Gastric sleeve surgery

Gastric sleeve surgery

What is Gastric Sleeve Surgery? How is it performed?

With the increasing prevalence of obesity, bariatric surgical methods are gaining more attention. One of these methods, known as gastric sleeve surgery (sleeve gastrectomy), yields effective results in addressing obesity and obesity-related health issues.

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What is Gastric Sleeve Surgery?

Gastric sleeve surgery is one of the surgical methods used in the treatment of obesity. It involves the reduction of the stomach size in obese or severely overweight individuals, leading to a feeling of fullness with smaller amounts of food.

This surgical procedure is performed on individuals who have been unable to lose excess weight through diet and exercise, and who are classified as obese. Its primary goal is to facilitate weight loss and eliminate health problems and risks associated with excess weight.

Through the surgery, the volume of the stomach is significantly reduced, typically by around 70-80%.

The reduction in stomach size allows it to fill with a smaller amount of food, leading to a sensation of fullness in a shorter period of time. Additionally, the decrease in the surface area of the stomach leads to a reduction in the secretion of hunger hormones. All of these factors result in patients consuming less food and achieving rapid weight loss.

How Is Gastric Bypass Surgery Performed

Gastric sleeve surgery can be performed in two different ways: open and closed (laparoscopic) methods. In modern times, the closed (laparoscopic) approach is preferred due to its lower risks and minimal scarring in the surgical area. Open surgery is rarely chosen and only in necessary circumstances.

During a laparoscopic procedure, the patient is placed under general anesthesia, and 4-5 small incisions are made in the abdominal area. Through these incisions, a calibration tube is inserted into the stomach. This tube is used later to ensure that there are no blockages.

The section of the stomach that will remain is shaped like a tube using the calibration tube, and the remaining part is cut and removed. Then, the cut section is sealed, and the calibration tube is taken out.

After this stage, various techniques and methods are employed to perform necessary checks to ensure there are no leaks. Once it’s confirmed that there are no leaks, the operation is concluded.

There are different surgical methods used in the treatment of obesity. The main difference between gastric sleeve surgery and others is the preservation of the stomach’s entrance and exit, without any intervention in these areas.

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Who can undergo gastric sleeve surgery

“Gastric sleeve surgery is a method that provides effective results for those who have been unsuccessful in losing weight through diet and exercise. Nowadays, it is also known as a weight loss surgery for this reason.

Although successful results are achieved in terms of weight loss, it is not a suitable method for everyone. The conditions to be sought in individuals who will undergo this surgery are as follows:

  •  -Having a body mass index of 35 or higher (Having a body mass index between 30 and 35 with serious health problems such as hypertension, type 2 diabetes)
  • Those who have tried to lose weight through diet and exercise but have not been successful
  • Those without a health problem that would hinder the surgical procedure
  • Those who are psychologically ready for the operation
  • Those who will change their eating habits after the surgery

Gastric sleeve surgery is an ideal treatment for those who meet all of these conditions. However, it is not recommended for individuals who do not meet these conditions.”


Advantages of Gastric Sleeve Surgery

When preferred as a treatment for obesity, sleeve gastrectomy offers patients significant advantages and benefits. The prominent ones include:

  1. Enables Rapid Weight Loss: After the surgical procedure, rapid weight loss is achieved. Some patients can lose approximately 50% of their current weight within a 6-month period.

  2. Faster Satiation and Reduced Hunger Hormone: Due to the reduction in stomach volume and surface area, a sense of fullness is reached more quickly, and fewer hunger hormones are released. This facilitates easier appetite control.

  3. Reduction of Obesity-Related Health Risks: It contributes to the reduction of health risks associated with obesity, such as diabetes, hypertension, and sleep apnea.

  4. Improved Quality of Life: Patients who lose weight more easily and healthily experience an improved quality of life.

  5. Minimally Invasive Laparoscopic Surgery: The use of laparoscopic techniques in this closed surgery results in shorter recovery times and lower risks.

  6. Preservation of Digestive System: The absence of intervention in the stomach’s entrance and exit contributes to maintaining the digestive system’s functionality.

  7. Long-Term Results with Lifestyle Changes: Adhering to post-operative instructions and making changes in dietary and lifestyle habits ensures lasting results.

Disadvantages of Gastric Sleeve Surgery

Although it offers effective outcomes in obesity treatment and presents numerous important advantages, this procedure also comes with certain disadvantages. These disadvantages are as follows:

  1. Removal of a Portion of the Stomach Permanently: A section of the stomach is permanently removed through gastric sleeve surgery. Consequently, there is no reversal of this procedure, and undoing the operation is impossible.

