Restrictive Bariatric Surgery: Sleeve Gastrectomy & Gastric Banding Explained
Restrictive procedures reduce stomach capacity, limiting food intake and promoting early satiety. They do not alter nutrient absorption.
1. Sleeve Gastrectomy (Vertical Sleeve Gastrectomy)
- Removes ~80% of stomach, leaving a narrow tubular sleeve
- Reduces ghrelin (hunger hormone) production
- Irreversible; most common bariatric procedure today
2. Adjustable Gastric Banding (AGB)
- Silicone band placed around upper stomach, creating small pouch
- Band adjustable via subcutaneous port (saline fills)
- Reversible; less weight loss than sleeve; higher reoperation rate
Mechanism & Benefits
- Early satiety → reduced caloric intake
- Significant weight loss → improvement in T2DM, hypertension, sleep apnea
Considerations
- Not suitable for all patients; requires lifelong dietary adherence and follow-up
- Risks: band slippage/erosion (AGB), staple line leak (sleeve), nutritional deficiencies
- Multidisciplinary evaluation (surgeon, dietitian, psychologist) mandatory
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