Our Summary

This study is about a type of weight loss surgery called laparoscopic sleeve gastrectomy (LSG). The researchers wanted to see how the size of the stomach before and after the surgery affects weight loss. They used a type of scan called multidetector computed tomography (MDCT) to measure the volume of the stomach one week before surgery and then again 6 and 12 months after surgery.

The study included 98 patients who were very overweight and preparing for LSG in 2018. The researchers kept track of 89 of these patients for 6 months after surgery and 82 for 12 months. On average, patients lost about 24% of their total weight after 6 months and about 33% after 12 months.

Before surgery, the patients’ stomachs could hold between 800 and 1800 milliliters. After surgery, the size of the stomach (now shaped like a sleeve) significantly decreased to hold between 140 and 210 milliliters. However, the size of the sleeve did not significantly change between 6 and 12 months after surgery.

Interestingly, the researchers found that the size of the stomach before surgery was related to the patient’s body mass index (BMI), which is a measure of body fat. However, the size of the stomach before or after surgery was not significantly related to how much weight the patients lost.

In conclusion, while the surgery significantly reduces the size of the stomach, the size of the stomach does not seem to directly affect how much weight is lost. Therefore, restricting the size of the stomach is important, but it is not the only factor that determines how much weight a patient will lose after LSG.

FAQs

  1. What is the correlation between preoperative stomach capacity and weight loss after laparoscopic sleeve gastrectomy?
  2. What changes in gastric volume were observed after laparoscopic sleeve gastrectomy?
  3. How significant is the restriction of stomach volume in controlling weight loss after a gastric sleeve procedure?

Doctor’s Tip

A helpful tip a doctor might tell a patient about gastric sleeve surgery is to focus on portion control and mindful eating habits in addition to the surgery itself. While the sleeve pouch is smaller than the preoperative stomach, weight loss after surgery is not solely determined by stomach volume. It is important to follow a balanced diet and make healthy lifestyle choices to optimize weight loss results.

Suitable For

Patients who are typically recommended for gastric sleeve surgery are those who are morbidly obese with a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health conditions such as diabetes, high blood pressure, or sleep apnea. Additionally, patients who have tried and failed to lose weight through diet and exercise may also be candidates for gastric sleeve surgery. This study found that preoperative gastric volume and sleeve volume measured using MDCT gastrography were not significantly correlated with postoperative weight loss after laparoscopic sleeve gastrectomy, suggesting that factors other than stomach capacity may play a role in weight loss outcomes.

Timeline

Before gastric sleeve surgery:

  • Patient consults with a bariatric surgeon to discuss options for weight loss surgery
  • Patient undergoes preoperative evaluations to determine candidacy for surgery, including physical exams, blood tests, and psychological evaluations
  • Patient may be required to follow a preoperative diet and exercise plan to prepare for surgery
  • Patient undergoes a preoperative multidetector computed tomography (MDCT) gastrography to measure stomach capacity
  • Patient undergoes laparoscopic sleeve gastrectomy surgery

After gastric sleeve surgery:

  • Patient is monitored closely in the hospital for a few days after surgery
  • Patient follows a strict postoperative diet plan, starting with clear liquids and progressing to solid foods
  • Patient attends regular follow-up appointments with the bariatric team to monitor progress and address any concerns
  • Patient may experience rapid weight loss in the first few months after surgery
  • Patient may undergo a postoperative MDCT gastrography at 6 and 12 months after surgery to measure sleeve volume
  • Patient’s sleeve volume is significantly smaller than preoperative stomach capacity
  • Patient continues to see weight loss and improvement in health outcomes over time

Overall, gastric sleeve surgery results in significant weight loss and improvement in health outcomes for many patients. The smaller sleeve volume helps to restrict food intake and promote weight loss, but other factors such as diet and exercise also play a role in long-term success. Regular follow-up and support from the bariatric team are important for ensuring the patient’s success after surgery.

What to Ask Your Doctor

  1. How will the gastric sleeve procedure specifically help me achieve my weight loss goals?
  2. What is the expected recovery time and potential complications associated with gastric sleeve surgery?
  3. How often will I need to follow up with you after the surgery for monitoring and support?
  4. Are there any dietary or lifestyle changes I need to make before or after the surgery to maximize the benefits of the gastric sleeve?
  5. Can you explain the role of stomach capacity and sleeve volume in impacting weight loss after the surgery, based on my individual circumstances?
  6. How will you measure and monitor my stomach capacity and sleeve volume postoperatively?
  7. What is the typical rate of weight loss that patients experience after gastric sleeve surgery?
  8. Are there any specific risk factors or contraindications for gastric sleeve surgery that I should be aware of?
  9. How long do the effects of gastric sleeve surgery typically last in terms of weight loss and overall health improvements?
  10. Can you provide me with information on support groups or resources for patients who have undergone gastric sleeve surgery?

Reference

Authors: El-Sayes IA, Abdelbaki TN, Sharaan MA, Shaaban MS, El Shafei MM, Elkeleny MR. Journal: Obes Surg. 2021 Feb;31(2):490-498. doi: 10.1007/s11695-020-05012-2. Epub 2020 Oct 1. PMID: 33006088