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Sleeve Science...A Summary of Some Current Research.
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Mostly I wanted to see what the medical literature has to say about VSG and dying. Turns out, it's pretty darn safe - but don't take my word for it, I'm not a medical doctor. Just sharing some research.
KEY FINDING: LAP-BAND FAILS 44% OF THE TIME.
This study finds that the LAGB failed as a primary bariatric procedure for 44% of patients due to either inadequate weight loss or adequate weight loss with unmanageable symptoms. This suggests that the LAGB [lapband] should be abandoned as a primary bariatric procedure for the majority of morbidly obese patients due to its high failure rate.
Kindel, T., Martin, E., Hungness, E., & Nagle, A. (2013). High failure rate of the laparoscopic-adjustable gastric band as a primary bariatric procedure. Surgery for Obesity and Related Diseases.
KEY FINDING: SLEEVE REDUCES GHRELIN AND IS MORE SUCCESSFUL THAN GASTRIC BANDING.
As a consequence of resection of the gastric fundus, the predominant area of human ghrelin production, ghrelin is significantly reduced after LSG but not after LAGB. This reduction remains stable at a follow-up 6 months postoperatively, which may contribute to the superior weight loss when compared with LAGB.
Langer, F. B., Hoda, M. R., Bohdjalian, A., Felberbauer, F. X., Zacherl, J., Wenzl, E., ... & Prager, G. (2005). Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obesity surgery, 15(7), 1024-1029.
KEY FINDING: LSG IS SAFE AND EFFECTIVE (as far as we know in the short-term).
Results: Of the 62 patients who underwent LSG performed by two surgeons, the data of 30 patients (7 males and 23 females) were further analyzed. Mean preoperative BMI was 41.4 (33-59) kg/m2. Mean operative time was 80 min (range 65-130). Mean hospital stay was 3.2 days (range 2 to 25). Mean weight loss at 3 and 6 months following the procedure was 22.7 kg and 30.5 kg respectively, and mean % excess weight loss (EWL) was 40.7 and 52.8, respectively. Three patients were considered to have mild complications, and one patient had a major complication that necessitated surgical intervention. There was no mortality. Conclusions: In the short-term, LSG is a safe and effective treatment option.
Roa, P. E., Kaidar-Person, O., Pinto, D., & Rosenthal, R. J. (2006). Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obesity surgery, 16(10), 1323-1326.
KEY FINDING: Even 5 years out sleeve gastrectomy is effective to fight obesity.
Five years after performance of SG, weight loss was satisfactory, few complications were observed, the reduction of co-morbidities was significant, but there was an increase in the frequency of GERD.
Fuks, D., Verhaeghe, P., Brehant, O., Sabbagh, C., Dumont, F., Riboulot, M., ... & Regimbeau, J. M. (2009). Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery, 145(1), 106-113. (Conducted in France)
KEY FINDING: Gastric sleeve works on its own, the weight stays off, and the ghrelin doesn’t come back in the first 5 years.
At 5-year follow-up, a mean EWL of 55.0 ± 6.8% was achieved, indicating that SG leads to stable weight loss. Beside significant weight regain, severe reflux might necessitate conversion to gastric bypass or duodenal switch. After an immediate reduction postoperatively, plasma ghrelin levels remained low for the first 5 years postoperatively.
Bohdjalian, A., Langer, F. B., Shakeri-Leidenmühler, S., Gfrerer, L., Ludvik, B., Zacherl, J., & Prager, G. (2010). Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obesity surgery, 20(5), 535-540.
KEY FINDING: Meta-analyses indicate that while there are a small number of complications (mainly fistulas for BMI<60) people don’t die from sleeve surgery. (Canada, Korea, France, Israel, USA)
Behrens, C., Tang, B. Q., & Amson, B. J. (2011). Early results of a Canadian laparoscopic sleeve gastrectomy experience. Canadian Journal of Surgery, 54(2), 138.
Han, S. M. (2005). Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obesity Surgery, 15(10), 1469-1475.
Nocca, D., Krawczykowsky, D., Bomans, B., Noël, P., Picot, M. C., Blanc, P. M., ... & Fabre, J. M. (2008). A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obesity surgery, 18(5), 560-565.
Rubin, M., Yehoshua, R. T., Stein, M., Lederfein, D., Fichman, S., Bernstine, H., & Eidelman, L. A. (2008). Laparoscopic sleeve gastrectomy with minimal morbidity early results in 120 morbidly obese patients. Obesity surgery, 18(12), 1567-1570.
Hutter, M. M., Schirmer, B. D., Jones, D. B., Ko, C. Y., Cohen, M. E., Merkow, R. P., & Nguyen, N. T. (2011). First Report from the American College of Surgeons--Bariatric Surgery Center Network: Laparoscopic Sleeve Gastrectomy has Morbidity and Effectiveness Positioned Between the Band and the Bypass. Annals of surgery, 254(3), 410.