What is
gastric sleeve surgery?
Gastric sleeve
surgery is a type of weight-loss surgery. Weight-loss surgery is also called
bariatric surgery. This surgery also known as sleeve gastrectomy or vertical
sleeve gastrectomy (VSG). Gastric sleeve surgery restricts your food intake,
which leads to weight loss. You may lose from 50 to 90 pounds.
It’s done as a
laparoscopic surgery, with small incisions in the upper abdomen. Most of the
left part of the stomach is removed. The remaining stomach is then a narrow
tube called a sleeve. Food empties out of the bottom of the stomach into the
small intestine the same way that it did before surgery. The small intestine is
not operated on or changed. After the surgery, less food will make you full
when eating.
Why might I
need gastric sleeve surgery?
Gastric sleeve
surgery is used to treat severe obesity. It’s advised for people who have tried
other weight loss methods without long-term success. Your doctor may advise
gastric sleeve surgery if you are severely obese with a body mass index (BMI)
over 40. Your doctor may also advise it if you have a BMI between 35 and 40 and
a health condition such as sleep apnea, high blood pressure, heart disease, or
type 2 diabetes.
What are the
risks of gastric sleeve surgery?
Bleeding,
infection, and blood clots in your legs are possible side effects that may
occur after any surgery. General anesthesia may also cause breathing problems
or other reactions.
Over time, you
may also have some trouble absorbing certain nutrients. Or you may develop a
narrowing (stricture) in your stomach sleeve. Some people may have heartburn or
reflux after the surgery. If you already have moderate to severe reflux, a
gastric sleeve could make that worse. You may want to consider a gastric bypass
surgery instead. That type of surgery can stop reflux and heartburn.
You may have
other risks based on your health. Make sure to talk with your healthcare team
about any concerns before the surgery.
How do I get
ready for gastric sleeve surgery?
Your healthcare
team will need to make sure that gastric sleeve surgery is a good option for
you. Weight-loss surgery isn’t advised for people who abuse medicines or
alcohol, or who are not able to commit to a lifelong change in diet and
exercise habits.
Before having
surgery, you’ll need to enroll in a bariatric surgery education program. This
will help you get ready for surgery, and life after surgery. You’ll have
nutritional counseling. And you may have a psychological evaluation. You’ll
also need physical exams and tests. You will need blood tests. You may have
imaging studies of your stomach, or have an upper endoscopy.
If you smoke,
you will need to stop several months before surgery. Your surgeon may ask you
to lose some weight before surgery. This will help make your liver smaller, and
make surgery safer. You’ll need to stop taking aspirin, ibuprofen, and other
blood-thinning medicines in the days before your surgery. You shouldn’t eat or
drink anything after midnight before surgery.
What happens
during gastric sleeve surgery?
You will have
general anesthesia for your surgery. This will cause you to sleep through the
surgery. Your surgeon will use laparoscopy. He or she will make several small
cuts (incisions) in your upper abdomen. The surgeon will then insert a
laparoscope and put small surgery tools into these incisions.
The
anesthesiologist will then pass a sizing tube through your mouth down into the
stomach. The surgeon will then use a laparoscopic stapler to divide the
stomach, leaving a narrowed vertical sleeve. The part of the stomach that was
removed is then taken out of the abdomen through an incision. Your surgeon may
then test for any leaks in the sleeve using a dye study or an upper endoscopy.
What happens
after gastric sleeve surgery?
You’ll likely
go home the day after surgery. You will be on a liquid diet for the first week
or two. Your surgery team will give you a schedule of types of meals over the
next weeks. You’ll go from liquids to pureed foods, then soft foods, and then
to regular food. Each meal needs to be very small. You should make sure to eat
slowly and chew each bite well. Don’t move too quickly to regular food. This
can cause pain and vomiting. Work with your healthcare team to figure out
what’s best for you to eat. After your stomach heals, you will need to change
your eating habits. You’ll need to eat small meals for your small stomach.
People who have
weight-loss surgery may have trouble getting enough vitamins and minerals. This
is because they take in less food, and may absorb fewer nutrients. You may need
to take a daily multivitamin, plus a calcium-vitamin D supplement. You may need
additional nutrients, such as vitamin B-12 or iron. Your medical team will give
you instructions.
You’ll need to
have regular blood tests every few months in the year after surgery. This is to
make sure you don’t have low blood iron (anemia), high blood glucose, or low
calcium or vitamin D levels. If you have heartburn, you may need to medicine to
reduce stomach acid.
After losing
weight, it’s possible to regain some of the weight that you lose. To avoid
this, make sure to follow a healthy diet and get regular exercise. The sleeve
may widen (dilate) over time. This will let you eat more. But keep in mind that
if you eat all you can, you can regain weight. You may want to join a
weight-loss surgery support group to help you stick with your new eating
habits.