Obesity is a common health problem among people around the world. Obesity not only causes an unpleasant appearance for people, but also can leads to some diseases such as cardiovascular disease, type 2 diabetes, sleep apnea (interrupted berating during sleep), increasing blood pressure or cholesterol (more about obesity complications).

Today, there is a variety of weight loss surgeries that sleeve gastrectomy is one of the best, most secure and fast methods.

What is sleeve gastrectomy?

Sleeve gastrectomy  is a laparoscopic surgery to treat obesity. In this method the stomach change from and size of a football to the size and shape of a banana. Sleeve gastrectomy include the removal of upper rounded part of the stomach called fundus that produces ghrelin hormones. These hormones control the appetite and send the hunger signals to the brain. Although around 75-80 percent of the greater curvature is removed during the sleeve gastrectomy surgery and just a narrow stomach tube is leaving but many of natural anatomic structures and its connection including antrum and pylorus (the opening from the stomach into the duodenum) along with vague nerve irritation, are preserved. Consequently, there is no disturbance in digestion and absorption.

Is sleeve gastrectomy right for me?

Although this surgery has many advantages but gastrectomy is not recommended for everyone who is overweight. Only obese people with the following conditions can do this surgery:

• Older than 8 years’ old
• BMI greater than 30
• Obesity for 5 years
• Unsuccessful weight loses despite of doing other methods seriously
• Having no disease causing obesity
• Preparation for change in eating habits and life style
• Willing to control by a specialist who guide you
• No alcohol addiction

Pre-assessment and the pre-operative diet

Your blood and health condition should be considered about 4 weeks before surgery to check the general health prior the anesthetic. Two weeks before surgery you need to start the liver shrinking diet. This is to ensure your liver does not get in the way of your stomach.

Recovery period after sleeve gastrectomy surgery

Since sleeve gastrectomy is done by the laparoscopy method, so the recovery period is shorter than the other ones. You need two days over stay in hospital. You can start doing daily activity after two weeks resting at home. After the procedure you may have pain. Any change in the digests and movement of intestinal is a normal condition. More addition mental and emotional instability is possible after surgery.

Try to minimize the recovery period by observing the following items:

• Avoid eating immediately after surgery
• Slowly change your diet from watery foods to solid and tight foods
• Move slowly after waking up
• Reduce your activity
• Avoid lifting heavy things

Can I get pregnant after sleeve gastrectomy surgery?

The good news is that sleeve gastrectomy doesn’t prevent natural digests and absorption and women can get pregnant after sleeve gastrectomy surgery. Although for a safe and healthy pregnancy, you should wait 4-6 months after the surgery. Some people are worry whether they can get enough foods. You can check up with your doctor.

Anyway if you drink enough water, eat several mini-meals during the day, take prenatal vitamins and iron supplement, use fresh vegetable and fruit, there won’t be any serious problems for you and your baby.

more about Healthy Weight Loss after Childbirth

Eating after sleeve gastrectomy surgery

The long term success of your sleeve gastrectomy surgery is dependent on observing food diets after surgery. During the first four weeks following the surgery, you should avoid eating solid foods. In first two weeks you should have liquid diet and the following two weeks apply soft moist diet. Then you can start solid foods but you should chew your food properly because solid foods can make pressure on your stitches and stretch the new stomach pouch that leads to vomiting and difficulty.

Is it possible to regain weight lost after sleeve gastrectomy surgery?

If the surgery is done correctly and patient observe the diet after surgery, it can’t reserve. If you don’t care to fullness signal that your gastric send to the brain and keep continue to eating, your stomach will extend and the extra food convert to the fat.

Sleeve gastrectomy surgery procedure

Sleeve gastrectomy surgery by the laparoscopic method is performed under the general anesthesia and it take time less than one hour. The procedure is as the following:

Complete anesthesia and create needed incision

After complete anesthesia, three to five small incisions are created on abdominal wall. Trocars are placed in these incision as a passageway for surgical instruments. Trocar is a surgical instrument with a cutting point enclosed in a tube that is used in surgery for access to the blood vessel and body holes.

Filling stomach by carbon dioxide gas

Stomach is filled by the carbon dioxide gas in order to lift the stomach wall away from the inside stomach structure. The surgeon uses a laparoscope (a tube with light and camera) to watch the stomach hole. After that, the surgeon uses a retractor to lift up the liver of the stomach in order to create enough room for surgeon to see behind the stomach.

The stomach separation from long intestine and spleen

The vessels and greater curvature ligaments, the fibrin tissue, that connect stomach to the spleen, stomach and large intestine, are divided. The stomach is fully separated from spleen and intestines. The entire underside of the stomach shouldn’t be connecting to the left crus of the diaphragm structures that attach the diaphragm to the vertebral column. The blood vessel of left side of the stomach and left branch of the vagus nerves left untouched.

Dividing the stomach to create a gastric tube

A sizing device called a bougie is then placed into the pyloric channel. The thick antrum or cavity of the stomach is divided by cutting transversely around the bougie to create a gastric tube.

Stapling the length of the gastric tube

A gastric sleeve is a pouch with an estimated capacity of less than 150 ml. Stapling along the length of the stomach that formed by the bougie creates a narrow tube. The staple line may be covered with material that is meant to reduce the risk of bleeding and/or leaks.

Removing the resected stomach

The resected stomach is placed in a specimen bag and then extracted through the trocar site. The port sites are then closed with non-absorbable sutures to prevent port site hernia.

Laparoscopic sleeve gastrectomy with duodenal switch

Duodenal switch procedure applies as the second surgery phase for patients who couldn’t lose much weight after several months of laparoscopic sleeve gastrectomy.

Along the duodenal switch, the small intestine, that is attached naturally to the stomach, is divided into two parts to create a pathway. Naturally, the digestive loop, takes food from the stomach to the entrance of small intestine; but after the switch, foods shift to the lower portion of the small intestine.

Advantages, disadvantages and possible complications with sleeve gastrectomy

This surgery as the other types of surgery has its advantages, disadvantages and some complications that are associated with this procedure.

Advantages

• The amount of foods you can eat is limited
• Feel fuller quicker and stay fuller for a long time
• Weight loss start quickly after the surgery
• Quick weight loss in compare to the other weight loss surgeries
• Losing weight on average 30-50 percent of the excess weight
• As with the band, the intestines remain intact so food is digested and absorbed as normal
• After sleeve gastrectomy you can do the conversion and duodenal switch surgery for further weight loss.
• Unlike the gastric band or the other method, no external thing will be placed in the body and consequently don’t have a risk of dumping syndrome

Disadvantages

• Your hair may thin due to fast weight loss but it is a temporary condition
• The possibility of developing gallstones due to fast weight loss, but it is quite a rare condition
• Losing part of the stomach forever
• Vomiting and nausea may occur
• During the first days after surgery, if you eat fast there is a more possibility for vomiting.
• You should take one tablet per day for reducing the stomach acid.

By observing the food diet and the related points, the above problems won’t occur and you can get much better results of the surgery.

The possible complications associated with sleeve gastrectomy

• Bleeding
• Staple line leak and peritonitis
• Infection that will be treat by antibiotics
• Wound related issues and poor wound healing for peoples with great DMI
• Unintended damage to the surrounding organs
• Blood clots