Gastric Sleeve Surgery

Gastric Sleeve Surgery is the most commonly performed surgical operation worldwide for patients with obesity who are unable to lose weight. Generally, patients are advised to follow diet and exercise programs before surgery, and in some cases, medication support is also provided. However, if the patient is unable to lose weight, surgical planning is carried out.

With this surgical operation, which is performed by removing approximately 60% to 90% of the stomach, it becomes possible for the patient to reach their desired weight. The operation can also be performed as Gastric Sleeve Surgery using a closed technique (laparoscopic), and after a comfortable recovery period, patients can return to their daily lives.

How Is Gastric Sleeve Surgery Performed?

First of all, it should be noted that the operation is performed under general anesthesia. In this way, it is absolutely impossible for the patient to feel pain or discomfort. In Gastric Sleeve Surgery performed laparoscopically, a few small incisions are made on the patient. Ports are placed through these incisions, allowing access to the abdominal area. One of the incisions is also used for a micro camera. The camera provides imaging of the inside of the abdomen, and the abdomen is inflated using CO2 gas, which does not harm health.

Then, with the help of a special instrument called a ligasure, the stomach is separated from the surrounding fat tissue, vessels, and spleen. The excess portion of the stomach is cut and removed from the body. During the Gastric Sleeve Surgery, the excess part of the stomach is both cut and stapled using a special device called a stapler.

Only 80 ml to 150 ml of stomach remains. A silicone drain is placed to allow accumulated fluid to exit, and the procedure is completed by suturing the incision sites. This surgery has some advantages compared to gastric bypass surgery. These advantages can be listed as follows:

• It is possible to lose approximately 60% of excess weight in a short time
• The body does not need to adapt to a foreign object
• Metabolic disorders improve much faster
• The recovery period is much shorter
• No change is required in the food passage route of the stomach–intestinal system
• Vitamin and mineral deficiencies are much less common
• Appetite suppression is more significant

Conditions That Require Gastric Sleeve Surgery

Although patients with obesity can benefit from the Gastric Sleeve Surgery option, not every patient is actually a suitable candidate for this procedure. The main principle of this surgery is to enable the patient to eat less and, accordingly, reduce the fat ratio in the body.

Obese patients who cannot lose weight with diet and exercise programs often turn to weight loss surgery, which is the correct approach. However, stomach surgery should not be considered the first option. Before surgery, the patient must undergo certain examinations. This helps determine whether they are a suitable candidate, and then the surgical planning stage begins.

How Long Does Gastric Sleeve Surgery Take?

It can be said that the surgery is completed within 30 minutes to 1 hour in experienced hands. When preparation for the Gastric Sleeve Surgery and anesthesia processes are included, this duration may extend up to 2 hours. The patient does not undergo surgery immediately upon entering the operating room; there is a preparation phase lasting between 30 minutes and 1 hour. After the surgery, the patient is taken to the recovery room and remains there for another 30 minutes to 1 hour under normal conditions.

Nutrition After Gastric Sleeve Surgery

Of course, there are some important points to consider regarding nutrition after Gastric Sleeve Surgery. Especially for 6 to 18 months, since the appetite hormone is removed during surgery, patients may not feel the need to eat. This period should be closely monitored by a dietitian because patients who have eaten regularly for years may enjoy the lack of appetite and may lose weight rapidly and unhealthily by consuming very little food.

To prevent this, the following should be considered:

• Meals should be more frequent, but portions should be small
• Food should be chewed thoroughly before swallowing
• Exercise and sports should be performed after surgery
• Solid and liquid foods should not be consumed together
• Daily fluid intake should eventually reach at least 1.5 liters
• A protein-rich diet should be followed after the operation
• Vitamin and mineral supplements recommended by the doctor and dietitian should be taken regularly
• Routine check-ups should never be neglected

Adhering to the nutrition program is extremely important for patients’ health and achieving their ideal weight.

Things to Consider After Gastric Sleeve Surgery

We can answer the question of what patients should pay attention to after Gastric Sleeve Surgery with some examples:

• You can take a shower at home after discharge
• You should stay active at home after discharge
• Avoid sexual activity for 1 week after the operation
• You can drive after discharge
• Alcohol should not be consumed
• Avoid heavy physical activities that strain the body for 1 month after the operation
• Vitamin and mineral supplements recommended by the doctor and dietitian should be taken regularly
• Avoid activities such as solarium and sunbathing until the stitches dissolve
• The most important factor is the nutrition program, and it should never be deviated from

Who Cannot Undergo Gastric Sleeve Surgery?

First of all, in order for a patient to benefit from Gastric Sleeve Surgery, their body mass index must be above 35. It is also important that the excess weight is of exogenous origin. If the excess weight is caused by hormonal disorders, medication treatment should be preferred instead of surgery.

Individuals under the age of 18 can only undergo surgery with the necessary approvals, and those with health conditions that prevent surgery cannot benefit from this procedure. There may also be certain risks for individuals over the age of 65. However, flexibility in the upper age limit may be applied depending on the patient’s health condition. Mothers who have recently given birth can undergo surgery after the third month. Special care should also be taken when performing gastric reduction surgery on individuals with alcohol or substance addiction. Some specific diseases may also prevent this surgery from being performed.

What Are the Risks of Gastric Sleeve Surgery?

There is no risk-free surgery. Therefore, weight loss surgery also carries certain risks. Since anesthesia is applied before the operation, we can mention risks related to anesthesia, shortness of breath, infection, nutritional disorders, blood clots, and vascular blockage. However, the risks of this surgery are much lower than those of gallbladder surgery.

It should also be noted that when the surgery is performed by an experienced physician, the likelihood of risks occurring is much lower. Another risk that may occur after Gastric Sleeve Surgery is leakage from the remaining part of the stomach into the abdominal cavity.

In very rare cases, long-term stomach narrowing (stenosis) may occur. However, this problem can be easily resolved with endoscopic dilation. All risks related to the surgery are explained to the patient before the operation, and procedures are carried out with the patient’s knowledge and consent.

Leakage Risk After Gastric Sleeve Surgery

One of the main concerns patients focus on before Gastric Sleeve Surgery is the risk of leakage. This refers to the leakage of stomach acid and contents into the abdominal cavity, which can lead to infection. The period when leakage complications are most commonly seen is between 5 to 8 days after surgery. After 10 days, the risk of leakage significantly decreases. Symptoms of leakage include:

• High fever
• Abdominal pain
• Difficulty breathing

Of course, these symptoms may also be caused by conditions other than this surgical procedure. However, even if only one of these symptoms occurs, you should inform your doctor. If leakage is detected during examinations, the necessary intervention is performed immediately. This intervention may sometimes be surgical or non-surgical. You can write all your questions about the topic in the comments section.

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