Sleeve Gastrectomy
Obesity is a serious and progressive public health problem that has increased in recent years. In the 20th century, many different surgical procedures have been developed to treat obesity.Gastric sleeve gastrectomy, one of the methods of reducing the size of the stomach, is a safe, permanent and effective method with high survival rates. Gastric sleeve surgery is a procedure in which approximately 80% of the stomach is removed and the remaining portion is closed with a staple line.It is a minimally invasive procedure and less invasive than Roux-en-Y gastric bypass surgery.It is also known as "sleeve gastrectomy" and is widely preferred today.
Who can have a sleeve gastrectomy?
The procedures for sleeve gastrectomy are essentially the same as for any bariatric surgery. The criteria for people who are candidates for bariatric surgery are as follows:
- BMI≥ 40 kg/m2 (morbidly obese status) or BMI≥35 and the presence of at least one obesity-related complication (diabetes, hypertension, sleep apnea, serious musculoskeletal problems such as arthritis).
- Unsuccessful non-surgical weight loss attempts
- No medical contraindications to surgery
Laparoscopic sleeve gastrectomy is performed in patients who are obese or morbidly obese based on their body mass index (BMI). Morbid obesity has many implications, especially for women. It can cause complications such as infertility, gestational diabetes, pre-eclampsia, and especially irregular menstrual cycles.
What are the benefits of sleeve gastrectomy?
Sleeve gastrectomy significantly improves several clinical parameters.
The benefits of the surgery include:
- Weight Loss: Significant (80%) long-term weight loss after sleeve gastrectomy, changes such as decreased hunger, rapid satiety, changes in food preferences are observed.
- Regulation of lipid disorders: Obesity is associated with hyperlipidemia and other lipid disorders. After sleeve gastrectomy, blood levels of triglycerides, total cholesterol, VLDL and LDL cholesterol decrease.
- Decrease in depression: Because of the association between obesity and depression, bariatric surgery is associated with a decrease in clinical depression. It helps with physical, psychosocial and sexual recovery after surgery.
- Reduced cardiovascular risk: Morbid obesity and changes in the coagulation mechanism run in parallel. As the coagulation system improves, the risk of cardiovascular disease decreases.
In addition, improvements in possible fibrosis, steatosis, ballooning degeneration in non-alcoholic fatty liver disease have been shown in patients after sleeve gastrectomy
Are there any harms associated with gastric sleeve surgery?
Each of the bariatric surgery procedures has advantages and disadvantages. The disadvantages of the treatment method, which is designed according to the physiological status and wishes of the patient, can be managed with the help of a doctor.
- Surgical Complications: Bleeding, leaks, and fistulas are the most common complications after sleeve gastrectomy.
- Nutrient deficiencies: Because a large portion of the stomach is removed, which affects the absorption of vitamins and minerals, nutrient deficiencies are inevitable.
- The most common micronutrient deficiencies are vitamin B12, iron, calcium, folic acid, vitamin D, and vitamin B1.Postoperative follow-up is important and nutrient deficiencies must be addressed.
- Early complications: Patients may experience bleeding, clots, infections, abscesses, reflux, and anatomic leaks after surgery. Patients may also experience dumping syndrome, which manifests as bloating, diarrhea, and dizziness approximately one to two hours after eating.
- Insufficient weight loss: Significant weight loss is experienced with sleeve gastrectomy surgery. However, approximately 23% of patients experience inadequate weight loss, progressive weight gain, or comorbidities.
Second stage surgery may be recommended for patients with inadequate weight loss. However, only a small proportion (2.5%) of cases with inadequate weight loss require a second operation.
What are the benefits of sleeve gastrectomy?
Sleeve gastrectomy surgery can be a solution to obesity and obesity-related health problems. For this reason, the benefits of the whole stomach surgery are considerable. With the elimination of obesity, overall health is expected to improve.
- Type 2 diabetes: It is successful in the treatment of diabetes due to a decrease in HbA1c levels and an increase in insulin sensitivity after sleeve gastrectomy surgery.
Obstructive sleep apnea: After sleeve gastrectomy surgery, the sleep apnea picture improves with the improvement of respiratory disorders. Thus, sleep disorder problems are eliminated in morbidly obese people after surgery. - Cardiovascular disease: There is a relationship between morbid obesity and the coagulation system, which affects cardiovascular health. Weight loss reduces the risk of cardiovascular disease, heart attack and stroke.
- Musculoskeletal pain: Gait abnormalities, muscle and joint pain are common complaints in morbidly obese patients. After surgery, some walking difficulties and physical limitations improve, and musculoskeletal pain decreases with physical activity.
