Sleeve Gastrectomy, 2 New Studies

The Vertical Sleeve Gastrectomy is a lesser-known weight loss procedure, but one that is gaining in popularity. The sleeve is an irreversible procedure that limits the amount of food that can be eaten by removing a large portion of the stomach. At the Obesity Society’s annual meeting this month, there were two posters about the gastric sleeve: one related to weight loss results and the other about levels of nutrients following the procedure.

The first study looked at about 1500 bariatric surgery patients and found that there was no significant difference in weight loss between gastric bypass and sleeve at up to 2 years post-surgery. However, in terms of insurance coverage, there was a significant difference: 87% of the gastric bypass patients had some insurance coverage, while only 8.8% of the sleeve patients had coverage. Insurance coverage did not seem to have an impact in the average weight loss.

Weight loss surgeon Dr. Toby Broussard of WeightWise Bariatric Program, who has performed over 1,000 sleeves with his colleague Dr Greg Walton, spoke with us about the study’s findings. He told us that the study confirms what he has seen in his practice, which is no difference in weight loss at 2 years. “The really big question is what happens further down the road post-op.  More studies will need to be done with longer follow up to help solve this problem.  This study also reflects a much larger percentage of patients that had gastric bypass were insured.  As the sleeve becomes a more widely accepted operation I would expect that the percent of sleeve patients that have insurance coverage will grow.” Coverage for the gastric sleeve could in fact be just around the corner. The Centers for Medicaid and Medicare Services (CMS) is currently considering adding the sleeve to the procedures that Medicare will cover.

The second vertical sleeve gastrectomy poster presentation was an evaluation of nutrient status after the sleeve.  The cross-sectional data showed that the sleeve resulted in health benefits through year 3 post-operation. At year 5, nutrient levels reverted toward pre-surgery values.  Dr. Broussard told us that “the interesting thing about this study is that it reaffirms the need for ongoing and active involvement in post-surgery support program.  Long term clinical monitoring is crucial for long term success after weight loss surgery, to prevent weight regain and safety.”

We also spoke with Dr. Gregg Jossart, Director of Minimally Invasive Surgery at California Pacific Medical Center, who has performed over 1,000 sleeve gastrectomies in the last 10 years. He said that the finding that weight loss with the sleeve is comparable to the gastric bypass is great news for potential patients who are concerned about the long term effects of intestinal bypass procedures.  “The sleeve is rarely associated with vitamin deficiencies or other nutritional problems.  In addition, there are no reports of ulcers or intestinal obstructions as seen with the bypass procedures,” Dr. Jossart concluded.

You can learn more about the sleeve gastrectomy, how it is performed, and what to expect after the procedure here.

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