Gastric Sleeve
Since 2014, it has become the most frequently performed bariatric surgery in the world. By most bariatric surgeons it is considered as a first choice surgery to be performed for the treatment of obesity. It is a restrictive, volume-limiting surgery. The stomach is cut through a tube which is placed through the mouth and approximately 75-80% of the stomach will be removed. The remaining stomach takes the form of a thin long tube. The patient will be satisfied with small portions and weight loss will be achieved. Weight loss rates are similar to other bariatric surgeries. In addition to its restrictive effect, it also contributes to the improvement of diabetes with the hormonal changes it causes. It is primarily preferred in patients with obesity. Vitamin-mineral support is often not required in the long term, as it is not an absorbable surgery.
What is gastric sleeve surgery?
Gastric sleeve surgery is a type of weight-loss surgery. Weight-loss surgery is also called bariatric surgery. This surgery also known as sleeve gastrectomy or vertical sleeve gastrectomy (VSG). Gastric sleeve surgery restricts your food intake, which leads to weight loss. You may lose from 50 to 90 pounds.
It’s done as a laparoscopic surgery, with small incisions in the upper abdomen. Most of the left part of the stomach is removed. The remaining stomach is then a narrow tube called a sleeve. Food empties out of the bottom of the stomach into the small intestine the same way that it did before surgery. The small intestine is not operated on or changed. After the surgery, less food will make you full when eating.
Why might I need gastric sleeve surgery?
Gastric sleeve surgery is used to treat severe obesity. It’s advised for people who have tried other weight loss methods without long-term success. Your doctor may advise gastric sleeve surgery if you are severely obese with a body mass index (BMI) over 40. Your doctor may also advise it if you have a BMI between 35 and 40 and a health condition such as sleep apnea, high blood pressure, heart disease, or type 2 diabetes.
What are the risks of gastric sleeve surgery?
Bleeding, infection, and blood clots in your legs are possible side effects that may occur after any surgery. General anesthesia may also cause breathing problems or other reactions.
Over time, you may also have some trouble absorbing certain nutrients. Or you may develop a narrowing (stricture) in your stomach sleeve. Some people may have heartburn or reflux after the surgery. If you already have moderate to severe reflux, a gastric sleeve could make that worse. You may want to consider a gastric bypass surgery instead. That type of surgery can stop reflux and heartburn.
You may have other risks based on your health. Make sure to talk with your healthcare team about any concerns before the surgery.
What happens after gastric sleeve surgery?
Unless there is a special situation (past abdominal surgeries, recurrent revision surgeries, technical difficulties), all surgeries are performed closed. Average operation times are 25-30 minutes for sleeve gastrectomy and 1-1.5 hours for bypass surgeries. These periods do not include the time taken for the patient to be put to sleep and awakened. Although the operation times of the patient are as stated, it will take longer for the patient to return to the bed from the operating room.
• When the patient comes to bed after the surgery, there will be a drain and a urine bag in the abdomen. Drain, for the purpose of safety to detect possible bleeding early; Urine bag is attached for the purpose of monitoring body functions and patient comfort.
• There will be some pain in the first few hours after the surgery, strong painkillers are used during this period. After a few hours the pain subsides, after a day the patients feel almost no pain.
• Nausea, retching and vomiting may occur in patients immediately after the operation. These are common cases. For this, effective drugs are used, after the first few hours these complaints do not occur.
• Blood pressure is monitored frequently in the first hours after the surgery. This is a precaution taken for patient safety. In the following hours, the frequency of follow-up is reduced.
• Six to eight hours after the operation, the patient is mobilized in the company of a nurse. If there is no sign of bleeding and there is no problem in mobilization, the catheter is taken.
• Leak test is performed on the patients the day after the operation. This test consists of ingestion of contrast material by mouth. Patients who have no problems with the leak test can start to take liquid food. Abdominal drains are taken after the leak test in patients who do not have any signs of bleeding.
• Patients are given nutrition education by a bariatric dietitian on how to eat in hospital and after they leave the hospital.
• Patients are discharged on the 2nd or 3rd day after surgery, depending on how they feel.
Changes in eating habits, exercise and lifestyle changes constitute the first step of obesity treatment. It is very important that changes in eating habits and exercise are included in the lifestyles of patients after bariatric surgery. Taking precautions by regulating the patient’s lifestyle after surgery is the key to the long-term success of any bariatric surgery.
