Sleeve Gastrectomy

What is Sleeve Gastrectomy?

Sleeve gastrectomy, also known as gastric sleeve surgery or vertical sleeve gastrectomy, is a weight-loss procedure where about 80% of the stomach is removed and only a tube-shaped stomach of the size and shape of a banana remains.
This is done laparoscopically with the aid of small instruments passed through several small incisions on the upper abdomen.
This procedure restricts food intake by shrinking the stomach down to almost 20% of its normal size. This surgery initiates hormonal changes that suppress appetite and enhance weight loss.
The hormonal effects may also enhance or cure obesity-related disorders, including hypertension, cardiovascular disease, and diabetes.
Unlike other bariatric surgeries, such as gastric bypass, sleeve gastrectomy does not involve rerouting the intestines; it is a relatively simpler and more straightforward procedure.

Who Needs Sleeve Gastrectomy?

Sleeve gastrectomy, a type of bariatric surgery, is recommended for people who are seriously obese or overweight and cannot reduce their weight significantly with dieting and exercise.
The general profile of candidates for this surgery includes a BMI of 40 or higher or more than 35 with one or more obesity-related health conditions like diabetes, hypertension, or sleep apnea.
It is also recommended for those committed to long-term lifestyle modifications and aiming for a permanent solution to obesity.

What Conditions Are Treated with Sleeve Gastrectomy?

Sleeve gastrectomy is for the management of severe obesity. However, it is also applied to help manage certain health conditions linked to obesity. Some of these conditions include the following:

• Type 2 diabetes
• Blood pressure
• Sleep apnea
• GERD
• Obesity-related joint pain
• Fatty liver disease
• Being infertile due to obesity

At Marengo Asia Hospitals, our skilled and experienced team of bariatric surgeons work in accordance with the needs and conditions of each patient to plan the treatment so that a person can achieve lasting results.

What Are the Benefits of Sleeve Gastrectomy?

Some of the advantages of sleeve gastrectomy include:

1. Starts Working Immediately: The gastric sleeve begins to take effect right away since it makes one feel full sooner and lowers the appetite. As soon as the sleeve is formed, just a little food can pass through it, and this usually leads to weight loss.
2. Long-Lasting Effects: Although the long-term outcome of weight loss surgery is dependent on the lifestyle decisions of an individual, individuals who receive a sleeve gastrectomy go on to achieve long-term results. Most patients have been proven to maintain a weight loss of 51% to 54% more than 10 years after surgery.
3. Minimally Invasive: The gastric sleeve procedure is performed as a minimally invasive surgery. It is performed laparoscopically, using a thin tube with a camera through several small incisions to conduct the surgery.

   This makes recovery much faster and less painful, with fewer chances of complications. Even high-risk medical conditions could be safer with sleeve gastrectomy than with open surgeries like gastric bypass.

4. Reduction in High Blood Pressure and Other Weight-Related Conditions: Gastric sleeve is proven to have reduce the risk of various weight-related conditions and certain non-obesity-related conditions, which include:

• High blood pressure
• Type 2 diabetes
• Cardiovascular ailments
• Stroke and heart attack
• Cancer
• Gout
• Obstructive sleep apnea
• Non-alcoholic fatty liver disease

What Tests and Preparations Are Needed Before Sleeve Gastrectomy?

Patients are evaluated against a variety of tests before they go through sleeve gastrectomy. Among them are:

1. Comprehensive Medical Evaluation: This is conducted to confirm that the patient has no severe health issues. It will include blood tests, a function test of the heart, and a review of past medical histories.
2. Imaging and Diagnostic Tests: Imaging and diagnostic tests are also crucial components of the evaluation process prior to sleeve gastrectomy. These tests offer detailed information on your internal organs and thus help in the identification of other conditions that may impact your surgical procedure or recovery following the surgery. Common imaging tests include:

• A chest X-ray: This test checks your lungs and determines whether there are any lung conditions that might influence your surgery.
• Abdominal Ultrasound or CT Scan:  These tests will provide a clear and sharp view of your abdominal organs such as the liver, gallbladder, and pancreas to diagnose your illness and detect anomalies.
• Echocardiogram: The echocardiogram is a non-invasive test evaluating the structure and function of the heart through sound waves. It reveals cardiac abnormalities that may have an influence on the surgical process or necessitate special considerations with respect to surgery.
• An upper GI endoscopy or an upper gastrointestinal X-ray is also done to examine any possible abnormalities in the stomach and the esophagus, particularly with patients showing significant gastrointestinal manifestations like acid reflux.

At Marengo Asia Hospitals, a multidisciplinary team of experts ensures proper preparation and customized care from the start of a patient's treatment journey.

How to Prepare for Sleeve Gastrectomy?

Appropriate preparation is the key to successful sleeve gastrectomy and to minimize complications. Patients must report to the healthcare provider all medicines they take, as some of these will be adjusted before the procedure.
A pre-surgery liquid diet is often advised by the surgeon to shrink the liver, making the procedure safer. Fasting before the procedure is also needed to reduce anesthesia risks.
Psychological preparation is also essential since the surgery requires significant lifestyle changes, such as new eating habits and long-term weight management.
Family and friends are also important to support in healing and maintaining post-surgery modifications. At Marengo Asia Hospitals, we offer personalized consultations to ensure you're fully prepared for the procedure.

What Happens During Sleeve Gastrectomy?

Sleeve gastrectomy is usually performed in a hospital setting. The surgery takes approximately 1.5 to 2 hours under general anesthesia. A few small incisions, sometimes 4-5 in number, are made directly into the abdominal cavity to allow access to the stomach.
Using a laparoscope-a small camera-the surgeon removes about 80-85% of the stomach, leaving a narrow sleeve or tube. The part of the stomach removed is then discarded, while the remaining stomach is stapled shut.
No repositioning of the intestines is required. After the procedure, the patient remains under observation in a recovery room until the anesthesia wears off, then is transferred to the hospital room for further follow-up. According to recovery, the duration of the hospital stay is generally 1 to 2 nights.
Most sleeve gastrectomies are done laparoscopically with minimal incisions on the upper abdomen. Some, however, may be done by open surgery through a larger incision in the abdomen.

Post-Surgery Recovery and Considerations

Recovery after a sleeve gastrectomy is usually fast. However, specific guidelines that patients must adhere to ensure a quick recovery and maximum weight loss take place, include:

• Pain Management: There is bound to be some discomfort following the surgery at the incision sites. Pain management will be provided for the patient to be comfortable with the initial period of recovery.
• Dietary Changes: The patient will have to follow a strict phase diet. First, patients will be on clear liquids, then soft foods, and ultimately regular foods once the stomach heals. The portion will be much smaller since the size of the stomach has been diminished.
• Physical Activity: Mild physical activity can usually be initiated after a few weeks, although heavy lifting and strenuous activities should be avoided for many months.
• Nutritional Supplements: Since the stomach's capacity is greatly reduced, patients will require vitamin and mineral supplements to avoid deficiencies.
• Follow-Up Appointments: Follow-up visits with the surgeon and nutritionist are important to monitor weight loss progress and ensure that nutritional needs are met.

At Marengo Asia Hospitals, our holistic approach to care includes comprehensive post-surgical support to navigate patients through their recovery and help them attain long-term weight loss success.