Gastric Sleeve

What is Sleeve Gastrectomy?

Sleeve gastrectomy also referred to as vertical sleeve, gastric sleeve or tube gastrectomy is a surgical procedure performed for the treatment of obesity. The procedure is a restrictive bariatric surgery to treat extremely obese patients with a high BMI. It encourages weight loss by restricting the stomach size, so it holds only a limited amount of food. This helps patients to eat less without hampering the normal digestive process.

Sometimes sleeve gastrectomy is carried out as the first stage of a two-stage operation in extremely obese patients with a BMI of 60 or more. This is done to achieve a considerable amount of weight loss, so it is safer for the patient to undergo a second bariatric surgery if needed.

What Happens During a Laparoscopic Sleeve Gastrectomy Procedure?

The procedure is performed under general anaesthesia. The surgeon makes up to 5 small incisions on your abdomen. A laparoscope, a thin instrument with a light and camera attached, is inserted through one incision, allowing your surgeon to clearly view the internal organs on a monitor.

Additional surgical instruments are inserted through the other incisions. Your surgeon will remove nearly 75-80% of the stomach. A thin sleeve shaped stomach looks like a banana is created by stapling the remaining part of the stomach. At the end of the procedure, the incisions are closed with sutures. The entire procedure takes about 60 to 90 minutes to complete.

Advantages of Sleeve Gastrectomy Surgery

Reduced stomach volume increases the feeling of fullness
Stomach functions normally allowing most foods to be eaten, just in smaller amounts
Stomach portion that produces a hunger-stimulating hormone (Ghrelin) is removed.
Unlikely to have dumping syndrome due to the pyloric portion of the stomach is left intact
No intestinal bypass and its associated risks
Can be performed laparoscopically
Simpler procedure than gastric bypass
Safer first stage procedure of two-stage surgery for super morbidly obese
Shorteroperative time than gastic bypass surgeries
Shorterhospital stay than gastric bypass surgeries
No foreign bodies used such as in gastric band surgery

Disadvantages of Sleeve Gastrectomy Surgery

Irreversible
Can lead to new reflux symptoms
Potential for dilation of the sleevedstomach leading to weight regain

Post-operative Care after Sleeve Gastrectomy

Your doctor will prescribe pain-relieving medications to keep you comfortable following the procedure.
You will be advised to take medication to reduce the amount of acid produced by your stomach.
Avoid strenuous exercises and lifting heavy weights until approved by your surgeon
For the first month after the procedure, eat only small amounts of soft foods
Sip water throughout the day to prevent dehydration.
Eat a highly nutritious diet rich in proteins with low-fat content.
Your dietitian will tailor a new diet regimen for you to follow.

Risks and Complications after Sleeve Gastrectomy

As with any surgery, there are potential risks involved. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages. It is important that you are informed of these risks before the surgery takes place. Most patients do not have complications after sleeve gastrectomy surgery; however, complications can occur and depend on the patient's health status.

Complications can be medical (general) or specific to sleeve gastrectomy.

Medical complications include those of the anaesthesia and your general wellbeing. Almost any medical condition can occur, so this list is not complete. Complications include:

Allergic reaction to medications
Blood loss requiring transfusion with its low risk of disease transmission
Heart attack, strokes, kidney failure, pneumonia, bladder infections
Complications from anaesthesia
Serious medical problems can lead to ongoing health concerns, prolonged hospitalization, or rarely death.

Specific complications for sleeve gastrectomy surgery include:
- DVT (blood clot in the deep leg veins)
- Damage to adjacent organs
- Leakage of digestive contents from the staple line can lead to serious infection