April 22, 2020

Is the Gastric Sleeve Reversible?

Pre-Surgery

How Gastric Sleeve Surgery Works

Gastric sleeve surgery, also known as sleeve gastrectomy, involves the removal of a significant portion of the stomach, approximately 75-80%. This procedure permanently reduces the stomach’s size, limiting the amount of food intake and promoting weight loss.

The gastric sleeve procedure involves stapling the stomach lengthwise and removing the stretchy portion through a small skin incision. Once removed, the specimen is placed into a preservative solution and sent to the pathology lab to be examined days later under the microscope.

Due to the intricacies of the surgery, reversing a gastric sleeve is simply not feasible and cannot be done. Fortunately, even if it were possible, there are only a few extreme scenarios where this would even be desired or required.

Understanding Gastric Sleeve Reversibility

Can you reverse gastric sleeve surgery?

This question is a critical concern for many considering or who have undergone gastric sleeve surgery.

Gastric sleeve, gastric bypass, and duodenal switch surgeries are permanent, and irreversible, but it can be converted into a different procedure if necessary.

To address this, we need to delve into the medical and technical aspects of the surgery and understand what factors contribute to its reversibility or irreversibility.

Why would you need to reverse a gastric sleeve?

There are two scenarios that would lead a bariatric surgeon to recommend converting the gastric sleeve to a different weight loss procedure:

Severe and unrelenting heartburn.

A very small number of patients may develop severe, unrelenting heartburn after gastric sleeve surgery that fails to respond to powerful antacid medication. This is most typically seen in patients with a history of severe daily heartburn before they even had the gastric sleeve procedure. In this tiny fraction of patients, when all other options have been exhausted, we will sometimes recommend converting the gastric sleeve to a gastric bypass procedure which tends to improve heartburn symptoms.

Insufficient weight loss:

In patients that have lost an insufficient amount of weight following gastric sleeve surgery, the option exists to perform a “second stage” procedure such as the duodenal switch, which provides additional weight loss. This is most commonly seen in patients who are presented with super-obesity (e.g., BMI>55-60) prior to having a sleeve gastrectomy.

While there are many factors to consider when deciding whether weight loss surgery such as a gastric sleeve is right for you, it is important to ensure you get all the answers you need. The Sleeve Clinic is available to go through any questions you may have and offers virtual consultations to get you started.

We hope you found this article on answering the popular question of “Is Gastric Sleeve Reversible” informative. Here’s an article on “4 Things to Know Before Having Gastric Sleeve Surgery” to further assist you in the decision making process.

Factors Influencing Reversibility Of Bariatric Surgery

Extent of Stomach Removal:

The amount of stomach removed is a primary factor. The more extensive the removal, the less likely a gastric bypass or gastric sleeve reversal is possible. In gastric sleeve surgery, approximately 75-80% of the stomach is permanently removed.

This procedure creates a tube or “sleeve”-shaped stomach, significantly smaller than its original size. The removed section of the stomach is responsible for the production of hunger-inducing hormones. Its removal not only limits food intake capacity but also affects hunger and satiety signals, contributing to weight loss.

Surgical Technique:

The method used during the original surgery can influence reversibility. Some techniques may leave a larger portion of the stomach intact, allowing for potential reversibility.

Post-Surgical Changes and Adaptations:

After the bariatric surgery, the body undergoes several changes, including hormonal adjustments and alterations in the digestive process. These changes can complicate or negate the possibility of reversing the procedure.

Health Considerations and Complications:

The patient’s health post-surgery, including any complications that have arisen, can impact the feasibility of a reversal. In some cases, complications might necessitate a different type of intervention or surgery.

Potential Risks of Gastric Sleeve Reversal

Reversing a gastric sleeve surgery carries its own risks, including complications from another major surgery, potential for reduced effectiveness in weight management, and the return of obesity-related health issues.

Permanent Structural Changes:

Both surgeries [gastric sleeve and gastric bypass] result in permanent structural changes to the stomach. In gastric sleeve surgery, the removed section cannot be restored, making reversal a complex and often impractical option.

In gastric bypass, while technically some rerouting may be reversed, the original anatomy and function of the stomach and intestines can’t be completely restored.

Volume Reduction and Its Consequences:

The reduced stomach size limits food intake, a primary goal of these surgeries. Reversing the procedure could risk returning to pre-surgery eating habits and associated health issues.

The body adapts to the smaller stomach size, and attempting to reverse the procedure could lead to complications such as gastrointestinal discomfort, malabsorption, or nutritional deficiencies.

Hormonal and Metabolic Changes:

Both procedures significantly alter hormonal and metabolic responses related to hunger, satiety, and blood sugar control. Reversing the surgery might not reverse these hormonal changes completely, potentially leading to metabolic imbalance.

Alternative Solutions:

For patients experiencing issues post-surgery, healthcare providers often explore other management strategies, such as dietary adjustments, lifestyle changes, or other medical interventions, rather than opting for reversal.

Consultation with Healthcare Professionals:

It’s crucial for individuals to discuss thoroughly with their healthcare providers. Understanding the implications, risks, and alternatives to a gastric sleeve reversal is essential in making an informed decision.

If you’re thinking about sleeve surgery, here’s some next steps to take:

Evaluate your eligibility: Take a quick online quiz to see if you qualify for sleeve surgery – How Much Will I lose After Sleeve Surgery? Calculate weight loss
Seek expert advice: Speak with a Sleeve Clinic Program Advisor
Become part of our community: Follow The Sleeve Clinic on Instagram
Gastric Sleeve Surgery vs. Gastric Bypass: Which is Right for You?

Please note that the information provided in this article is for general informational purposes only and should not replace medical advice. It is always recommended to consult with a qualified healthcare professional for personalized guidance regarding weight loss surgery.

If you are considering sleeve surgery you can book a consultation with our gastric sleeve surgeon at our weight loss clinic inToronto here: Contact us!

Dr. Scott Gmora, Bariatric Surgeon, MD FRCSC FACS

Dr. Scott Gmora is a double board-certified weight loss surgeon. He is a bariatric surgeon at St. Joseph’s Healthcare Hamilton, the designated lead Bariatric Centre of Excellence in the province. Dr. Gmora is also an Associate Professor of surgery at McMaster University where he serves a senior faculty member training future bariatric surgeons. He is the proud founder of The Sleeve Clinic which provides private, out-of-hospital gastric sleeve surgery to Canadians struggling with obesity.