Sleeve Gastrectomy

Sleeve gastrectomy, also called a vertical sleeve gastrectomy, is a surgical weight-loss procedure. This procedure is typically performed laparoscopically, which involves inserting small instruments through multiple small incisions in the upper abdomen. During sleeve gastrectomy, about 80% of the stomach is removed, leaving a tube-shaped stomach about the size and shape of a banana.

Sleeve gastrectomy surgery could be an option for you if:

• Your body mass index (BMI) is 40 or higher (extreme obesity).
• Your BMI is 35 to 39.9 (obesity), and you have a serious weight-related health problem, such as type 2 diabetes, high blood pressure or severe sleep apnea. In some cases, you may qualify for certain types of weight-loss surgery if your BMI is 30 to 34 and you have serious weight-related health problems.

Gastric Sleeve Surgery brings profound changes to life!

• Overall improved quality of life
• Excess weight loss of about 60-70% within one year of surgery
• Remission or improvement of obesity related health conditions such as diabetes mellitus type II, hypertension, sleep apnea, fatty liver disease, joint pain, and hyperlipidemia
• Desire to eat decreases
• Reduction in hunger sensation

How Gastric Sleeve surgery is performed ?

• 5 Small incisions ( 1-3cm)  are made in the abdominal wall for the insertion of small trocars
• The stomach is inspected and the blood vessels to the lateral side of stomach are divided
• A Bougie tube is inserted into the stomach and serves as a sizer for the new stomach
• A special device called stapler is used to divide the stomach into two parts
• The stomach is completely divided into two parts
• The new banana shaped stomach has about 20-25% of original stomach volume

How does the Gastric Sleeve surgery work?

• There is a reduction in stomach volume, causing people to feel full much quicker after the surgery.
• Reduced secretion of hunger hormone ( ghrelin ) cause people to feel less hungry
• Increased stomach motility, which allows food to pass stomach and intestine quicker after surgery

How much weight will I lose after the Gastric Sleeve?

Sleeve gastrectomy is a restrictive type of obesity surgery. There is no decrease in calorie absorbtion. For that reason, if  high -calorie foods are consumed weight loss gradually decrease and even in some cases weight gain occurs.

There is no  surgery that will be successful  without absolute commitment and participation of the patient !!!

• On average, people lose about 60-70% of their excess weight
  • The first 2 weeks: 10-20 pounds; most patients lose about one pound a day
  • The first 3 months: 35-45% of excess weight loss
  • The first 6 months: 50-60% of excess weight loss The first year: 60-70% of excess weight loss
• Most people reach their lowest weight 12-24 months after surgery
• The Gastric Sleeve success rate is approximately 80-90%

Recovery after Surgery

• The surgery takes approximately 40-70 minutes
• Discharge from hospital typically occurs usually after 2/3  nights
• All patients are encouraged to walk as early as 4-6  hours after surgery
• In general, the pain is easily manageable after surgery. Most patients take less than the recommended pain medication
• Most patients go back to work and/or school after 2-4 weeks. Fatigue is common the first 2 weeks due to low calorie intake from liquid diet. However, the majority of patients do not feel hungry during this stage of the diet. The energy level improves quickly after the introduction of the soft diet, which is approximately 2 weeks after surgery.
• Patients can begin exercising 4 weeks after surgery

Diet after Gastric Sleeve Surgery

• Day 2-14: Clear liquids without sugar, caffeine, carbonate and particles are allowed.30-60ml liquid is drunk in one-hour intervals, the targeted daily total intake is 1500-2000ml.
  Between 3rd and 14th days
• Day 15-30:  Soft food diet

Patients can begin introducing regular food 4 weeks after surgery

• They are encouraged to eat a small amount of food each time and have meals that are more frequent.
• All patients must take multi-vitamin and B complex after surgery

Advantage of Gastric Sleeve versus Gastric Bypass Surgery

• Technically, the Gastric Sleeve is a much simpler surgery. The operating time for gastric sleeve is usually 40-70 minutes, while gastric bypass surgery takes approximately 2-3 hours to complete.
• There is a much lower chance for nutrient or vitamin deficiency with the Gastric Sleeve procedure. In addition, there is no malabsorption for Gastric Sleeve patients.
• Some long-term complications could occur with the Gastric Bypass patients including bowel obstruction, marginal ulcer, and internal hernias. The chance of Gastric Sleeve patients developing these complications is exceedingly rare.

Complications and Risks

Over the past decade, with the improvement of surgical techniques and surgeons’ experience, the gastric sleeve has become an overall safe bariatric surgical procedure. However, complications can still occur during and after surgery. Below are the main complications and risks of the gastric sleeve surgery:

• • Leakage from the staple line – this is a rare complication of the gastric sleeve surgery. The stable line opens after surgery. Most leaks can be treated with endoscopic procedures.
  • Stricture/stenosis – another rare complication with narrowing of the stomach after sleeve gastrectomy. Most stricture/stenosis can be treated with endoscopic dilation.
  • Bleeding
  • Blood Clot
  • Heart Burn (reflux) – This is a very controversial topic in bariatric surgery and the data from different centers is inconsistent. In our experience, most patients with heartburn before surgery see improvement of symptoms after surgery due to weight loss. Some patients may develop new heartburn, which is treatable with over-the-counter anti-acid medications, in most cases.
  • Nutrient or vitamin deficiency
  • Weight Regain – After 1-2 years, slight weight regain is common among all bariatric procedures and about 10-20% of patients can have significant weight regain after gastric sleeve surgery. After 5 years of follow up, many centers collected data to show that the majority of patients can maintain their weight loss after the Gastric Sleeve Surgery.