Sleeve gastrectomy is technically the process of removing the large part of the stomach that serves as storage. Thus, it consists of turning the stomach, which normally has a volume of 1.5-2 liters, into a thin tube with a volume of roughly 50-100 ml (roughly a large banana). The goal is to reduce the amount of food that can be eaten at one time, but there is no intervention in the natural flow of the digestive tract that would reduce absorption.
Even in the United States, where gastric bypass surgery was once considered the gold standard, sleeve gastrectomy was 24% in late 2011. The gastrectomy rate has exceeded 60% today. In this process, gastric bypass decreased from 62% to 37%.
The main advantages of gastric sleeve surgery are that it does not change the natural flow of the digestive system, thus causing less vitamin and mineral deficiency, Dumping syndrome is not seen, it is more effective than gastric banding. While it causes less reflux complaints and does not place a foreign object in the body; Its most important disadvantages are that it contains a relatively long stapler, that is, the risk of bleeding and leakage from the stapler line, since it contains an incision line.
After gastric sleeve surgery performed in accordance with the technique, if the patient complies with the nutritional rules well, complaints such as nausea, vomiting and pain may occur. It is extremely rare. Frankly, the only significant effect of sleeve gastrectomy that may affect the comfort of life after surgery is reflux. While almost one in 5 patients experiences reflux in the first year after the surgery, this rate decreases to 3% after 3 years.
In terms of overall short-term risks, sleeve gastrectomy is equal to gastric bypass, higher than gastric banding, and lower than duodenal switch. has low risk. It has lower risks than all other methods in terms of long-term risks. The feeling of hunger is lower than gastric band and gastric bypass surgery.
The effectiveness of sleeve gastrectomy in improving type 2 diabetes is close to or equal to gastric bypass. However, there are studies showing that diabetes may reoccur in the long term. In terms of surgery time, sleeve gastrectomy is much more advantageous than bypass. Both operations have similar effects in terms of quality of life.
How Does Gastric Sleeve Surgery Work?
During the procedure, approximately 85% is removed and can only be removed by your thumb. A stomach in the form of a thin tube is left on the pediment. Thus, the amount of food that can be eaten is seriously reduced and a feeling of satiety is achieved earlier. This is the restrictive effect of the surgery.
However, gastric sleeve surgery is not only a restrictive surgery, but also a surgery with hormonal and metabolic effects. The removed part of the stomach is the part that produces the hormone Ghrelin, which triggers hunger. Removal of this section reduces the amount of the appetite-stimulating hormone in the blood and generally causes appetite suppression.
Since the natural flow of the digestive system is not interfered with, digestion and absorption continue normally after sleeve gastrectomy surgery. Therefore, there is a much lower risk of vitamin and mineral deficiency than surgeries that interfere with absorption.
How Much Weight Can Be Lost After Gastric Sleeve Surgery?
Obesity is not just about the imbalance between calories consumed and calories expended, as initially thought. Many hormonal mechanisms lie behind the fact that people who have reached the obesity stage cannot lose weight by simply reducing calories.
Sleeve gastrectomy surgery, when supported by a healthy nutrition system and exercise, can help you lose 60-80% of your excess weight within a year after the surgery. Of course, if the rules are not followed and one returns to old bad habits, there is a risk of not losing enough weight or even gaining weight again.
How is Gastric Sleeve Surgery Performed?
Sleeve gastrectomy surgery is performed by laparoscopic method, that is, by making 4 or 5 small incisions in the abdomen. The surgery takes approximately 30-45 minutes. Of course, this is also related to previous surgeries or anatomy. Generally, the hospital stay is 2 or 3 days.
What is the Follow-Up Process After Gastric Sleeve Surgery?
All other aspects of obesity surgery As in other methods, success in sleeve gastrectomy surgeries increases directly with strict post-operative control and follow-up. Therefore, the first evaluation is made approximately 7-10 days after the surgery. In this initial evaluation, clues to early complications of the surgery are investigated and postoperative nutrition and other life functions are evaluated. It is determined whether the blood flow is normal or not. Routine checks 1-2-3-6-9-12-18-24. It is carried out in your months. During these checks, sugar, insulin, liver enzymes, kidney function tests, vitamin and mineral levels are checked with blood tests. If any deficiency is detected in these, special supportive treatments are determined.
Is Sleeve Gastrectomy Surgery Suitable for Me?
If the World is Obesity and If you have a weight problem that falls within the surgery limit according to the criteria of the Society for Metabolic Surgery (IFSO), if you have vitamin-mineral deficiencies that will cause problems in bypass and other methods, if you have conditions that require the use of prednisolone or anti-inflammatory drugs and will cause problems in bypass surgeries, if you have Chron's disease or a history of major abdominal surgery. If you have heart or lung problems that would cause problems with a long surgery, or if you are on the border of supermorbid obesity, gastric sleeve surgery will definitely be the first option for you. The age ranges where sleeve gastrectomy can be performed are 12-79 years of age.
In what cases may gastric sleeve surgery not be suitable for me?
Type 2 If you have diabetes, especially one that requires the use of insulin, a BMI of 50 or above, and if you have serious reflux complaints, bypass may be a better option for you. Let us remind you again that sleeve surgery can be applied as the first step for the super morbidly obese group, and performing the main surgery after a certain amount of weight loss is achieved may also be a good option. Since reflux complaints increase in 20% of patients after sleeve surgery, great care should be taken when making a sleeve decision in patients with reflux. A condition associated with chronic reflux, called Barrett's esophagus, is an absolute contraindication for sleeve gastrectomy. In other words, gastric sleeve surgery should never be performed on patients with Barrett's esophagus, bypass should be preferred.
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