WHAT IS GASTRIC SLEEVE SURGERY?

Gastric sleeve surgery is a surgical procedure in which approximately 80% of the stomach is removed and 150-200cc of stomach tissue is left behind. Sleeve Gastrectomy, which was performed in the 2000s as the first step of more complex multi-step laparoscopic bariatric surgeries (biliopancreatic diversion with duodenal switch BPD-DS,Roux-en-Y gastric bypass LRYGB), when the results obtained later are evaluated and the complication rates are very few compared to complex surgeries, it has been a separate surgery in the treatment of obesity and it constitutes approximately 60% of the current obesity surgeries.

In Gastric Sleeve surgery, the stomach is cut from the points where it meets the esophagus and duodenum and turned into a tube.Since the volume of the stomach is reduced and the dome-shaped “fundus” part, in which Ghrelin, known as the hunger hormone is secreted, is removed, patients loose weight easily in the post operation period without feeling hungry.

The operation is performed with the laparoscopic method and the duration is approximately 1 –1.5 hours.

Because of patients do not feel much pain after sleeve gastrectomy surgery,  the process of rapid recovery and weight loss is easily started. There is a very rapid weight loss,especially in the first month, and then the process slows down a bit and continues for up to a year.

WHO IS ELIGIBLE FOR GASTRIC SLEEVE SURGERY?

Gastric sleeve surgery can be considered for people between the ages of 18-60, who do not have an obstacle to surgery, who have not benefited from the exercise and diet programs applied, and who meet the criteria.

In general, the group for which surgical treatment is prescribed;

Morbidly obese with a body mass index of 40 kg/m2 and above
Those who have a body mass index of 35 kg/m2 and above and have additional diseases (diabetes, hypertension, sleep apnea, high cholesterol, joint problems)

It is also very important that the patients who are planned for surgery do not have alcohol or substance addiction, are stable in terms of psychiatric conditions, and are stable in terms of long-term follow-up and lifestyle changes after the surgery.

WHAT IS THE SLEEVE GASTRECTOMY SURGERY PROCESS?

After your doctor decides that the most suitable method for you to lose weight is gastric sleeve surgery, the preliminary preparation process for the surgery is started. Liquid or solid food intake must be stopped 12 hours before the operation. If food or fluid has been taken, it is important to report this. Blood thinners should not be used before surgery.
We recommend that smokers do not smoke heavily or even not at all before surgery.
Necessary controls are carried out to determine whether there is a situation that prevents you from having surgery or losing weight after surgery

In addition, the anesthetist evaluates whether if there is any restriction for the patient to receive anesthesia.

It is known that psychological disorders or past traumas are the causes of obesity. For this reason, the patient is also evaluated psychologically.

We naturally see stress and anxiety in our patients before surgery. First of all, it should be noted that gastric sleeve surgeries are performed laparoscopically. Therefore,post operative pain is very less. Approximately 4-5 hours after the operation,you will recover and you can even walk. The fact that the surgery is performed by experienced surgeons using quality materials reduces the risk of complications significantly.

You will be sedated to reduce your fears and anxieties before the surgery. After the anesthesia is taken, your surgery is started by our expert team.

The surgery is performed laparoscopically (laparoscopic sleeve gastroctemy) and takes approximately 1-2 hours. You can stand up in 4-5 hours after the operation.Generally, you stay in the hospital for 3 days. How you should be fed with liquid foods in the first 3 weeks after discharge will be followed by your doctor and bariatric dietitian.
Since gastric sleeve surgery is performed by removing a part of the stomach,patients can easily lose weight without feeling hungry, as there is a decrease in the appetite hormone secreted by the stomach.

AFTER THE GASTRIC SLEEVE SURGERY

You will be taken to your room after the surgery and kept under constant observation by the expert team. After about 5 hours, you can get up and walk. In fact, walking is very important during the recovery phase to prevent blood clots and to all eviate the effects of gases remaining in the abdomen during surgery.

Is There Any Pain After Gastric Sleeve Surgery?

After the surgery, the pain is normally very little, but since the pain varies from person to person,it can be alleviated with medications.

Is There a Risk of Leakage After Gastric Sleeve Surgery?

During the surgery, just before finishing a leakage test is performed. After 1 day, a radiological liquid is drunk and an x-ray of the abdomen is taken to see if there is any leakage.

The risk of leakage in gastric sleeve surgery depends on the experience of the surgeon, the quality of the material used in the surgery and the an atomical structure of the patient. In gastric sleeve surgeries, where a part of the stomach is cut and removed, there are risks, as like any complex surgical intervention.

If no problems are detected, you can start drinking water.

How Many Days Will You Stay in the Hospital After Surgery?

You stay in the hospital for a total of 3 days. During this period, the body is fed with serum.It is important for patients to be able to take fluids on their own. Because serum cannot be used in the home environment. Dehydration after surgery is a possible condition. Therefore, it is necessary to pay attention to fluid in take after surgery.

Before discharge, you will be given information about the post-operative process, you will be discharged after information about the rules you need to follow, the nutrition program, and the drugs to be used.

What to Eat  After Gastric Sleeve Surgery?

Liquid foods must be consumed in the first stage after the surgery. There may be liquid foods specially prepared for this. Your dietitian and doctor will give you detailed information about this. Your stomach size has only been reduced, it is still digesting the foods you take, since the absorption does not change in sleeve gastrectomy surgery, these foods should not contain high fat and calories. For example, you can drink low-fat milk. Low-fat milk rich in both protein and calcium.

The first 2 months can be seen as a transition period from liquid food to normal solid food. In the first 2 weeks, liquid foods and protein and vitamin supplements such as B12 should be taken. In the second stage, after 2 weeks, pureed foods should be taken. Fruits and vegetables can be crushed and pureed and consumed. These foods should be high in protein and low in calories.

After the 5th week,solid foods can be consumed. However, bites should be chewed slowly and portion control should be ensured. Drinks should be drunk sparingly. When you feel you are full, the meal should be finished. Carbonated drinks should be avoided.

Drinks should not be consumed with meals after sleeve gastrectomy surgery. High-calorie, sugary drinks should be avoided.

HOW LONG DOES IT TAKE FOR STOMACH TO HEAL  AFTER GASTRIC SLEEVE SURGERY?

Gastric sleeve surgery is performed using advanced techniques and equipment. This shortens the recovery time after surgery. Although the recovery process varies from person to person, patients can usually return to their homes after 3 days and continue their work that does not require heavy working conditions at the end of 15 days. Healing of the wounds (laparoscopy wounds)  formed during the surgery heals in approximately 4-6 weeks. The healing of the stapler line, which is used to cut the stomach and keeps the remaining part of the stomach in place may take 6-8 weeks. In this process, it is very important for the patient to abide by the given rules and prohibitions and to follow the nutrition method stricly.

WHEN AND HOW MUCH WEIGHT WILL I LOOSE?

After the gastric sleeve surgery, the patient starts to lose weight. In sleeve gastrectomy surgeries, an average of 60% of excess weight is lost in general. This is more in some patients.

While the results can be much higher than this rate with eating habits and exercise after gastricsleeve surgery, lower rates are observed in patients who return to their old habits. Therefore, surgery is a start. The next process should be followed with precision.

Weight loss may stop over a period of time. This can be defined as the self-balancing process of metabolism (homeostasis) against changing external influences. Since weight is lost rapidly in the post-operative period, the metabolism enters the adaptation process. This can usually be seen at 6 months. This situation is called a weight loss plateau. In fact, this situation is also observed in the case of losing weight with normal diet and exercise. The easiest way to over come such asituation can be by changing the external factors.