Sleeve Gastrectomy: Ken Croken
When he was 80 pounds overweight, Ken Croken used to joke that he liked to associate with friends bigger than himself. In jest, he posed for a photo with some of the largest land mammals on Earth -- his elephant friends at the Niabi Zoo.
He knew, however, that 25 years of being overweight and more than a decade of dealing with diabetes was no laughing matter.
"In my lifetime, I've lost a couple of thousand pounds. By rights, I feel like I should be little enough to dangle from a charm bracelet," says Croken, who is vice president of Corporate Communications & Marketing at Genesis. "But every time I lost 10 pounds, I would find 15. Up and up my weight went."
Concerned about his diabetes and its associated health complications, he began to consider the surgical weight-loss options offered by the Genesis Center for Weight Management, the Quad-Cities' only center of excellence for bariatric surgery. On July 14, 2008, he became the first patient at Genesis to have a sleeve gastrectomy, a restrictive bariatric surgery and the newest of three surgical options available to Genesis patients.
An End to Diabetes
Today, he is more than 80 pounds lighter. In six months, he has gone from a size 44 to 34 in pants and from a size 52 long to 46 long in suits. Most important, he no longer has diabetes. His blood sugar was under control, and he was completely off all diabetes medications just weeks after surgery.
Despite his pre-surgery apprehensions, the fact he could "surgically cure" his diabetes ultimately motivated him to undergo the life-changing procedure, he says.
"Whenever I thought about surgery as an option for weight loss, I would get cold feet. But when I thought about curing my diabetes, it was a completely different discussion. The best thing about the surgery was how quickly the results came -- not just the weight loss but the resolution of my diabetes."
Sleeve Gastrectomy at Genesis
Genesis is the only health care provider in the Quad Cities to offer the sleeve gastrectomy procedure, during which the surgeon creates a small, sleeve-shaped stomach by stapling and dividing it vertically. As a result, between 70-80 percent of the stomach is removed. The smaller stomach reduces the amount of food a patient can eat, thus promoting weight loss.
The procedure is technically less difficult than the Roux-en-Y gastric bypass, which reroutes a length of the small intestine to connect to a newly created stomach pouch. But it's more involved than introducing an adjustable gastric band, which is placed around the outside of the stomach to divide it into a small upper pouch above the band and a larger pouch below the band.
For Croken, the sleeve gastrectomy seemed the perfect fit: It was less invasive than the Roux-en-Y, and he liked that his digestive tract would remain essentially intact. He also didn't have to worry about the reliability of an adjustable gastric band device. With the laparoscopic procedure, he was home from the hospital in 24 hours.
"I could still digest and absorb my food in the same way," he says. "I didn't have to worry about avoiding certain foods or the potential complications."
Advantages of Sleeve Gastrectomy
Matthew Christophersen, M.D., FACS, who performed the first laparoscopic Roux-en-Y gastric bypass in the Quad Cities in November 2004, describes sleeve gastrectomy as a middle-of-the-road approach to surgical weight loss.
"With a sleeve gastrectomy, there is no reliance on a device to perform flawlessly to ensure the weight loss, as there is with a gastric band," Dr. Christophersen says. "There also is no intestinal bypass with this procedure, only stomach reduction, so we avoid potential complications such as marginal ulcers, vitamin deficiencies and intestinal obstructions."
Like the Roux-en-Y and gastric band, the sleeve gastrectomy is usually done through a minimally invasive approach, using several small incisions instead of a single, large one. That means recovery time, discomfort and surgical wound complications are significantly reduced, and patients can return to normal, daily activities much faster. Patients undergoing a gastric sleeve procedure normally require only a one-night hospital stay.
Other advantages of the sleeve gastrectomy include retention of normal stomach function so most food items can be consumed, albeit in small amounts, and lowering of the hunger-stimulating hormone, Ghrelin, which is produced in the portion of the stomach that is removed. Available clinical data,shows patients lose 60 percent of their excess body weight by the end of the first year. That is less than with the Roux-en-Y procedure, but more than patients achieve with a gastric band.
Bariatric Surgery Choices
Patients in the Genesis program attend an introductory education class, followed by consultations with the surgeon, nursing staff, pharmacist, dietician, physical therapist and recreational therapist. Psychological evaluations and consultations are done through Genesis Psychology Associates. Only patients who follow the pre-surgery requirements are scheduled for surgery.
"With the addition of sleeve gastrectomy to our program, we have even more flexibility in helping our patients find the procedure that's right for them," Dr. Christophersen says. "If you only offer one option, the patient doesn't have a choice, and some times, that one option isn't the best one."
The sleeve gastrectomy option has been the right one for Croken, who has lost an average of 20 pounds a month since his surgery. Redefining his relationship with food and his body image is a continuing journey. "For 25 years, I worried about my weight. In six months, I've completely resolved my weight problem. That's pretty remarkable, I think."