What is Gastric Sleeve Surgery? How is it done?

Gastric sleeve surgery is the most common surgical operation worldwide for those who have obesity and cannot lose weight. Generally, diet and exercise programs are recommended to patients before the surgery and support is sometimes provided with medication. However, if the patient cannot lose weight, surgery planning is fulfilled.

With this surgical operation performed with the procedure of removing approximately 60 -90% of the stomach, the patient can reach the desired weight. The operation can be performed with “sleeve gastrectomy”, that is, closed technique (laparoscopic), and it is possible for patients to return to their daily life after a comfortable recovery period.

How is Gastric Sleeve Surgery Done?

First of all, let us state that the surgery is performed under general anesthesia. In this way, it is never possible for the patient to feel pain or pain. In sleeve gastrectomy surgery performed with laparoscopic surgery, several small incisions are applied to the patient. Ports are placed through these incisions so that the abdominal area can be reached. One of the incisions is used for the micro camera. The camera allows the inside of the abdomen to be viewed and inflated using CO2 gas, which is not harmful to intra-abdominal health.

Afterwards, it is separated from the adipose tissue around the stomach, vessels and spleen with the help of a special tool called ligasur. The excess stomach section is cut and evacuated from the body. During the tube stomach surgery applied, the excess part of the stomach is sutured with a special device called stapler and cut at the same time.

Only 80 ml – 150 ml of the stomach remains. In order for the accumulated fluid to come out, a silicone drain is placed and stitches are made to the places where the incision is made and the gastric sleeve surgery is completed. This surgery has some advantages over gastric bypass surgery. We can list these advantages as follows:

• It is possible to lose approximately 60% of the excess weight in a very short time.
• Body does not need to adapt to a foreign object
• Metabolic disorders recover much faster
• Rest time is much shorter
• No change in the food passage route in the gastrointestinal system
• Vitamin and mineral deficiency becomes much less
• Appetite decrease is more

Situations Requiring Gastric Sleeve Surgery

Although patients with obesity problems can benefit from the gastric sleeve surgery option, in fact, not every patient is a suitable candidate for this surgery. The basic principle of this surgery is that the patient eats less and consequently the body fat ratio decreases.

Obesity patients who cannot lose weight with the diet and exercise programs applied this surgery in the option of weight loss, which is the right thing. Gastric sleeve surgery should not be considered as the first option. Before the operation, the patient should have some tests. In this way, it is evaluated whether there is a suitable candidate for surgery, and then the surgery planning phase is started.

How Long Does Gastric Sleeve Surgery Last?

We can say that the surgery is completed between half an hour and an hour in competent hands. This period can be extended up to 2 hours when the stages such as preparing the patient for sleeve gastrectomy and applying anesthesia are included. As soon as the patient goes into surgery, there is no surgery. There is a preparation time. This period is between half an hour and an hour. When the operation period is over, he is taken to the wake-up room inside the operation under normal conditions, and the patient stays between half an hour and an hour here.

Nutrition After Gastric Sleeve Surgery

Of course, there are some issues to be considered about nutrition after gastric sleeve surgery. Especially for 6 to 18 months, patients do not need to eat because they will not have appetite for the reason that their appetite hormone is taken during surgery. This period should be followed by a dietician because people who have eaten for years do not have an appetite anymore and they spend their days with very little food and it causes losing rapid and unbalanced weight.

We can list the things to do to prevent this as follows:

• More meals should be consumed, but it should be cared to keep the portions small.
• Food should be swallowed after being too chewed
• Exercise and sports should be done after the surgery
• Solid and liquid foods should not be consumed together.
• After a while, it should be increased to at least 1.5 liters per day.
• A diet program rich in protein should be applied after the operation.
• Vitamin and mineral supplements recommended by the doctor and dietician should be taken.
• Routine checks should never be interrupted
• It is a great importance to adhere to the nutrition program for the reaching the ideal weight and health of the patients.

Things to Consider After Gastric Sleeve Surgery

We can answer the question of what patients should pay attention to after gastric surgery with some examples.

• You can take a bath at home when you are discharged
• Be active in the house after discharge
• Sexual abstinence should be applied for 1 week after the operation
• After discharge, you can drive
• Alcohol should not be taken
• Avoid heavy physical activities that force the body for 1 month after the operation.
• Vitamin-mineral supplements recommended by the doctor and dietician should be taken properly.
• Activities such as solarium and sunbathing should be avoided until the stitches dissolve.
• The most important element is the nutrition program and you should never be left out of the nutrition program.

Who Cannot Have Gastric Sleeve Surgery?

First of all, the body mass index must be above 35 in order for the patient to benefit from the gastric sleeve operation. It is also important that the excess weight should be exogenous in order to benefit from this surgery. If there is an overweight problem caused by some hormonal disorders, drug treatment should be performed instead of surgery.

Those under the age of 18 can only be operated after obtaining the necessary approvals, those who have a health problem that prevents surgery cannot benefit from this surgery. Surgery may also have some drawbacks for people over 65. However, depending on the health status of the patient, flexibility can be shown in the upper age limit. Fresh mothers can have surgery after 3 months. People with alcohol and drug addiction should be very careful when performing gastric sleeve surgery. Some specific diseases can also prevent this surgery.

What are the Risks of Gastric Sleeve Surgery?

There is no risk-free surgery. Therefore, weight loss surgery also carries some risks in itself. Since anesthesia is applied before the surgery, we can mention various risks such as anesthesia-related risks, shortness of breath, infection, malnutrition, blood clot and vascular occlusion. However, the risks of this surgery are much less than the risks of gallbladder surgery.

It should be noted that if the surgery is performed by an experienced doctor, the risks will be much less likely to occur. In addition, one of the risks that may arise after sleeve gastrectomy is leaking from the remaining part of the stomach to the abdominal part. At the same time, in very rare cases, complications of stomach stenosis may occur in the long term.

However, this problem is easily eliminated with the application of endoscopic expansion. The risks related to the surgery are definitely transferred to the patient before the operation, and the operations are performed with the patient’s knowledge and approval.

Leakage Risk After Gastric Sleeve Surgery

The issue that patients mostly focus on before sleeve gastrectomy is the risk of leakage. This is the leakage of stomach acid and stomach contents from the stomach into the abdomen. This situation can lead to infection in the abdomen. The most common period of leak complications is between 5 and 8 days after surgery. After 10 days after the operation, the risk of leakage is extremely reduced. Leak symptoms are as follows;

• High fever
• Abdominal pain
• Respiratory distress

Of course, these problems may arise from a different disease other than the surgical intervention in question. However, you should inform your doctor even if only 1 of these 3 symptoms are experienced. If a leak is detected in the examinations, the necessary intervention is made immediately. This intervention is sometimes surgical and sometimes non-surgical methods. You can write all your questions on the subject in the comments section.