Laparoscopic Sleeve Gastrectomy, a type of stomach reduction operation, is purely a restrictive type of weight loss surgery which involves surgery on the stomach only.
About 75% of stomach is excised vertically with the help of staplers thereby reducing the storage capacity of stomach from 1.5 litres to 100ml.
How Sleeve Gastrectomy works:
• Reduced hunger –Your stomach is responsible for secreting the hunger-causing hormone called ghrelin. Since such a large part of the stomach is removed following gastric sleeve surgery, your feelings of hunger may decrease, increasing the likelihood of sustained weight loss.
• Hormonal changes-hormonal changes that occurs in our body following surgery changes the taste for sweet things, reduces the craving for sugar and cure of obesity related diseases like diabetes and hypertension.
• Reduced storage- due to removal of about 80% of the stomach, the storage capacity is highly reduced and as a result you tend to feel fuller after taking a small amount of meal.
Positives of Sleeve Gastrectomy:
• Average weight loss is 60% of excess of body weight.
• Gastric sleeve surgery also helps in getting rid of obesity related heath problems:
Diabetes – 80% have their diabetes cured and 90% have improvement in diabetes. However, patient selection criteria and type of surgery performed is very essential for optimal results.
High Blood Pressure (hypertension) – 68% patients get their high blood pressure cured permanently and 95% have improvement following surgery.
Obstructive Sleep Apnea – 80% have their obstructive sleep apnea completely resolved and 90% showed marked improvement following surgery
• Patients usually do not require long term vitamin or mineral supplements.
• Low maintenance surgery as very few blood tests and follow up are necessary.
How long does the procedure take?
Sleeve gastrectomy is done through laparoscopic or key hole surgery and generally takes less than an hour to perform.
How long will be the scars?
The procedure involves making 3 or 4 small cuts ranging from 5 mm to 10 mm long in the abdomen.
How does the patient feel following surgery?
The morning after this gastric reduction surgery, you should be able to walk around in your room, use the washroom and take bath. You should be able to sit comfortably and drink liquids as advised. Your pain should be well controlled with mild, soluble painkillers.
How long will be the stay in hospital?
Most patients go home the day after surgery once they are comfortable and can drink and digest enough to stay well hydrated.
How long the patient need off work?
Patients are able to join their work usually within 7-10 days.
After how much time patient can exercise?
The morning after surgery we would expect our patient to walk around relatively comfortably. On discharge from hospital we recommend increasing activity levels on a daily basis under the constant guidance of our physiotherapists. More active exercise such as at the gym can be introduced one week after surgery, with a gentle reintroduction to aerobic exercise such as light jogging, cycling or swimming. Any exercise involving heavy lifting can be started after one month.
Any chances of weight regain after gastric sleeve surgery?
Over the past few years, sleeve gastrectomy as a weight loss procedure has gained popularity worldwide. Large data sets from many centers with more than 7 years of follow up after the surgery showed sustained weight loss.
What are the advantages of the gastric sleeve over gastric bypass surgery?
The long term complication rate for gastric sleeve is lower than the gastric bypass surgery. The chances of nutrient deficiency is also lower than gastric bypass surgery because there is no malabsorption. Having said that, gastric bypass surgery has its own advantages and proper selection of surgery depending upon the patients requirements is a must ffor best results.
Are there any contraindications for undergoing sleeve gastrectomy?
As discussed, patient selection criteria is very important. In certain medical conditions like esophageal dysmotility (patient finds difficult to swallow food), gastroparesis (food stay in the stomach for too long time) disorders, severe Gastroesophageal Reflux Disease (GERD), especially those with Barrett’s esophagus, sleeve gastrectomy is not the preferred option. For patients with mild reflux, gastric sleeve may still be an option.
Any appetite change after surgery?
This one aspect makes bariatric surgery a preferred method for weight loss over dieting especially in severe obese patients. Because of hormonal changes, there is significant decrease in appetite. As a result, you do not starve or fight with your hormones by keeping away from food. You tend to feel full and energetic after a small quantity of food. Appetite does tend to return after approximately one year but it will be a more normal healthy hunger feeling.