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Gastric Sleeve Surgery- Types, Indications, and Procedure

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Gastric sleeve is a surgical method of weight loss. It is advised in cases of severe obesity. The article explains the procedure in detail.

Medically reviewed by

Dr. Pandian. P

Published At November 8, 2022
Reviewed AtFebruary 27, 2024

Introduction:

A gastric sleeve is a type of surgery performed to lose weight. Weight loss surgery is also known as bariatric surgery. This surgery is called vertical sleeve gastrectomy (VSG) or sleeve gastrectomy. The surgery's main aim is to restrict food intake, leading to weight loss. The person may lose 50 to 90 pounds.

What Is the Need for Gastric Sleeve Surgery?

Gastric sleeve surgery is used to treat severe obesity. People who have tried other weight loss methods with no long-term success are the ones who are advised gastric sleeve surgery. It is advised by the doctor to get gastric sleeve surgery only in individuals above 40 BMI (basal mass index). Gastric sleeve surgery is suggested in cases of high blood pressure, heart disease, type-2 diabetes, or sleep apnea associated with BMI between 35 to 40.

What Is Overweight or Obesity?

A person's weight more than the considered normal weight for a given height is known as overweight or obesity. Body mass index is used to measure the weight of an individual. Some basic causes of obesity are genetics, quantity and quality of food intake and drinks consumed, the intensity of physical activity, sleeping habits, and some medical conditions.

What Are Different Types of Weight Loss Surgery?

  • Gastric Sleeve: A vertical sleeve is made in the stomach by removing a part of the stomach.

  • Gastric Bypass: In this technique, the stomach is cut into two segments, upper one small pouch and lower one remnant pouch, and then the intestine is adjusted and attached to both parts.

  • Adjustable Gastric Band: In this technique, an adjustable gastric band is put around the stomach laparoscopically, this makes a small pouch in the stomach, and food intake is reduced.

  • Bleeding, blood clots, and infection are the basic possible side effects that can occur after the surgery.

  • There might be breathing complications due to general anesthesia.

  • Over a period of time, there might be some difficulty in absorbing some nutrients.

  • Formation of strictures (narrowing of the wall) in the stomach sleeve.

  • In some cases, there can be moderate to severe reflux after the surgery. In cases with a history of acid reflux, gastric sleeve surgery can worsen the situation. Gastric bypass surgery may be needed to stop the reflux and heartburn.

How to Get Ready for Gastric Sleeve Surgery?

  • It is very important that the individual undergoing surgery maintains a lifelong change in diet, does regular exercise and workout, and does not abuse medicines and alcohol consumption.

  • Before undergoing surgery, the person has to enroll in a bariatric surgery education program. This program helps the patient prepare for surgery and life after the surgery.

  • Physical examination and tests are performed, including blood tests and imaging tests of the stomach before the surgery.

  • If the patient has a history of smoking, it should be stopped completely several months before the surgery.

  • The patient is asked to lose some weight before the surgery, which helps to make the liver smaller and the surgery safer.

  • Blood-thinning medicines such as Ibuprofen or Aspirin have to be stopped a few days before the surgery.

  • Fasting of 6 to 12 hours should be done till the time of surgery.

How Is Gastric Sleeve Surgery Performed?

  • The anesthesiologist administers the patient general anesthesia for the surgery. This causes the patient to sleep during the entire surgery.

  • The technique used is laparoscopy. The doctor makes several incisions in the upper abdomen and inserts a laparoscope, and puts small surgery instruments inside through the incisions.

  • The anesthesiologist then passes a sizing tube from the mouth into the stomach.

  • The surgeon then uses a laparoscopic stapler to divide the stomach, leaving a vertical narrowed sleeve. The part of the stomach which was removed is taken out through the incision.

  • After this, leaks are tested in the sleeve using a dye or upper abdomen endoscopy.

  • At last, the laparoscope is removed, and all the incisions are sutured back.

What Happens Post Gastric Sleeve Surgery?

  • The patient is generally discharged one day after the surgery.

  • The patient is instructed to follow a liquid diet for the first two weeks after the surgery.

  • Gradually moving from liquid food to pureed food, then soft food, and then at last to regular food is advised.

  • The quantity of meal should be very small and chewed properly and slowly. Sudden shifts to regular food can give rise to pain and vomiting.

  • Even after the healing, eating habits need to be small quantity meals only, as the size of the stomach has reduced.

