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Sleeve gastrectomy, also known as gastric sleeve surgery, is a procedure that reduces the stomach size to help with weight loss. About 75-80% of the stomach is removed, leaving a tube-shaped stomach. This limits food intake and promotes a feeling of fullness quickly.
It’s considered when diet and exercise haven’t worked, or serious health issues due to weight have arisen. Sleeve gastrectomy surgery might be suitable for you if:
Your BMI is 40 or more (extreme obesity).
Your BMI is 35-39.9 (obesity), and you have a serious weight-related health issue like type 2 diabetes, high blood pressure, or severe sleep apnea.
In some cases, if your BMI is 30-34 and you have serious weight-related health problems.
The surgery achieves weight loss by restricting food intake due to the smaller stomach and reducing appetite by removing the part of the stomach that produces certain hunger-stimulating hormones.
This surgery is typically done using a method called laparoscopic (keyhole) surgery. The doctor makes five or six small cuts in your belly and uses a special camera, called a laparoscope, and long tools to do the surgery through these small cuts. During the surgery, the doctor reshapes your stomach into a long, thin pouch, or “sleeve,” and takes out the rest of your stomach. This surgery doesn’t involve removing or bypassing any part of your intestines. The operation usually takes about one and half hours and is done under general anaesthesia, which means you will be asleep through the procedure.
You can expect to lose roughly 50-70% of your excess weight over 2 years.
It can help with full recovery (remission) of type 2 diabetes.
The surgery is less complex, has fewer complications, and doesn’t take a lot of time.
You’re less likely to experience a complication called “dumping syndrome,” which can make you feel weak, dizzy, or nauseous after eating. Dumping syndrome results from rapid emptying of the stomach in individuals who have had part of the stomach removed.
The surgery can cause changes in your gut hormones that help control hunger and reduce your appetite.
It is not reversible.
15% of people will have inadequate weight loss following the operation.
There is a risk of weight re-gain by stretching of the stomach sleeve if portion sizes are not strictly controlled
Has the potential for long-term vitamin deficiencies
Incision site pain or swelling: After the surgery, you might have pain, swelling or bruising around the area where the operation was done. This is normal and should go away after a few days.
Anesthesia Reactions: Some people may have adverse reactions to anesthesia.
Vomiting: Some people may experience vomiting post-surgery which may resolve with appropriate treatment
Stomach Leak: Sometimes, there can be a leak from the part of the stomach that was stapled. This may cause a serious infection and needs surgery. Signs of this include a fast heartbeat, fever, chest pain, and belly pain.
Bleeding: Some people might have bleeding from the operation site or from damage to other organs. If this happens, you might need another procedure to stop the bleeding.
Infection: There’s a risk of infection at the surgical site.
Long term complications may include:
Reflux or Heartburn: You might have heartburn because your stomach is smaller and makes more acid. Medicine can help with this, and it usually gets better after the first 2 years.
Gallstones: Rapid weight loss can sometimes cause gallstones.
Failure to lose weight: About 15% of people might not lose enough weight or may regain weight. This can happen if the stomach sleeve stretches over time, allowing you to eat larger meals.
Malnutrition: There’s a risk of malnutrition if dietary guidelines aren’t followed.
After surgery, you’ll be watched in a recovery area for a few hours. A drip will provide fluids until you can drink enough on your own. You’ll likely go home 2-3 days post-surgery, with full recovery taking 4-6 weeks.
Hydration: Sip liquids often to avoid dehydration.
Bowel Movements: Constipation is normal in the first week and resolves afterwards. Bowel movements may initially be difficult or painful, but will get better with time.
Medication: Take pain medication as needed. You may get a prescription to decrease stomach acidity.
Movement: Get up and move as soon as possible to reduce the risk of blood clots.
Exercise and Activity: Start with gentle exercise like walking, then gradually increase intensity. Walk often to facilitate healing, but avoid heavy lifting for 2-4 weeks.
Fatigue: You may feel tired for a month due to lower calorie intake.
Bathing: Avoid baths and hot tubs for 3 weeks, but showers are fine.
Work: You can return to work in 2-4 weeks, depending on the physicality of your job.
Weight Loss: Weight loss depends on diet, exercise, lifestyle, and commitment. With dedication, most people lose about 60% of excess weight over 2 years.
You can consult your surgeon if you experience any of the following symptoms: Fever over 39 degrees centigrade with shaking or the chills, pain that increases over time, redness, warmth or pus draining from incision sites, persistent nausea and inability to swallow liquids.
Pre-operative diet: Starting 1week before surgery, you’ll follow a diet to shrink your liver for safer surgical access to the stomach. This diet is low in fat, carbs, and sugars. It is recommended to eat more lean proteins, less carbs like bread and pasta, and avoid sugars and high-calorie drinks. Two days before surgery, it is recommended that you switch to a strict clear liquid diet.
Post-operative diet: With a small stomach, it’s utterly important that the food you do eat is nutrient dense. This means you should be eating foods like vegetables, lean protein sources and whole grains. You will follow a post-operative diet
Day 1: Clear liquids only, such as water, decaffeinated tea, sugar-free beverages that are not carbonated and broth. Avoid carbonated, highly sweetened beverages, or caffeinated drinks.
Day2 to Week 1: Full liquid diet with protein, such as protein powder, sugar-free pudding, soup with soft noodles, non-fat yogurt, thin creamed soups, oatmeal, diluted fresh juice, or sugar-free non-fat ice cream.
Week 2: Add soft pureed foods. Introduce new foods slowly to identify any that cause discomfort. Foods may include cereals, cheese, pureed chicken, beef, fish, eggs or vegetables. Avoid sugary or starchy foods
Week 6 and beyond: Introduce solid foods one by one as tolerated. Eat three small meals daily, hydrate throughout the day, stop drinking fluids 30 minutes before each meal, avoid snacking and if you do, choose a nutrient-dense food (fruit, vegetable, nuts), take your recommended daily vitamins, ensure you get 60 grams of protein, supplement daily with a protein shake, incorporate exercise into your daily routine and avoid sodas.
Healthy Eating: Choose nutrient-rich foods, avoid sugary drinks, chew thoroughly, eat slowly, plan meals when going out, ask for half portions at restaurants, and drink water regularly but not with meals.
Vitamins & Supplements: Take a daily multivitamin and mineral supplements for the first year post- surgery. Supplements don’t replace a balanced diet. Multivitamins, iron, protein, calcium citrate and Vitamin B12 may be recommended.
Stomach Stretching: Your stomach can stretch post-surgery. To reduce this risk, drink water an hour before and after meals, don’t eat and drink simultaneously, avoid carbonated drinks, eat small healthy snacks between meals, and focus on small portions of nutrient-dense foods.
Weight Plateaus: You may hit a weight plateau about 6 months post-surgery. Overcome this by reducing carbs, increasing protein, changing your exercise routine, managing stress to curb cravings, and adding small healthy snacks between meals.