechnology Information , U.