Gastric Sleeve Surgery- Types, Indications, and Procedure

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.

What Are the Risk Factors Related to Gastric Sleeve Surgery?

• 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.