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. This helps patients to eat less without hampering the normal digestive process.
This is the most popular surgical treatment in Australia now. It involves removing the outer portion of stomach and reducing its size.
Sometimes sleeve gastrectomy is carried out as a first stage of a 2-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 is obesity and what are the possible consequences of untreated obesity?
Obesity is a chronic condition in which there is an excessive accumulation of fat in the body.
Obesity is defined as a Body Mass Index (BMI) of 30 to 34.9 and extreme or morbid obesity is a BMI of 40 or more.
Obesity is a global problem affecting people of almost all age groups, and is associated with increased risk of cardiac problems, diabetes, high blood pressure, breathing difficulties, and other diseases.
What are the indications for a sleeve gastrectomy?
Sleeve gastrectomy is indicated for people with a BMI of 40 and more, and also in those whose BMI is >30 and suffering from obesity associated conditions.
The surgery is recommended when diet, exercise or medication have not helped in reducing the patients weight.
What can you expect during the sleeve gastrectomy procedure?
The procedure is performed under general anaesthesia. The surgeon makes 2 to 5small 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 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.
What are the advantages of a sleeve gastrectomy?
- Reduced stomach size makes you feel full sooner.
- Normal functions of the stomach are retained.
- Simpler than other bariatric surgeries.
- Can be performed laparoscopically
- Shorter hospitalization stay
- Less operative time
- No implant used as in lap band surgery.
- Minimal post-operative pain and discomfort.
- Shorter recovery time
What are the disadvantages of a sleeve gastrectomy?
- Intermediate in complexity, more complex then band but less complex then bypass
- Surgery can be defeated by high consumption of calorie rich liquids
- Exposure to surgical risks twice in the case of 2-stage procedures
What post-operative care is necessary following a 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 a low-fat content.
- Your dietitian will tailor a new diet regimen for you to follow.
What are the risks and complications associated with a sleeve gastrectomy?
As with any surgery there are potential risks and complications involved. The risks include blood loss, infections, problems associated with anaesthesia, and deep vein thrombosis (blood clot in the leg).
The major complication following sleeve gastrectomy surgery is occasional leakage or breakdown of the gastric contents from the staple line that secures the divided stomach.