There are various strategies and techniques used to treat individuals with obesity, such as diet, exercise, surgery, prescription medication, behavioral therapy, and newer endoscopic procedures.

Dr. Steven Batash with Batash Endoscopic Weight Loss Center in NYC offers non-surgical Suture Sculpt ESG, which rivals the results of traditional gastric sleeve surgery but without the elevated risks associated with a surgical procedure. Today, we are going to talk about how a gastric sleeve works to help individuals lose weight, give details about the surgery, and then provide an overview of Suture Sculpt, the non-surgical sleeve.

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Bariatric Surgery And The Gastric Sleeve

Historically, bariatric surgery has been one of the most effective treatments since its inception, about 70 years ago. These surgeries use a combination of restrictive and malabsorptive techniques to help individuals lose weight.

The restrictive technique limits the amount of food a person can eat, while the malabsorptive technique prevents the body from absorbing all the nutrients and calories. All versions of bariatric surgery use the restrictive method, and gastric sleeve surgery was specifically designed to create and enforce this type of restriction. In fact, it was originally developed as the first step of the two-part duodenal switch surgery. While patients were healing from this first step so they could proceed to step two, many lost so much weight that they never completed the second part of the surgery.

What Is A Gastric Sleeve?

This surgery is also known as laparoscopic sleeve gastrectomy (LSG) and vertical sleeve gastrectomy (VSG), but is most often called gastric sleeve. Its name describes the resulting stomach shape after most of the patient’s stomach is removed. What remains is shaped into a sleeve-like pouch that is positioned vertically in the upper portion of the abdomen. This new shape represents between 20% and 25% of the stomach's original size.

What Is Involved In Gastric Sleeve Surgery?

The typical steps that are used during a laparoscopic gastric sleeve surgery include:

1. The administration of general anesthesia to the patient before the surgery begins;
2. The surgeon creates around five half-inch incisions in the patient's abdomen, one of which is placed near or in the belly button and is used for a special medical device with a camera called a laparoscope. This device allows the surgeon to visualize their progress as they navigate the surgical site via a nearby video monitor;
3. A special gas is used to help distend the patient's abdomen and create some space that allows the surgeon to move around and access the stomach more easily when conducting the surgery;
4. Other thin surgical instruments are inserted through the remaining incisions, and the surgeon uses them to remove most of the patient’s stomach. Then a new, smaller stomach is crafted by using surgical staples to close the edges left by the removal incisions;
5. When the surgeon finishes reducing the stomach’s size, the surgical instruments are removed, and the incisions are sutured closed.

Recovery can take an individual anywhere between six and eight weeks, depending on the technique used to access the stomach, the patient's age, health, BMI, and how well they follow their post-surgery aftercare directions. Everyone’s body heals at its own rate, but living a healthy lifestyle like eating a well-balanced diet, getting plenty of rest, and staying properly hydrated will help provide your body with what it needs to heal quickly and properly.

How Does Gastric Sleeve Work For Weight Loss?

During the surgery, about 75-80% of the stomach is removed, leaving a narrow, tube-like structure. This smaller stomach holds much less food, which helps patients with portion control, and they feel full after eating very small amounts of food. The surgery also removes many of the stomach glands that manufacture and release ghrelin, which is the hormone that causes hunger pangs and cravings. The reduced stomach capacity coupled with the appetite suppression helps individuals struggling with obesity achieve sustainable weight loss.

Do I Have To Qualify For Gastric Sleeve Surgery?

Yes, there are criteria that must be met before you can undergo gastric sleeve surgery. The surgeon who will be performing your procedure will have requirements, as will the medical insurance carrier being relied upon to subsidize or cover the surgery expenses. The basic qualifications for gastric sleeve surgery include:

• The candidates must have a body mass index (BMI)of 40 or over. Or;
• The patient has a BMI of at least 35 and suffers from at least one weight-related illness, such as hypertension, type 2 diabetes, or sleep apnea;
• They must be in general good health and free from any medical issues that would disqualify them from having surgery;
• The individual must be willing to commit to the lifelong lifestyle changes that are necessary for the gastric sleeve surgery to be successful.

Medical insurance companies may have additional requirements beyond those listed above, which may include:

• Being at least 18 years old;
• The individual may need to be at least 100 pounds overweight;
• Showing proof that they tried to lose weight during the last two years using a structured program like Jenny Craig for at least 6 months or tried two separate times to follow programs that were each at least 3 months long. Certain carriers require their preferred program to be attempted before they will approve the surgery;
• If applicable, the individual must quit smoking;
• The patient might be asked to submit to drug testing to rule out substance abuse issues;
• Patients may need to submit to psychological evaluations to ensure they understand and are dedicated to making permanent lifestyle changes.

What Are Associated Risks Of Gastric Sleeve?

Any surgery or procedure carries the potential for adverse side effects or complications. The risks associated with gastric sleeve include:

• An adverse reaction to general anesthesia;
• Leaking from the staple line;
• Infection;
• Bleeding;
• A blocked intestine;
• Hernia;
• GERD (very common after gastric sleeve);
• Nausea;
• Throwing up.

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Is There A Non-Surgical Gastric Sleeve?

Yes. If you would like all the benefits of traditional gastric sleeve surgery but without incisions, pain, and very long recovery time, Suture Sculpt ESG is a good choice for you.

Suture Sculpt endoscopic sleeve gastroplasty (ESG) is a non-surgical procedure that is significantly less invasive and does not involve a difficult qualification process. Patients with BMI levels of around 30 can take advantage of its weight loss potential before their condition worsens.

Some patients do not qualify for gastric sleeve surgery because they do not meet the BMI requirements and would actually have to gain weight or develop a chronic medical condition for them to qualify for help.

How Does Non-Surgical Gastric Sleeve Work?

Suture Sculpt ESG does not use any incisions or remove any stomach tissue. Instead, the patient’s stomach size is made smaller using strategically placed sutures that are administered from inside their stomach.

A specially trained gastroenterologist uses a medical tool called an endoscope, which is a bendable, hollow hose with a camera that is carefully lowered down the patient’s esophagus while they are sedated. Then the doctor lowers an endoscopic suturing device and other tools through the hollow portion of the endoscope and reshapes the stomach into a small pouch using several sutures to hold it securely in place. The procedure can be reversed if needed, and because no portion of the stomach is removed and there are no incisions used, there is no associated hospital stay. Most patients recover within a week or less and can return to their normal routine.

Why Have Surgery When Suture Sculpt ESG Has More Benefits?

There is no reason to put yourself through the intense challenge of trying to qualify for gastric sleeve surgery or endure the pain and inconvenience of a long recovery when you have non-surgical options available.

At Batash Endoscopic Weight Loss Centers, we understand how challenging losing weight is, but we also know how to overcome these challenges. Dr. Steven Batash is a highly experienced gastroenterologist with expertise in endoscopic weight loss procedures as well as an extensive background in obesity management. He and his team can identify any underlying issues that may have hindered your previous weight loss attempts. They will create a plan that is aimed at overcoming these challenges and promoting sustainable weight loss.

Contact us today and schedule a consultation to learn more about the non-surgical weight loss options that are available to you. Join thousands of our other patients who have experienced life-changing weight loss results through Suture Sculpt ESG and other non-surgical strategies.

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