Stomach reduction (gastric sleeve)

/Stomach reduction (gastric sleeve)
Stomach reduction (gastric sleeve)2018-01-09T13:13:39+00:00

Gastric sleeve

If you think about stomach reduction (gastric sleeve) as a solution to your obesity issues, then you should continue reading. You can find here answers to the most frequently asked questions, coming from patients. At the same time, you will also find the main ideas about the gastric sleeve procedure, tackling the main steps: surgical preparation, details about the procedure itself and life after the surgery.

What does the gastric sleeve surgery entail?

Longitudinal gastrectomy also known as gastric sleeve implies the removal of the lateral part of the stomach, along the lesser curvature, from near the esophagus until the gastric antrum.

Gastric sleeve is the latest surgical approach used in obesity treatment. This surgery can also be performed laparoscopically due to the significant progress of medical technology in electrosurgery and mechanic sutures!

The efficiency of longitudinal gastrectomy

The efficiency of longitudinal gastrectomy in the treatment of obesity is determined by several mechanisms to reduce food intake:

  1. Reducing gastric reservoir capacity. Quantitatively reduced meals are the goal of any weight loss programme! The longitudinal gastrectomy surgery (gastric sleeve) a rather large part of the stomach is removed (approx. 80%), leaving a very small (approx. 100 ml) gastric tube in the digestive circuit. In this way, the patient will have to eat foods in very small quantities.
  2. Reducing hunger. The bottom part of the stomach is the one responsible for producing hormones that cause increased appetite. Whenever the stomach is empty, the gastric wall will produce substances that reach the brain and trigger the hunger sensation (the Ghrelin substance, for instance). Through the gastric sleeve surgery, this segment of the stomach is removed (the bottom of the stomach) and, consequently, the Ghrelin plasma level decreases significantly. Thus, patients have a much lower hunger sensation, which will determine a reduced number of daily meals, over a period of 24 hours.
  3. Early feeling of satiety. After the gastric sleeve surgery, the repletion of the 100ml gastric tube will determine the early feeling of satiety. The patient can’t eat anymore – because is no more room for it! Food (in highly reduced quantities) will loosen the small stomach and the patient will declare himself/her full. On the other hand, the absence of an authentic gastric reservoir will determine the stomach to empty itself very fast and food will end up in the small intestine early. In this situation, in the presence of food, substances responsible for the satiety sensation will be produced (enteric hormones).

In other words, patients with gastric sleeve eat just a bit, do not complain about being hungry and get full really quick.

Advantages of the Gastric Sleeve

In terms of reducing weight excess, the results achieved in patients with Gastric Sleeve, were superior to other restrictive methods.

Moreover, stomach reduction does not entail the use of additional materials (textile band, silicon ring, gastric band caliber adjusting system), which, in time, can generate associated morbid reactions or sensations.

In patients with major co-morbidities associated with obesity, the minimally invasive approach (laparoscopic) lowers the risk of postoperative complications.

Results of the Gastric Sleeve surgery

After this procedure, all patients have experience weight loss. Weight excess was reduced, on average, with 38% at 6 months, 61% at 12 months and 74% at 24 months. The average body index has evolved from 52,1 kg/m2 preoperatively, to 42,5% kg/m2 at 6 months, 39,4 kg/m2 at 12 months and 33,5 kg/m2 at 24 months.

Remember that the most important step to be completely aware of this situation and take the best decision is to get proper and comprehensive information.

Stomach reduction = gastric sleeve = longitudinal gastrectomy

  1. What is stomach reduction (gastric sleeve)?

Stomach reduction (gastric sleeve) is a surgery that removes approximately 75% of the stomach. It is performed laparoscopically and its purpose is to make the patient eat less, leading thus to major, safe and long-term weight loss.

  1. What are the advantages of the stomach reduction (gastric sleeve) surgery?

Stomach reduction (gastric sleeve) has the best risk/benefit ratio. In other words, it achieves results that are comparable to the gastric bypass, but without the related potential complications. This procedure offers numerous benefits, such as diminished hunger sensation, small food intake and as effect, safe, stable and significant weight loss postoperatively, without restrictions involved.

  1. Is there a special diet following the stomach reduction (gastric sleeve) surgery?

The answer to this question is yes! The diet after the gastric sleeve procedure is highly important and it’s essential to fully understand its purpose. This diet is mandatory in the first 2 weeks following the surgery. Immediately after the gastric sleeve, you must only have liquids for 7 days, and in the following 7-14 days, mashed food. Starting with the 3rd week, you will be able to consume solid food, just like before the surgery. The purpose of this diet is to let the stomach heal and give you some time to adapt to the new, smaller stomach.