- Ovarian Diseases: Obesity is associated with gestational diabetes, pre-eclampsia, increased likelihood of cesarean delivery, and prolonged labor. After sleeve gastrectomy, menstrual cycles improve in premenopausal women. It may provide improvements in polycystic ovary syndrome that causes infertility.
In addition to surgery, adequate exercise and a healthy diet will reverse most medical conditions.
What are the risks of sleeve gastrectomy?
As with any surgery, some complications can occur with sleeve gastrectomy. As with many surgeries, complications may be seen early or late.
The incidence of bleeding after sleeve gastrectomy is 1-6%. It typically originates from the staple line, spleen, liver and abdominal wall.
After laparoscopic sleeve gastrectomy, leakage may be seen with increased pressure in the staple line. Although it manifests with high fever, palpitations and rapid breathing, it may not always cause symptoms.
Gastroesophageal reflux in sleeve gastrectomy patients is a relative complication. Although not definitive, some studies have linked the development of reflux to sleeve gastrectomy surgery.
Narrowing of the lower part of the stomach may occur after surgery. It is characterized by dysphagia, nausea and vomiting and affects about 4% of patients.
Nutritional deficiencies caused by the removal of a large portion of the stomach can be improved by careful monitoring and evaluation of clinical symptoms.
Medications and supplements must be used under the supervision of a health care professional. Taking medications and supplements indiscriminately can cause very serious health problems.
How should I eat after a sleeve gastrectomy?
After surgery, some problems may occur with the rapid passage of food into the small intestine. Nutrition after sleeve gastrectomy begins with clear liquids, called a light liquid diet, which should be consumed in the first few days. Depending on the length of hospital stay, dark liquid diet and pureed foods are consumed in the following days. Gastric sleeve is an important procedure in terms of nutrition, and some important points to consider are as follows
Food should be chewed thoroughly and eaten slowly.
Liquids should not be consumed while eating.
Liquids should be consumed slowly half an hour after eating.
Processed, sugary, fatty foods and carbonated beverages should be avoided.
After the first two or three months, you can return to a normal diet. Consult your dietician and doctor for the most appropriate diet for you.
Frequently asked questions about gastric sleeve gastrectomy
Is the sleeve gastrectomy healthy?
Gastric sleeve gastrectomy is a relatively safe and healthy procedure if the instructions are followed. It is important to improve your diet and exercise before and after the procedure.
What age group is gastric sleeve gastrectomy suitable for?
It is suitable for adults who are morbidly obese and cannot achieve a solution with diet and physical activity in cases of various medical conditions. There is no strict age limit, but bariatric surgery may be preferred for patients between the ages of 17 and 65.
How do you prepare for a sleeve gastrectomy?
Losing some weight with a diet plan before the sleeve gastrectomy will help you get through both the surgery and the postoperative period easily. You may need to start an exercise program and stop using tobacco products. Your doctor may change your medications a few days before surgery.
How long does gastric sleeve gastrectomy take?
Gastric sleeve gastrectomy takes about an hour on average. The surgery is performed through several small incisions in the abdomen using a laparoscope, an instrument with a camera. Medical instruments are inserted through additional incisions and most of the stomach is removed.
Will I regain weight after my sleeve gastrectomy?
In general, patients begin to gain weight about 12-18 months after surgery. However, how quickly and how much weight you gain depends on your eating habits, diet, and physical activity. Uncontrolled and fast eating, lack of exercise, and improper diet are largely responsible for weight gain.
Will I have scarring after sleeve gastrectomy?
Some scarring is likely to remain after sleeve gastrectomy surgery. However, most scars fade over time and become almost invisible with skin color changes.
Will my stomach grow after sleeve gastrectomy?
The stomach is flexible and can expand due to its anatomical structure. It is important to remember that the stomach can expand and return to its previous size with continued eating beyond satiation.
What is robotic sleeve gastrectomy?
This procedure is typically performed using the da Vinci robotic surgery system. During robotic gastrectomy, surgeons make small incisions and use a robotic platform to assist. Robotic surgery provides better visualization and helps reduce the length of the procedure.
What are the risks of stomach reduction surgery?
There is a possibility of infection and bleeding after surgery. In addition, leaks may rarely occur after sleeve gastrectomy surgery. Serious vitamin and mineral deficiencies can occur if the supplements and dietary regimen are not followed.
What is the price of sleeve gastrectomy?
The cost of sleeve gastrectomy varies depending on the surgeon, location, and length of hospital stay. Surgery and nutritional support also affect the price. Consult your doctor for price information before surgery.
* Contents of this page is for informational purposes only. Please consult your doctor for diagnosis and treatment. The content of this page does not include information on medicinal health care at Liv Hospital .
