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Sleeve_gastrectomy

Sleeve Gastrectomy

The vertical sleeve gastrectomy, or sleeve gastrectomy, is a type of restrictive weight loss surgery. Vertical gastrectomy surgery causes weight loss by restricting the amount of food that a person can consumed before feeling full.

Vertical sleeve gastrectomy is not a “quick fix” for obesity. It will greatly change the patient’s lifestyle. One must diet and exercise after this surgery. The patient may have complications from the surgery and poor weight loss if he does not diet and exercise.

Vertical sleeve gastrectomy has most often been done on patients who are too heavy to safely have other types of weight loss surgery. Some patients may eventually need a second weight loss surgery. This procedure cannot be reversed once it has been done.

The final weight loss may not be as large as with gastric bypass. However, this may be enough for many patients. Because vertical sleeve gastrectomy is a newer procedure, there is less data about the long-term benefits and risks. The weight will usually come off more slowly than with gastric bypass. The patient will keep losing weight for up to 2-3 years.

Losing enough weight after surgery can improve many medical conditions the patient might also have. Conditions that may improve are asthma, type 2 diabetes, arthritis, high blood pressure, obstructive sleep apnea, high cholesterol, and gastroesophageal disease (GERD). Weighing less should also make it much easier for the patient to move around and do his everyday activities.

This surgery alone is not a solution to losing weight. It can train one to eat less, but the patient will still have to do much of the work. To lose weight and avoid complications from the procedure, the patient will need to follow the exercise and eating guidelines that the doctor and dietitian give.

How the procedure is done?

The sleeve gastrectomy procedure can be the first step before other surgical procedures (e.g., gastric bypass) or it may be employed as a single procedure for weight loss.

  • The surgeon creates a small stomach "sleeve” using a stapling device; the rest of the stomach is removed.
  • This procedure induces weight loss in part by restricting the amount of food (and therefore calories) that can be eaten without bypassing the intestines and therefore absorbed.
  • Weight loss and improvement in parameters of metabolic syndrome are connected with the resection of the stomach and subsequent neurohormonal changes.
  • If the sleeve gastrectomy is used as the first step before gastric bypass, in the second step the surgeon attaches a section of the small intestine directly to the stomach pouch, which allows food to bypass a portion of the small intestine.

Sleeve gastrectomy procedure:

The majority of weight loss sleeve gastrectomies performed today use a minimally invasive laparoscopic technique. The entire procedure is done through a small incision in your abdomen. Most surgeons prefer this method because it results in shorter hospital stays, faster recoveries, smaller scars, and less pain than open surgical procedures.

The conventional vertical gastrectomy surgery isolates a small section of the stomach for processing food, limiting the size of meals to approximately 90 – 100 ml after surgery. The surgery is typically performed on patients who are too heavy to have other types of weight loss surgeries with the expectation that a second surgery will be performed once weight has been lost or on individuals who do not suffer from severe co morbidities and are young.

Benefits Of This Type Of Surgery:

77% of people improved their high cholesterol

Improvement and in some cases resolution of comorbidities are the more notable benefits of sleeve gastrectomy, there are other advantages such as improvements in weight loss, cost-savings and a better quality of life.

Shorter hospital stays, faster recovery

The majority of sleeve gastrectomy procedures are performed using a minimally invasive laparoscopic technique resulting in smaller scars and less pain than open surgical procedures.

Better quality-of-life

Clinical studies of laparoscopic bariatric and metabolic surgery patients found that they felt better after the procedure, and spent more time doing recreational and physical activities. They also benefited from enhanced productivity and economic opportunities, and had more self-confidence than they did prior to surgery.

Risks And Complications:

As with any surgical procedure, potential risks and complications can occur. Although these problems rarely happen, it’s important to know the facts.

If you’re considering sleeve gastrectomy surgery, we encourage you to attend a bariatric and metabolic surgery informational seminar hosted by a trained surgeon.

Possible post-surgery complications

One or all of the following conditions and complications are possible following all types of bariatric and metabolic surgery procedures, as well as all types of bariatric and metabolic procedures.

Potentially serious complications

Surgical:

  • Perforation of stomach/intestine or leakage, causing peritonitis or abscess
  • Internal bleeding requiring transfusion
  • Severe wound infection, opening of the wound, incisional hernia
  • Spleen injury requiring removal/other organ injury
  • Gastric outlet or bowel obstruction

Pulmonary:

  • Pneumonia, atelectasis (collapse of lung tissue), fluid in chest
  • Respiratory insufficiency, pulmonary edema (fluid in lungs)
  • Blood clots in legs/lungs (embolism)

Cardiovascular:

  • Myocardial infarction (heart attack), congestive heart failure
  • Arrhythmias (irregular heartbeats)
  • Stroke (cerebrovascular accident)

Kidney and liver:

  • Acute kidney failure
  • Liver failure
  • Hepatitis (may progress to cirrhosis)

Psychosocial:

  • Anorexia nervosa, bulimia
  • Postoperative depression, dysfunctional social problems
  • Psychosis

Other complications (may become serious):

  • Minor wound or skin infection/scarring, deformity, loose skin
  • Urinary tract infection
  • Allergic reactions to drugs or medications
  • Vomiting or nausea/inability to eat certain foods/improper eating
  • Inflammation of the esophagus (esophagitis), acid reflux (heartburn)
  • Low sodium, potassium, or blood sugar; low blood pressure
  • Problems with the outlet of the stomach (narrowing or stretching)
  • Anemia, metabolic deficiency (iron, vitamins, minerals), temporary hair loss
  • Constipation, diarrhea, bloating, cramping, malodorous stool or gas
  • Development of gallstones or gallbladder disease
  • Stomach or outlet ulcers (peptic ulcer)
  • Staple-line disruption, weight gain, failure to lose satisfactory weight
  • Intolerance to refined sugars (dumping), with nausea, sweating, weakness

Evaluate all your options before considering Sleeve Gastrectomy

Be sure to discuss the procedure with your doctor. It’s important to understand that:

  • Bariatric and metabolic surgery is not cosmetic surgery. The procedures do not involve the removal of fatty tissue by cutting or suction.
  • A decision to elect surgical treatment requires an assessment of the benefits and risks to the patient and the meticulous performance of the appropriate surgical procedure.
  • The success of bariatric and metabolic surgery is dependent on long-term lifestyle changes in diet and exercise.

Safety

Metabolic and bariatric and metabolic surgery is as safe or safer than other commonly performed procedures, including gall bladder surgery. When performed at a Bariatric and Metabolic Surgery Center of Excellence, metabolic and bariatric and metabolic surgery has a mortality rate of 0.13 percent. Gall bladder removals have a mortality rate of 0.52 percent.

All surgeries present risks. These risks vary depending on weight, age, and medical history, and patients should discuss these with their doctor and bariatric and metabolic surgeon.

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