GASTRIC SLEEVE

Gastric Sleeve Surgery

Restrictive weight loss surgeries such as a Laparoscopic Vertical Gastric Sleeve, which decreases the size of the stomach, help people lose their excess weight and recover their health. With a smaller stomach, you will feel full a lot quicker than you are used to. This means that you will need to make big lifelong changes in how you eat, including smaller portion sizes and different food in order to lose weight.

This surgery can be done by making several small incisions and using small instruments and a camera to guide the surgery (laparoscopic approach). More than half of your stomach is removed, leaving a thin vertical sleeve, or tube, that is about the size of a banana. Surgical staples keep your new stomach closed. Because part of your stomach has been removed, this is not reversible.

Sometimes this surgery is part of a larger approach to weight loss done in several steps.

The surgery lasts approximately one hour and you need to stay at the hospital for 48 hours, with antibiotics, pain killers and IV fluids.

A barium swallow test must be performed before you are discharged from the hospital. This test is designed to check that there are no leaks in your stomach; all you need to do is drink a special blue tinted liquid.

Who is a Good Candidate for Gastric Sleeve Surgery?

No reliable statistics exist yet for how many of these procedures have been done. The current scientific literature supports use of sleeve gastrectomy as a primary bariatric procedure. This means that the indications for the sleeve are the same as other covered procedures such as gastric bypass or adjustable gastric banding. The National Institutes of Health (NIH) requires a body mass index (BMI) greater than 40. This is the equivalent of being about 100 pounds overweight for men and 80 pounds overweight for women.

People with a BMI between 35 and 39 may also be candidates for weight loss surgery if they have obesity-related illnesses such as diabetes, high blood pressure or high cholesterol. A BMI takes height and weight into account to measure body fatness. A BMI of 30 or higher in adults is considered obese.

Gastric Sleeve Surgery also may be appropriate for people who can’t return as often for the follow-up visits required by gastric banding procedures such as Lap Band surgery or Realize Band surgery.

What to Expect after Gastric Sleeve Surgery

A non-reversible procedure, gastric sleeve surgery is performed under general anesthesia and takes about one to two hours. Afterward you will probably stay in the hospital for one or two days; recovery from gastric sleeve surgery may last a few weeks.

The abdomen is often swollen and sore for several days. Your surgeon may prescribe pain medication for the discomfort. Some scarring may occur, but this can be covered with clothing.

Following surgery, you will need to become re-accustomed to eating solid foods. Normally this starts with two weeks on a liquid-only diet, two weeks of semi-solid, pureed foods and then solids.

As far as weight loss goes, most people who have gastric sleeve surgery lose 50 to 80 percent of their excess body weight over the first six months to one year after surgery. Studies have shown that after the gastric sleeve resection procedure people show improvement in diabetes, high blood pressure, high cholesterol and sleep apnea within one to two years. These improvements are comparable with those seen after other weight loss surgeries.

As this is a relatively new procedure, limited data is available on long-term weight loss (beyond five years after surgery) or overall health improvements. Following recovery, certain lifestyle changes and follow-up care occur. People who have gastric sleeve surgery must:

Exercise regularly.

• Learn behavior modification techniques.
• Follow very specific dietary instructions for the rest of their lives, including eating very slowly, consuming only small quantities of food at a time, chewing thoroughly and swallowing food only when it is mashed, and not eating and drinking at the same time.

Gastric Sleeve Surgery Risks and Complications

There are several risks and complications of gastric sleeve surgery:

• Leaking of the sleeve. The operation requires stapling inside the stomach, and there is always a chance that the staples won’t hold, resulting in a leak. The leaking stomach acids frequently lead to infection of surrounding tissues and other serious problems that may require another operation or a drainage tube.
• Blood clots.
• Weight may be regained over time, because the stomach can stretch.

Since this procedure is relatively new, long-term risks and benefits are not known. However, it does have several advantages over gastric banding and other surgical procedures. For example:

• Wound infection.
• Unlike gastric banding surgeries, no foreign objects are left in the body during the procedure. With gastric banding, the band may slip, erode or become infected.
• Unlike gastric bypass or duodenal switch, there is no bypass of the small intestines with the gastric sleeve, so all nutrients are absorbed and very little chance exists of absorption issues.
• DIET AFTER SLEEVE There are four major nutrition goals to follow after surgery. They include consuming the right amount of protein that will help minimize the loss of lean body mass and help healing. Patients should also learn how to eat properly, which will help them with their long-term weight loss goals. Weight loss should occur in a safe and healthy way. Next, always consume enough fluids to maintain hydration. Lastly, consume the proper nutrients through vitamins and mineral supplements throughout the day.
• Most patients will take an acid-blocking medication for at least 12 weeks following surgery, which helps reduce the risk of ulcers. A multivitamin, calcium citrate tablets, Vitamin B12 and other vitamins may also be recommended.

Plastic Surgery after Massive Weight Loss

Although the full extent of weight loss may not occur until after a second procedure has been performed, such as gastric bypass, it is important to know that plastic surgery after massive weight loss may be necessary to remove excess skin and fat and create a more shapely body profile. Arm lift surgery and body lift are common post-bariatric procedures.