Gastric Sleeve (Sleeve Gastrectomy)

The gastric sleeve, also known as sleeve gastrectomy, is a surgical procedure for those who want to lose weight.

It is a restrictive procedure, which means that it limits the amount of food a person eats. It does so by decreasing the size of the stomach. The need for such a procedure is appropriate when the body mass index (BMI) of a person is between 35 and 40 or above 40.

The gastric sleeve procedure is considered superior to gastric banding and is not like a major gastric bypass. Therefore, you may not feel so much the discomfort of alteration in your bowel habits.

In this procedure, a large part of the stomach is removed while stomach edges are fixed together to create a sleeve shaped like a banana. By doing this, a surgeon can permanently reduce the size of the stomach. It is usually carried out via a laparoscope.

It must be kept in mind that the procedure is irreversible. Once the stomach size has been reduced, it functions the same way it used to. No alterations in stomach functions have been recorded so far. The only difference occurs in the stomach’s storage capacity – a little food may make you feel full, so stopping you from eating. This is how weight loss is successfully achieved.

The sleeve gastrectomy is a relatively safe weight-loss method, but it should only be considered in people who fail to lose their weight by other means such as diet and exercise. Weight loss with a gastric sleeve has been found to range between 55% to 70% of the surplus body weight, but it also depends upon the patient’s body condition and circumstances. It has been widely demonstrated to help achieve better weight loss than gastric banding surgical procedures.

Since, no foreign body is placed in your body, the allergic reactions and complications associated with those foreign bodies are not present here. Another significant factor of this procedure is that the pylorus – a part of the stomach – is preserved here.

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Indications for Gastric Sleeve

  • Extremely obese people
  • Those with a BMI of 40 and above
  • Those who fail to achieve weight loss by conventional methods.
  • Those who have a high risk of disease or mortality due to obesity.
  • Patients with obesity-related ailments, for instance high blood pressure, diabetes, or high cholesterol levels

Steps Taken Before Surgery

There is a need to quit smoking if you want to remain safe from the complications after this surgery. Those undergoing this procedure should stop smoking so you may heal quickly and remain safe from conditions such as pneumonia or thrombosis.

Special diets are also recommended by the surgeon 1-2 weeks before the operation.

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The Procedure

Gastric Sleeve surgery is performed under general anaesthesia. The maximum time it takes to perform is 1 to 2 hours.  5 small incisions are made in the abdomen. The stomach is incised and divided and a tube-shaped stomach left behind. The ideal capacity of the stomach achieved is 15mL. Opened edges are tied up with staples. This procedure usually requires an overnight stay in the hospital. People who undergo this procedure can usually resume their normal activities within 2-3 weeks.

After the surgery, the abdomen of the patient usually remains tender and swollen. To alleviate pain, analgesics are prescribed. Liquid diets are suggested for two weeks and then semi-solid diets for the following two weeks. After this, a solid food diet can be resumed. An anticipated weight loss of around 50 to 70% within 6 months to one year can be expected, following this procedure.

Risks and Complications

Risks associated with gastric sleeves include problems related to poor nutrition, arising due to the failure of proper absorption of minerals and vitamins as a result of removal of a large portion of the stomach. It is therefore suggested that people who experience this should work with their doctors to prevent such risks.

Other risks common to all such weight loss-related procedures include infection at the site of an incision, or generalized body infection. If it should spread, fever, and leakage of food from the stomach into the peritoneal cavity leading to peritonitis (an inflammatory condition of the peritoneum) can occur. A risk of pulmonary embolism is also seen. In this condition, a blood clot or thrombos forms in the lungs. Owing to the deficiency of nutrition, anemia is also common in those patients. Osteoporosis risk also increases because of inadequate nutrients delivered to the bones. Increased risk of gallstones formation has also been seen after gastric sleeve surgery.

Complications associated with this particular procedure include internal bleeding, perforation of the stomach, nearby organs damage, infections such as pneumonia, peritonitis, infection at the site of the incisions, and certain heart, lungs, kidney and psychosocial problems.

Frequently Asked Questions (FAQ)

Q. Is the Gastric Sleeve procedure safe in comparison to other weight loss surgeries?

A. Gastric sleeve is a relatively safe weight-loss procedure as it is less invasive than some other procedures.

Q. What type of diet will I consume post-operatively?

A. You will need a liquid diet for 2 weeks, then need to replace it with a semi solid one for next 2 weeks, after which time you can resume your normal diet.

Q. When can I go back to my work or daily routine following surgery?

A. With this procedure, recovery time is usually shorter. A rest of a week is usually recommended on the basis of your condition. You can however return to your work if it is not strenuous. Heavy lifting should be limited for 4-6 weeks.

Q. Is there a possibility of any adverse outcome on my current medical condition after this surgery?

A. Many ailments improve following gastric sleeve surgery, particularly diabetes, sleep apnea and hypertension. Please talk to your surgeon about any particular concerns you may have.

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