Stomach Stapling Surgery – What is it?

You’ve probably heard the term stomach stapling. But what does that mean exactly? Is stomach stapling a procedure to lose weight?

Did you know there are two common weight loss surgery procedures that involve stomach stapling?

What is Stomach Stapling?

Stomach stapling is not the technical name of any procedure. However, there is one procedure that only staples your stomach. It’s the gastric sleeve procedure. Gastric sleeve surgery only became popular in 2009. And you may have heard your grandma say, ‘She lost a lot of weight. Did she get that stomach stapling thing?’

The term stomach stapling has been used since bariatric surgery started. Why? Well, it’s much easier to remember than laparoscopic roux-en-y gastric bypass. Gastric bypass is the likely procedure that people refer to when they say ‘stomach stapling.’

Gastric bypass has been around for more than 20 years and is considered the ‘Gold Standard’ of weight loss surgery. It’s considered the ‘Gold Standard’ because it’s the most researched of all procedures, it has excellent results and a low risk profile. And aside from the Lap Band, which everyone knows because of Allergan’s marketing team, gastric bypass is the ‘other’ weight loss procedure.

In this article we will discuss both gastric bypass and gastric sleeve surgery; the two common stomach stapling procedures. However, it’s important to note there are some other procedures that also include stomach stapling (these are less common).

1. Mini-gastric bypass
   1. This procedure is relatively new and typically not covered by insurance. However, it does have some strong proponents.
   2. It claims to have less complications, shorter operating times, and weight loss similar to gastric bypass.
2. Banded sleeve gastrectomy
   1. This procedure had some proponents about 5 years ago.
   2. However, there wasn’t much data to support improved long-term weight loss by adding a band to a sleeve gastrectomy (the procedures original intent).
3. Duodenal Switch
   1. A less common but very effective procedure for weight loss surgery.
   2. It is often covered by insurance.

Gastric Bypass Surgery – Staple My Stomach, Please

Gastric bypass surgery is a very effective weight loss surgery procedure. This procedure combines two weight loss mechanisms.

1. Restriction
   1. The stomach is reduced in size. This restricts the amount of food you can eat in a single sitting.
   2. If you try to eat more than your stomach can hold, you will feel sick.
2. Malabsorption
   1. Part of your intestines are bypassed (typically about 150 cm).
   2. Your intestines process the food and absorb nutrients.
   3. The less time your food is processed, the less calories you absorb.
   4. Less calories = reduced weight.

 

Gastric Sleeve Surgery – Only Staple My Stomach

Gastric sleeve surgery is on fire. It’s become very popular since it was first approved for insurance coverage in 2009. The procedure is straightforward, easy to understand, and produces excellent weight loss (up to 68% according to this study). Complication rates are acceptable and hunger levels are significantly reduced afterwards. This article compares gastric bypass and gastric sleeve. Gastric sleeve works by only utilizing restriction.

1. Restriction.
   1. The stomach is reduced by about 70%.
   2. The stomach is stapled from the bottom to the top, removing the majority of the greater curvature.
   3. The hormone ghrelin causes hunger. And because 70% of the stomach is removed, hunger is significantly reduced.

 

A Little More About Stapling

I’m a bit of an expert on surgical staplers. They are an important tool for any bariatric surgeon. If your staples fail, then the patient may end up with a leak.

Below is a picture of a typical surgical stapler. These are the staplers that are used to staple and cut your stomach.

 

They’ve become fancy over the years. They have powered options. Some even look like a power drill and rotate left or right with the push of a button.

But the science remains the same. The stapler clamps down on your stomach. It compresses the tissue to a certain thickness (different staples are made for different parts of the stomach). The bigger staples close to about 2.5 mm. In thinner areas of your stomach your surgeon may choose a staple that closes to 2.0 mm. The stapler will try to compress your tissue to a thickness within the indicated staple range. Choosing the wrong staple load for the tissue can lead to a leak.

The stapler then cuts the tissue in between the two sets of staples. One set of staples (typically 3 rows) is placed on the side of the tissue that remains in the body and the other set of staples (another 3 rows) is placed on the tissue that is being removed.

When the staples close they form a ‘B’ shape. Why is this important?

A ‘B’ shape compresses the tissue enough so there is little or no bleeding. But it also allows for some blood flow. The blood flows through the two holes in the ‘B’ shape. This allows the tissue to heal properly and the staples to remain in place. If the staple closed down like a normal staple, blood would not flow to the edge of the tissue. The tissue would die and the staple would fall off.

Conclusion

Stomach stapling can be whatever procedure you want. Ultimately, you’re choosing bariatric surgery to lose weight. The choice of procedure is personal. Your doctor can give you recommendations, but ultimately, the decision is yours.

And if you choose to staple your stomach (have either gastric bypass or gastric sleeve surgery), you’ll lose weight. It’s up to you to keep the weight off.

So when grandma says, ‘Honey, you’re going to staple your stomach? That sounds dangerous.’ You can tell her the ins-and-outs of surgical stapling. She will probably doze off when you get to why the ‘B’ shape is important.

If you’re on the fence about which procedure to have, take our test.