  • Patients who underwent gastric sleeve surgery may suffer from vitamin and mineral deficiency due to impaired nutritional absorption. Thus vitamin and mineral supplements should be prescribed to the patients.

  • Regular blood tests are advised every few months after the surgery. This helps to check on high blood glucose, anemia, or low calcium or vitamin D levels.

  • There are chances of gaining some weight back after losing it due to surgery. So it is important to follow a healthy diet and regular exercise.

  • The sleeve may dilate over time, which can lead to excess eating and gaining weight. So it is important to control the food intake and maintain a diet.

Conclusion:

Gastric sleeve surgery is done to lose weight. It is also known as bariatric surgery. Gastric sleeve surgery is suggested in people with a basal metabolic index of more than 40 who could not lose weight with other alternating methods. Obese patients with high blood pressure, diabetes, or sleep apnea also suggest gastric sleeve surgery. Maintaining a proper diet and following all the instructions during and after the surgery is important for a successful prognosis.

Frequently Asked Questions

1.

Can the Stomach Grow Back to Normal Size After Gastric Sleeve Surgery?

No, the stomach does not grow back to its original size after the surgery. It will hold a capacity that will allow the patient to have a normal life after achieving their weight loss goal. Gastric sleeve surgery is effective in losing weight and is a permanent procedure that lasts a lifetime.

2.

What Are the Negatives of Gastric Sleeve Surgery?

- It is not reversible since a part of the stomach is removed during the surgery.
- Due to stomach stapling, there is a potential risk for leaks and other complications. 
- Slow weight loss as the body still tolerates high-fat and carb-rich foods.

3.

Is Gastric Sleeve a Major Surgery?

Gastric sleeve surgery is a bit risky procedure as it involves taking out a large portion of one of the vital organs of the body. This surgery involves possible side effects, such as infection, bleeding, and blood clots in the leg, and people may have trouble absorbing certain nutrients.

4.

How Much Weight Can a Person Lose Through Gastric Sleeve Surgery?

Generally, a person can expect to lose, on average, up to 70 percent of their excess weight. However, weight loss depends on many factors, such as current weight, health, and gender. Hence, weight loss varies from person to person. Some people may lose a little less, and some may lose a little more. No one loses too much weight to look skinny or malnourished.

5.

Is Gastric Sleeve Surgery Painful?

The pain after gastric sleeve surgery is bearable for some people and they feel only a little tenderness. While some experience pain and require medications such as painkillers to subside it.

6.

Is There a Possibility That the Gastric Sleeve to Not Work?

Gastric sleeve has a high success rate, but there is a possibility of failure also. The failure of this surgery can be due to many factors, such as hormonal adaptation, gradual sleeve dilation, or recurrence of improper eating behaviors.

7.

How Long Does a Person Have to Stay in the Hospital After Gastric Sleeve Surgery?

 
After the surgery, the patient can expect to stay for two or three nights in the hospital as they are monitored for any complications. The hospital stay varies from person to person, as some may be allowed to go home the same day. 

8.

How Long Is the Gastric Sleeve Surgery?

The gastric sleeve surgery generally takes about two hours. It is performed laparoscopically, which requires only small incisions. Through these incisions, narrow sleeves are created by stapling the stomach vertically, and the larger part is removed.

9.

How Long Do People Take To Lose 100 Pounds After Gastric Sleeve Surgery?

The amount of weight loss depends on multiple factors such as current weight, patient dedication, and positive attitude. People can expect to lose at least 50 % of excess weight in the first year. For example, if a person’s current weight is 200 pounds, he may lose 100 pounds within a year of the surgery.

10.

How to Reduce Belly Fat After Gastric Sleeve Surgery?

As people lose weight, belly fat goes away. However, some measures can be taken to escalate this, like following a strict post-op diet, exercising regularly, avoiding snacking, adding protein to meals, and staying away from beverage calories.

11.

Is It Possible to Lose Weight After Five Years of Gastric Sleeve Surgery?

No, it is not possible. The excess weight loss due to gastric sleeve surgery happens around one year after the surgery. Patients do not lose weight for an indefinite period as they reach an equilibrium between energy consumption and energy expenditure.

12.

What Happens if People Overeat After Gastric Sleeve Surgery?

 
As gastric sleeve surgery removes a large portion of the stomach, overeating can cause significant weight gain, cramps, abdominal pain, indigestion, and heartburn. It can also result in stretching more and more, making the surgery futile. 
Dr. Pandian. P
Dr. Pandian. P

General Surgery

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bariatric surgery
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