Understanding Gastric Sleeve Surgery for Teens

Gastric sleeve surgery (sleeve gastrectomy) is a type of weight-loss surgery. This surgery removes about 80% of the stomach. The part that is left is shaped like a narrow tube or sleeve. This sleeve holds much less food. So a person will feel full faster after surgery. This procedure also removes the part of the stomach that makes a hormone that causes hunger (ghrelin). So most people do not feel as hungry after the procedure.

If your teen has been struggling with being severely overweight or obese, gastric sleeve surgery may be a choice. Talk with your child's doctor. It's important to know that this procedure requires a major commitment. Your teen will have to learn new ways of eating and drinking because their stomach will be much smaller.

This surgery can be helpful for teens who struggle with being severely overweight or obese. Getting a teen to a healthier weight is important because obesity can lead to health problems, such as:

• Type 2 diabetes
• High blood pressure
• High cholesterol
• Sleep apnea
• Heart problems
• Joint problems
• Anxiety
• Depression

In general, weight-loss surgery may be advised for teens who have either:

• Class 2 obesity, along with one or more health problems linked to obesity. Class 2 obesity means that body mass index (BMI) is 35 or higher, or it is 120% of the 95th percentile for BMI for the teen's age and sex, whichever is lower.
• Class 3 obesity, with or without other health problems linked to obesity. Class 3 obesity means that BMI of 40 or higher, or it is 140% of the 95th percentile for BMI for the teen's age and sex, whichever is lower.

To be a candidate for this surgery, a teen should also:

• Be mentally and emotionally mature
• Understand and be ready to commit to making diet and lifestyle changes after surgery
• Have support from their family
• Not have an untreated eating disorder or mental illness
• Not be pregnant or planning a pregnancy in the next 12 to 18 months
• Not have a substance use problem

In most cases, this surgery is done laparoscopically. This means it uses very small cuts (incisions). And tiny tools are put into these incisions. These include a small video camera (laparoscope). The video images are displayed on a screen to help guide the surgeon.

The surgery may take about 2 hours. In general, here is what you can expect during the procedure:

• An I.V. (intravenous) line is put into your teen's arm or hand. They will be given medicine (general anesthesia) through the I.V., and a breathing tube will be inserted. This makes them sleep during the surgery.
• The surgeon will make several small incisions in the belly. They put tiny tools into these incisions.
• The surgeon cuts the stomach up and down (lengthwise) with a tool that staples as it cuts. The part that is left is a thin tube or sleeve shape. The side of the sleeve is closed with numerous staples that will remain in place.
• The surgeon removes the larger part of the stomach.
• The small incisions are closed with stitches or surgical glue. They are covered with bandages.

As with any surgery, there are some risks. The possible risks for this surgery include:

• Bleeding
• Infection at the incision sites
• Blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism)
• Leaks in the sleeve
• Narrowing (stricture) of the sleeve