  2. Necessity of Changing Eating Habits Post-Surgery: Changing dietary habits is required after the operation. However, altering these habits may not be easy and can be psychologically challenging for some patients.

  3. Successful Weight Loss and Permanent Results Require Adherence: Adhering to instructions is crucial for achieving weight loss and permanent results. Limited weight loss may occur for those who do not modify their eating habits. Furthermore, this loss may not be lasting.

  4. Stomach’s Expandable Nature: The stomach can stretch. If dietary considerations are neglected post-surgery, the effects of the procedure can diminish.

  5. Results May Not Be as Desired for High-Calorie Food Consumers and Those Who Do Not Follow Instructions: The desired results may not be achieved for individuals consuming high-calorie foods or continuing with improper dietary habits.

  6. Achieving Satiety with Less Food Requires Careful Diet Planning: Reaching a sense of fullness with less food makes precise diet planning essential. When diets are not properly planned, vitamin and mineral deficiencies can arise

Risks of Gastric Sleeve Surgery

Sleeve gastrectomy is a surgical procedure, and like any surgical procedure, it carries certain risks. Before making the decision for surgery, it’s important to thoroughly review these risks.

Firstly, it’s crucial to remember that risks are inherent in any surgical procedure. Sleeve gastrectomy is considered one of the safest surgical operations. The rate of complications is lower compared to many other surgeries.

The risk of complications varies based on several factors. The patient’s age, overall health condition, weight, and the surgeon’s experience are some of the influential factors. The risks of sleeve gastrectomy include:

  • Infection
  • Bleeding
  • Anesthesia-related complications
  • Stomach bleeding
  • Internal bleeding
  • Early leakage issues
  • Post-operative nausea, vomiting, and inability to eat
  • Gastritis and reflux

Many of these risks are present in various surgical procedures. The most significant risk specific to sleeve gastrectomy is early leakage. Leakage from the stitches used after removing a portion of the stomach might require the operation to be redone.

Checks for leakage are performed during the operation. Subsequently, patients are kept under surveillance in the hospital or clinic. During this period, patients are given an opaque liquid for further checks to ensure there is no leakage.

Despite all these checks and close monitoring, there is still a risk of leakage. Therefore, after the surgery, patients should monitor the changes in their bodies. Newly emerged abdominal pain and high fever are the most important signs of leakage.

When examining the risks, they might seem serious. However, their occurrence rates are very low. In modern times, almost all patients undergo the surgery without experiencing such problems and have a smooth treatment process.

Nutrition After Gastric Sleeve Surgery

After the surgery, patients need to pay special attention to their nutrition. In the first few days following the surgery, patients will only be able to consume liquid foods. In the subsequent period, they transition to pureed foods first, followed by solid foods.

The stomach is a fast-healing organ. To navigate this process smoothly and quickly, it’s crucial to adhere to the diet and nutrition instructions provided by the doctor. These instructions will ensure both a seamless recovery process and rapid weight loss.

After the surgery, patients will experience a decreased appetite and quick satiety. To maintain this and prevent the stomach from expanding, it’s important not to consume solid and liquid products simultaneously. Keeping a 30-minute gap between them can be beneficial.

Experiencing some difficulties in nutrition during the initial post-operative period is normal. During this time, some patients might receive vitamin and mineral supplements.

Apart from nutrition, following the exercise routines recommended by the doctor is also vital. Exercises not only accelerate weight loss but also help prevent potential skin sagging in the abdominal area.

Can Weight Be Gained After Gastric Sleeve Surgery?

Some patients, after losing a certain amount of weight, revert to their old habits and start consuming high-calorie foods. In such cases, there is a possibility that patients may regain weight and become obese again.

Before undergoing gastric sleeve surgery, patients need to ensure that they will change their eating habits and lifestyle. Patients who have doubts in this regard might not achieve the desired results.

Obtaining the desired results and achieving permanent weight loss highly depends on the post-operative period. In fact, it is as important as the surgery itself.

During the post-operative period, patients must adhere to the instructions without any flexibility. Initially, abandoning and changing these habits can be challenging for patients. However, they will become regular over time.

To achieve permanent results from gastric sleeve surgery and the subsequent period, it’s important to choose the right surgeon and the right clinic. Making the correct choices is crucial not only for shorter recovery time but also for lower complication risks.

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Before & After

Op.Dr.ErdemCan Yardımcı, General Surgery