Sleeve Gastrectomy

Sleeve gastrectomy, also called a vertical sleeve gastrectomy, is a well known and most popular surgical weight-loss procedure. This procedure is typically performed laparoscopically using surgical devices called “staplers”.Laparoscopy is a minimal invasive surgery using an endoscope pass through the abdomen. Minimal invasive surgery means less risk to the patient.

Sleeve gastrectomy, also called a vertical sleeve gastrectomy, is a surgical weight-loss procedure. This procedure as mentioned above is performed laparoscopically through several small abdominal incisions.

Vertical sleeve gastrectomy is a procedure thet reduces stomach size via partial gastrectomy that preserves the lesser curve and pylorus. The patient’s stomach is removed about 75-80 percent of its original size resulting in a sleeve or a tube-like structure like a banana reducing the volume of the stomach to 150-200 ml, consequently limiting food intake. Although sleeve gastrectomy appears to be a purely restrictive procedure, its mechanism of action is more complex. As a result small size of stomach after the surgery causes patients to feel satiated sooner and reduces the secretion of ghrelin also called hunger inducing(orexigenic) hormone. Thus, the patient does not feel hungry, and he/she gets full so quickly because of the reduced size of stomach.

The patients lose about 80 % of the excess body weight in the first year after sleeve gastrectomy. However, the stomach volume may increase in the following years.

There is the risk of not being able to lose adequate amount of weight and even regain weight when diet and exercise rules and bariatric eating habits are broken and former bad habits such as sweet tooth and binge eating are resumed because of the interruption of psychiatric treatment. That’s why the patients undergoing sleeve gastrectomy should be followed-up closely as recommended by bariatric team

Diet after sleeve gastrectomy:

Patients will have a special diet after gastric sleeve operation. This type of diet will be prepared and followed up by our dietitians and the patient will has to obey the rules for 3 weeks. Then, it is followed by mash food period, allowing the patient to eat pureed meals after 3rd week and then to start eating solid foods after 4th week. Patients can have their normal dieting after 4th week but have to eat small amounts of food because of the reduced size of stomach.

Some advantages of sleeve gastrectomy are listed below:

• Less postoperative pain
• Less blood loss and scarring
• Reduce patient risks and accelerates recovery
• Not change the natural anatomy of the digestive system, thus does not lead to mineral or vitamin deficiencies,digestion and absorption functions continue normally after sleeve gastrectomy.
• Not cause Dumping syndrome
• No foreign body in the abdominal cavity such as adjustable gastric band

Some disadvantages of sleeve gastrectomy are listed below:

Risk of bleeding (0,1%) and leakage (0,1%) according to relatively longer staple line and high intraluminal pressure due to lack of anastomosis between the stomach and small bowel.

Am I eligible candidate for obesity surgery?

You are eligible candidate for obesity surgery;

• If body mass index is over 35 with significant health problems due to obesity related conditions, such as hypertension or type 2 diabetes;
• Failed weight loss attempts with diet and exercise;
• Between 12 and 70 years of age
• If body mass index is 40 or more.

Is postoperative course painful after sleeve gastrectomy?

There is no serious pain occurs after the surgery because of minimal invasive-laparoscopic surgery. Strong painkillers are given to the patient in the early postoperative period especially first 6 hours.

The patients are able to walk 4-6 hours after the surgery.

Will there be any scars after sleeve gastrectomy?

Since the operation is performed using a closed method, only very small incision marks will be present in the abdominal region after the intervention. These marks will become completely invisible in a few months.

How much weight loss is expected after gastric sleeve surgery?

Expected weight loss is 80% of excess body weight during the 2 years after the surgery. Too many morbidly obese patients lose their excess weight with gastric sleeve surgeries and have never weight regain. But laparoscopic revisional surgery such as by-pass surgery can be performed if failed weight loss after gastric sleeve surgery. Carefully selected patients undergoing revision for weight regain have satisfactory additional weight loss.

Is it possible that the patient will regain weight and return to previous body weight after gastric sleeve surgery?

The risk of weight regain is very low if the patients obey the rules after the gastric sleeve surgery.

Will I have to lose weight before the surgery?

You don’t have to follow a special diet program before the surgery if your body mass index below 60. You don’t have to eat solids only one day before the surgery.

Some details about the procedure:

• Lenght of operation is about 1 hour.
• Postoperative length of hospital stay is around 2-3 days after being follow-up. The length of hospital stay varies from one patient to the other.
• Recovery time: 1-2 weeks.
• Leak test during the procedure: Yes
• When sleeve gastrectomy is unsuitable for me? Uncontrolled Type 2 Diabetes esp requires insulin use; Crohn disease; Barret’s esophagus according to the reflux disease; below 12 and above 75 years of age.

How Is The Follow-Up Process After Sleeve Gastrectomy?

The success rate after gastric sleeve surgery increases depending on strict postoperative controls and observations. Therefore, your first visit will be done 7 days after surgery for early complications.

Your routine controls will be done in the 1st-3rd-6th-12th-18th-24th-36th-48th-60th
postoperative months. Fasting blood sugar and insulin levels, liver enzymes, vitamins and mineral levels as well as renal functions will be checked through blood tests. Supportive treatments will be started if any deficiencies found. Our dietitian will also follow up your body composition.

If you have severe metabolic conditions such as uncontrolled diabetes, your follow up will be done by our endocrinologist. You can send your test results if you are living abroad via whatsapp and face-to-face communication with our team with video conferences.