Sleeve Gastrectomy is a surgery in which the stomach is narrowed longitudinally... It is also known as gastric sleeve surgery.
Weight loss is achieved in two ways in the surgical treatment of obesity. The first of these aims to reduce the amount of food eaten. In this type of surgery, stomach volume is reduced. The second way aims to reduce the absorption of food intake. This type of surgery closes the small intestine to food passage at varying lengths. Sleeve Gastrectomy is a procedure performed only to reduce the stomach volume. The stomach is cut lengthwise and part of it is removed. The volume of the remaining stomach decreases. The shape of the stomach resembles a thin banana. It is also called a stomach tube because it looks like a tube.
In the Sleeve Gastrectomy procedure, the part of the stomach that stretches the most and increases the stomach volume is removed. The remaining stomach part does not stretch very much. Therefore, it prevents overeating. Turning the stomach into a tube also increases the stomach's resistance to food. It does not allow the passage of excessively large volumes of food. Your bites in the food you eat become smaller. Tubalization of the stomach ensures that the food entering the stomach is quickly emptied from the stomach. Foods that cannot stay in the stomach for a long time leave the stomach before they have time to increase the stomach volume. With gastric tubing, the passage of food into the small intestine is accelerated. This rapid transit stimulates movement in the small intestines. Although Sleeve Gastrectomy does not make any changes in the small intestines, it also prevents the excessive absorption of calories taken with food.
To which patients can Sleeve Gastrectomy be applied?
Sleeve gastrectomy can be applied to all patients who need treatment due to obesity. Although it was first applied as a first-line treatment to overweight and super obese patients in the early years, today it is also widely and successfully applied to patients with much lower weight.
BMI (Body Mass Index) over 50 kg/m2. Sleeve gastrectomy is applied as the first-line treatment in super obese patients due to the short surgery time.
Sleeve gastrectomy is performed in patients who are hesitant about any gastric bypass surgery due to possible long-term problems.
Sleeve gastrectomy is applied as an alternative in patients who are planned to undergo Gastric Banding. .
M In patients who have had gastric band applied but have problems with the gastric band, sleeve gastrectomy is performed by removing the gastric band.
Sleeve gastrectomy is performed in patients who are afraid of the problems caused by a foreign body such as gastric band or who do not want to come to the doctor for gastric band adjustments after surgery.
A sleeve gastrectomy is performed.
Sleeve gastrectomy is performed because it is the easiest surgery to convert to another long-acting surgery.
What are the risks of Sleeve Gastrectomy surgery?
In sleeve gastrectomy surgery, a part of the stomach is removed. There is a stitch line left behind in the stomach whose volume has been reduced. In some cases, small leaks may occur from this suture line. This risk is less than 1%. Many of the leaks heal unnoticed. In some cases, small abscesses may develop due to these leaks. In these cases, the problem is solved by external drainage of the abscess and appropriate antibiotic treatment. In rare cases, appropriate treatment may be required with re-operation.
The causes of these leaks that may occur in the stomach may depend on both the surgical technique and the patient's problems.
Today, there are a wide variety of surgical methods to ensure the safety of the suture line. These methods are used differently by each surgeon.
The reasons related to the patient arise mostly due to the burden of obesity on the body. Obesity itself can cause the immune system to weaken. This may cause the surgically created trauma to heal a little longer and more difficult.
We see these problems related to Sleeve Gastrectomy surgery almost non-existent anymore. Our preoperative and postoperative care conditions are at a level that can easily overcome these problems and maximizes the safety of the surgery.
How is Sleeve Gastrectomy performed?
Like all obesity and metabolic surgery methods, sleeve gastrectomy surgery is also available. It is applied with a completely closed method, which we call laparoscopic. In the laparoscopic method, the entire surgery is performed through holes smaller than one centimeter opened in the abdomen. Special tools are used for this. The process of cutting and stitching the desired part of the stomach is specially designed for this purpose. It is performed with special devices that are used only in your surgery. These devices cut your stomach wall and glue it together with special stitches. In our application, we manually cover this seam line with a second layer. This procedure increases the reliability of the surgery even more. You start drinking water the same day after the surgery. The next day, most patients' bowel movements return to normal and grain-free liquid foods are started.
How does Sleeve Gastrectomy work?
With sleeve gastrectomy, the volume of your stomach, which is reduced to a tube or banana shape, is reduced. Your food portions become smaller. For example, before the surgery, while you are eating a plate of soup, 5-6 meatballs, accompanied by rice or pasta and salad and only feeling full; After the surgery, you will be full with 4 spoons of soup and one meatball.
The hunger hormone p-80, secreted from the removed part of your stomach, decreases after the sleeve gastrectomy surgery. The name of this hormone is ghrelin. Thanks to the reduction of the hunger hormone (ghrelin), you feel less hungry between meals. Your feeling of fullness lasts longer. Since your stomach is tubed with sleeve gastrectomy, your stomach empties faster. The rapid passage of eaten food from the stomach to the small intestine also increases your bowel movements. Although sleeve gastrectomy does not make any changes in your intestines, some of the excess calories of foods are excreted without being absorbed, partly due to increased bowel movements. The majority of patients state that they do not feel their old cravings for different foods that they used to love. They even don't want to eat some foods because their taste gets worse. Among such foods, the ones frequently mentioned are coffee, cola, some pastries and cookies.
The part of the stomach closest to the exit is called Antrum. At the end of sleevegastrectomy (stomach tubing), the pressure of the antrum, which is the exit part of the stomach, increases. This increase in pressure causes the antrum to stretch and suppress the feeling of hunger. (Bergman JF. Correlation between echographic gastric emptying and appetite: influence of psyllium. Gut, 1992 Aug;33(8):1042-3)
Since sleeve gastrectomy does not leave foreign bodies inside, problems related to this are not encountered.
Needs adjustment, such as a gastric band It is not heard. It does not change the anatomy of the digestive system.
The only long-term side effect is partial weight gain.
Read: 0
