Obesity is a debilitating disease which is associated with lifestyle habits such as junk food consumption, lack of adequate sleep, sedentary lifestyle, alcohol consumption and smoking. Diet control and regular exercise is the most appropriate way of losing additional weight to keep oneself fit. But in individuals who are severely obese, having a BMI (body mass index) of 40 and above who are not able to lose weight with diet and lifestyle modification only, bariatric or gastric surgeries are recommended. Sleeve gastrectomy is one such surgical procedure in which the size of the stomach is surgically reduced to that of a banana to reduce the appetite and hence controlling excess weight. Sleeve gastrectomy is a bariatric or surgical weight-loss procedure in which the stomach is decreased to around 15% of its original size. This is achieved by surgical removal of a major portion of the stomach along the greater curvature. The final result is a sleeve or tube like structure. This procedure permanently decreases the size of the stomach, although later the stomach could dilate again. The procedure is by and large performed laparoscopically and what is important to note is that it is irreversible.
When is sleeve gastrectomy indicated ?
Sleeve Gastrectomy is indicated in individuals who are morbidly obese and other treatments like lifestyle modification and exercise have proven unsuccessful. If you are about 50 kg or more overweight , if your BMI is above 40 or if your BMI is in the range of 30-35 but you have other pathological conditions like diabetes, hypertension and obstructive sleep apnea it is advisable to consult a physician or a gastric surgeon for further treatment planning.
What are the types of sleeve gastrectomy surgeries ?
- Vertical sleeve gastrectomy : A part of the stomach is removed vertically to create a sleeve like structure. The principle behind a sleeve gastrectomy is reduction in the size of the stomach which in turn reduces the overall appetite.
- Laparoscopic sleeve gastrectomy : Here a Laparoscope (a specialized instrument resembling a telescope to view the abdomen) is used to perform the procedure.
How do you prepare for a sleeve gastrectomy surgery ?
The consulting bariatric surgeon usually conducts an overall physical examination along with a BMI evaluation. The consultant will also analyze the overall benefits of a sleeve gastrectomy before suggesting the same as the further treatment plan. The bariatric surgeon will also explain the risks and benefits of the sleeve gastrectomy procedure. The consulting bariatric surgeon might advise you a diet modification including reduction in sugar intake, low-carbohydrate diet, no alcohol and smoking which usually helps in reduction of the size of the liver and post operative complications as well and helps in faster recovery.
How does sleeve gastrectomy surgery work ?
This procedure works by two mechanisms. Firstly, the new banana-shaped stomach pouch is far smaller in size, thus holding a smaller volume of food and helps to reduce the food (or calories) that can be consumed. The greater impact of the surgery, however, is on the gut hormones that impact hunger, satiety (feeling of fullness) and blood sugar control.
Sleeve gastrectomy is a surgical procedure which is based on the principle of reduction of the size of the stomach so that it reduces the amount of food it can hold thereby reducing the appetite. In the conventional sleeve gastrectomy after the administration of anesthesia the surgeon makes 4-5 incisions on the stomach and the left part of the stomach is excised and the remaining part is sutured. This procedure does not require any bypass in the intestine.
In the laparoscopic sleeve gastrectomy procedure the incisions are much smaller and a laparoscope is used to excise the stomach and staple the remaining part.
Does sleeve gastrectomy surgery require administration of anesthesia?
The anesthetist will administer general anesthesia before the start of the procedure.
How does sleeve gastrectomy surgery differ from gastric bypass surgery ?
In gastric bypass surgery, the surgeon makes a small pouch that skips the majority of your stomach and small intestine going straight to the large intestine. However, in gastric sleeve surgery, only the anatomy of the stomach is altered. This is best for people who have a very high BMI (body mass index) of at least 40. That in figures, means when you are 100 pounds or more over your ideal range of weight. It is a good option for people who are too heavy for gastric bypass surgery.
What are the advantages of sleeve gastrectomy surgery over gastric bypass surgery ?
- Stomach volume is reduced/restricts the food holding capacity of the stomach
- Rapid and significant weight loss
- Requires no foreign objects like a band to be banded around the stomach
- Does not bypass or re-route the food stream as in gastric bypass
- Shorter hospital stay
- Causes favorable changes in gut hormones that suppress hunger, reduce appetite, improve satiety and patient experiences decreased hunger anger and appetite
- It is a far simpler operation due to the fact that it does not entail rerouting or reconnection of the intestines to the stomach.
What happens during a sleeve gastrectomy surgery ?
The patient is initially shifted to a post operative care unit. A catheter is used for drainage of urine. If a nasogastric tube is inserted it might be removed on the second day of the surgery. X-ray is done to check the healing of the staples and stitches. If the X-rays seem fine you can start taking liquids and fruit juices. Medication for pain and other medications are usually administered intravenously. The length of the stay in the hospital depend usually rages from 4-7 days and is also dependent on the type of surgery and patients condition. In cases of a laparoscopic sleeve gastrectomy procedure the length of the stay in the hospital is reduced. The consulting bariatric surgeon and the nurse will give you at home instructions for the appropriate care of the surgical site and suggest you a date for follow up.
What is the care to be taken after a sleeve gastrectomy surgery ?
Sleeve gastrectomy surgery is a tool to help you lose weight to live a healthier and more productive life. Success requires a dedicated change in eating habits, lifestyle changes and exercise after the surgery in order to achieve the aim of the surgery. A lot of medications have to be taken after the procedure. These include some for a few months after surgery, whilst others you have to take for life. Acid reduction medication or “proton pump inhibitors” (PPIs) have to be taken to prevent gastric ulcers. You will need to take multivitamins, calcium, Vitamin D and B12. You will be able to return to work after a period of two to four weeks. Regular follow-up is advised with your doctor.
A dietician or nutritionist will mostly prepare a customized diet chart as per your requirements. Lifestyle modifications are required after a gastric sleevectomy procedure to help in losing excess weight. Diet control and cessation of habits like alcohol drinking and smoking are strongly suggested. The consulting doctor might even advise you to restrict the meal portion and drink more amount of water. Apart from routine follow-ups it is also essential to check for any nutritional deficiency.
The common risks include bleeding, infection at the surgical site or complications related to anesthesia. Rare risks could be leakage of gastric contents.
The chances of malabsorption and complications like damage to bowel and bladder, vomiting, nausea and diarrhea are greatly reduced.
Sleeve gastrectomy and laparoscopic sleeve gastrectomy is a fairly recent development in the field of bariatric surgery but the results related to loss of weight post- procedure are well documented in literature. It is essential to consult a specialist bariatric surgeon for appropriate treatment planning as per individual’s requirement. The success of the sleeve gastrectomy surgery is based on the choice of appropriate treatment and lifestyle modification.
How to find and reach bariatric surgeons for sleeve gastrectomy surgery ?
Now you can find and reach bariatric surgeons from different hospitals and destinations on a single platform, Hinfoways. You can avail opinions and information from multiple bariatric surgeons, get approximate cost of sleeve gastrectomy surgery from various hospitals, compare things and then choose a bariatric surgeon for sleeve gastrectomy surgery.
Find, reach and choose a bariatric surgeon for sleeve gastrectomy surgery on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
