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What does a sleeve
gastrectomy consist of?
It is a restrictive procedure;
by reducing the stomach
capacity, the patient feels full
after a small intake of food. It
is advisable for people with a
body mass index of 60 or more,
since the risks of intra and
post surgical complications for
them is very high. In these
cases, sleeve gastrectomy is
performed before a gastric
bypass. This is done so that the
patient will weigh a lot less at
the time of the bypass, reducing
the risks of complications. It
helps the patients reduce their
weight considerably in 40% of
the cases. If these patients
also change their eating habits,
they may not need a second
surgery to complete the
treatment. If it is necessary to
resort to a second surgery, such
as a bypass or a gastric band,
the patient will have to wait 18
months. It may also be used as a
first option of a restrictive
procedure in patients of a BMI
of between 45 and 60, if the
medical assessment of the case
determines so.
How is sleeve gastrectomy
performed?
It is done by means of
laparoscopic techniques. These
techniques involve the use of
special instruments that are
introduced through very small
incisions that allow the area
treated to be seen on a closed
circuit monitor.The incisions
that the surgeons make nowadays
are of no more than 0.4 inches
(1 cm); the surgical trauma they
produce is much lower and the
post surgical pain much more
tolerable. Through these
incisions, the surgeon can reach
the stomach and, using a special
stapler, he makes a vertical
suture to divide the stomach in
two. One of the sections is
shaped like a tube that goes
from the esophagus to the
intestine. The other one is
separated and removed. The
staples used are very strong.
The Results
Bariatric surgery procedures
have -generally- good results.
Apart from losing weight, most
of the patients recover physical
and psychological health.
Before surgery: Tips
Before thinking about undergoing
bariatric surgery, such as a
sleeve gastrectomy, it is
important for you to bear the
following things in mind:
You must be at least 18 years
old. Your obesity must not be
due to other diseases that could
be treated with other
procedures. Your body mass index
(BMI) should be over 40, or at
least over 35 if you suffer from
a disease related to morbid
obesity. You must have lived at
least 5 years with that BMI and
failed in your attempts to lose
weight by non-surgical
treatments. Take your time to
think about the important
changes in your diet after a
reduction of your stomach
capacity. Get psychologically
prepared to follow these new
habits for the rest of your
life. Bear in mind that you will
not be able to drink large
quantities of alcohol. If you
are used to drinking a lot of
alcohol, you may not be a good
candidate for this surgery.
After surgery: Tips
Hospitalization
3 or 4 days (1 day in intensive
care unit and 2 or 3 days in the
recovery room)
Bandages
You will have small adhesive
strips on each of the incisions
of 0.4 inches (1 cm). You will
also have two drainage tubes
connected to airtight plastic
bottles, one of which will be
removed on the third day after
the surgery and the other on the
seventh day.
Amount of pain
Mild to moderate.
Scars
Seven scars of only 0.4 inches
(1 cm) will be distributed on
your abdomen in the shape of a
diamond; its lower vertex will
be on the navel and the upper
one at the base of the
breastbone.
Removal of the stitches
7 to 10 days after the surgery.
Recovery
At first, you will feel
discomfort on the abdominal
area, but very oon the pain will
become milder.
Risks and complications of
vertical gastroplasty
Every surgical procedure,
regardless of its triviality,
has some risks and we should
always think of them as a
possibility. Gastric bypass is a
major surgical procedure and it
is certainly not against this
rule. The average percentage of
immediate post surgical
complications is about 2%.
The main complications are:
Acid reflux. The sutures
(staples) may open or there may
be leakage through them.
Hemorrhages where the incisions
and/or sutures have been made.
Intestinal obstruction. Blood
clots may form on the legs or
other parts of the body and
migrate to the lungs, increasing
the risk of pulmonary embolism.
Breathing problems. As time goes
by, the remaining portion of the
stomach may stretch and
partially recover its original
capacity. |