  1. What can you after the stomach reduction (gastric sleeve) surgery?

Starting with the 3rd week after the stomach reduction (gastric sleeve) surgery you will be able to eat ANYHTING, just in smaller quantities. Unlike the gastric band where a narrow area is created by the band or ring inserted, after the gastric sleeve, the stomach is simply narrower, but not as much as to block the food inside. Of course, you should not exaggerate with sweets, which, if consumed often, can affect the effect of the gastric sleeve surgery.

  1. How much can you eat after the stomach reduction (gastric sleeve) surgery?

This aspect varies depending on the volume of the remaining stomach, age, food intake speed and the type of food consumed. Generally, after the surgery you will only be able to eat a few bites. In time, your food intake will increase, but not more than half of what you used to eat before the surgery.

  1. Are you going to lose weight after the stomach reduction *gastric sleeve) surgery?

Yes, you will definitely lose a lot of kilograms, as long as you observe the doctor’s instructions accordingly. Most patients lose approximately 50-70% of their weight excess during the first postoperative year.

If you think about stomach reduction (gastric sleeve) as a solution to your obesity issues, then you should continue reading. You can find here answers to the most frequently asked questions, coming from patients. At the same time, you will also find the main ideas about the gastric sleeve procedure, tackling the main steps: surgical preparation, details about the procedure itself and life after the surgery.

7. What are the costs for the stomach reduction (gastric sleeve) surgery?

This surgery implies the use of special tools without which its accomplishment would be impossible. The Health Insurance Fund does not cover the costs of these materials, so the costs of the surgery are the same whether the procedure is carried out at a public or private hospital. However, costs do vary:

  • At “Sf. Ioan” Emergency Hospital – Bucharest – gastric sleeve tool set – 3,600 Euros
  • At Regina Maria private hospital – complete procedure costs – 5,600 Euros

 8. Are there risks and complications after the stomach reduction (gastric sleeve) surgery?

Yes, as with any other surgical procedure, there are risks and complications. They usually manifest in different percentages depending on the mentioned medical literature.

Potential gastric sleeve complications:

  • bleeding during or after the procedures
  • gastric fistula
  • infections
  • venous trombosis
  • gastric stenosis

 9. Can postoperative vomiting occur?

Yes. If you eat fast and more than the stomach can hold, you will throw up! It is highly important to avoid this. In order to prevent this from happening, eat slowly, chew your food well, and don’t forget that you must not finish everything on your plate. These habits are long gone. You must now stop as soon as you feel full.

 10. How long does it take to lose weight?

During the first year, patients averagely lose around 2-4 kg. There are stagnation periods as well and they are normal. Do not weigh yourself every day. Do not develop an obsession for your scale. The gastric sleeve procedure will lead to weight loss, surely and permanently.

 11. Do I have to keep to the diet after the surgery?

You only need to follow the diet mentioned before for 2 weeks postoperatively. Starting with the 3rd week, you will be able to eat normally from a quality point of view.

 12. Any long-term complications?

This surgery has been carried out for 5-7 years. There are no long-term complications known so far (in terms of years) after the gastric sleeve surgery. The specialty literature compares the gastric sleeve procedure with the ulcerous gastric resections performed 20-40 years ago which were not marked by any severe or frequent complications.

 13. What does the stomach reduction (gastric sleeve) surgery consist in?

  1. Consultation and a discussion with the surgeon and the anesthetist.
  2. One-week high protein diet before the surgery.
  3. The surgery is carried out laparoscopically under general anesthesia. 2-5 nights hospitalization needed.
  4. Special diet for 14 days.
  5. Social reintegration (returning to the work place) 7 days postoperatively.

 14. Is there a chance to gain my weight back?

Definitely not the weight you had prior to the surgery. A few years after the stomach reduction (gastric sleeve) surgery weight loss will stop and depending on your food intake customs and physical activity carried out, the weight curve can stagnate or slightly increase. But you will never gain back the weight you have had prior to the surgery.

15. Is there monitoring necessary after the stomach reduction (gastric sleeve) surgery?

Check-ups of certain analyses are necessary at 3,6 and 12 months after the gastric sleeve surgery. Depending on the results, a vitamin intake may be prescribed.