What is Gastrıc Sleeve Surgery?

What is Gastrıc Sleeve Surgery?

One of the most applied surgical procedures today is sleeve gastrectomy and is commonly known as “gastrıc reduction surgery”.

In sleeve gastrectomy surgery, the stomach is turned into a long, thin tube like a banana. 80 percent of the stomach is cut and removed laparoscopically, that is, with the closed surgery method. Thus, the food intake of the stomach is restricted. In addition, sleeve gastrectomy surgery has the effect of reducing food absorption, although at a very low level.

The appetite of those who have gastric sleeve surgery decreases. In addition, insulin resistance is broken without even weight loss.

What is the duration of gastrict reduction surgery?

Gastric sleeve surgery is performed in 1.5 hours on average. Since the exit and entrance section of the stomach is preserved and the continuity in the digestive system is maintained, the risks after sleeve gastrectomy are low and some unwanted side effects are reported very little.

Which Gastric Reduction Surgery Is Performed Most Often?

Gastric sleeve surgery is the most commonly performed gastric sleeve surgery with proven effectiveness and low risk. The medical name of sleeve gastrectomy, which has a 15-year history, is sleeve gastrectomy.

The other type of stomach reduction surgery performed today is ‘gastric bypass’ surgery. However, gastric bypass is preferred only in special cases; In cases where type 2 diabetes is at the forefront and insulin use is old, and especially in people with very high BMI, gastric bypass method can be the first choice of surgery.

In addition, gastric bypass method can be applied as the second operation method in patients who have had sleeve gastrectomy surgery and gain weight again.

Can Gastrıc Sleeve Surgery Be Applied to Anyone With Weight Problems?

Those who have gastric sleeve surgery have to meet the following conditions:

Those with a body mass index over 40 kg/m² (morbidly obese, that is, severely obese).

Those who have a BMI between 35 and 40 and have problems such as type 2 diabetes, hypertension, and sleep apnea due to obesity are considered morbidly obese and may need to undergo gastric reduction surgery.

In addition, patients with obesity-related “new” type 2 diabetes and metabolism disorders and BMI between 30 and 35 can be operated with the decision of the obesity doctor.

Obesity surgeries are not performed for aesthetic purposes, that is, to make the person look weaker.

Until What Age Is Gastrıc Sleeve Surgery Performed?

Gastric sleeve gastrectomy surgery is performed on people between the ages of 18-65. In order for the person to be a suitable candidate for gastric surgery, the Body Mass Index (BMI) values ​​determined by the World Health Organization must be 35 and above.

For people under the age of 18, the presence of the above-mentioned diseases along with the degree of obesity is important, and parental approval is required as well as the physician’s decision.

For people over the age of 65, the health status and the necessity of surgery (the person’s weight-related problems and problems) are evaluated.

What is Revision Surgery after Obesity Surgery? Who is it recommended for?

Revision surgeries are surgeries performed due to different complications such as weight gain, stenosis or leakage after obesity surgery. The most important reason for revision surgeries is usually weight gain.

The basis of the reasons for patients to gain weight back is the insufficient follow-up of the patients, insufficient information of the patients or failure to comply with the process even if they are conscious. For these reasons, 20-30% weight gain can be seen in patients.

It is very important to choose the revision surgeries applied to the patients well. These surgeries are technically more difficult and must be performed by experienced surgeons. Today, with the increase in the number of obesity surgeries, revision surgeries have also increased.

There are types of surgery recommended for patients who have relapsed co-morbidities such as diabetes, high blood pressure, or regain weight. The most appropriate type of surgery should be decided by talking to the patient and evaluating.

Is There Any Pain After Gastrıc Sleeve Surgery?

Gastric sleeve gastrectomy surgery is performed laparoscopically, that is, with very small incisions by piercing the abdomen. These incisions are millimetric.

This method, called closed surgery, can also be performed with a ‘da Vinci robot’, that is, robotic surgery. In robotic surgery, the doctor who controls the arms of the robot and the specialists accompanying him perform the surgery

What is the normalization process after Gastrıc reduction surgery?

Since the abdominal muscles and membranes are not cut in laparoscopic surgeries, there is no serious pain after the surgery. After the operation, the patient is given painkillers.

Those with tube stomach start walking in the evening of the day of surgery and usually do not have serious pain on the second day. The patient may have a feeling of tension and pressure on the first day, which is relieved with painkillers.

Is There Any Scar After Gastrıc Sleeve Surgery?

Since the surgery is performed with a closed method, only very small incision scars remain in the abdomen. These lines become completely invisible in a few months.

How Much Weight Do Those Who Have Gastrıc Sleeve Surgery Lose?

Those who have gastric sleeve surgery lose 60 percent of their excess weight 5 years after the operation. This method is almost as effective as gastric bypass for weight loss. Since the absorption disorder is less compared to bypass, continuous vitamin and mineral support is required after sleeve gastrectomy surgery.

If sleeve gastrectomy surgery loses its effect in the long term and weight regains, gastric bypass is preferred for the next surgical method.

Can Weight Gain Again After Surgery?

The rate of regaining weight after sleeve gastrectomy surgery is around 15%. It is even possible to become morbidly obese again with a probability of 5-10% despite the operation. For this reason, close follow-up of the patient by specialists is of great importance in order to prevent those who have had sleeve gastrectomy surgery from gaining weight again.

Those who have gastric sleeve surgery are closely followed by the obesity team, which includes dietitians and psychologists. With this approach, which aims to follow the patient for life, support is provided against situations that may cause the patient to gain weight or affect his health.

Gastrıc Sleeve Surgery with Robotic Surgery

If an operation for weight control is recommended by the general surgeon, this may mean that the person may be a candidate for bariatric surgery performed with robotic surgery. The procedure performed with the robot ‘da Vinci’ is defined as ‘robot assisted laparoscopy surgery’.

With the da Vinci robot, the specialist has the opportunity to intervene in the patient as desired with small incisions. Many operations can be performed on morbidly obese patients with the robotic surgery method, which is used in many fields of medicine from urology to heart surgery, from gynecology to general surgery.

What is the Difference Between Gastric Sleeve and Gastric Bypass? Which Is Superior?

Gastric bypass surgery is a type of surgery that is performed especially in patients with severe diabetes for many years and in patients with very serious wounds (reflux) in the esophagus. Gastric bypass surgery, which has a history of about 20 years in our country, has left its place to sleeve gastrectomy surgeries.

One of the important reasons for the spread of sleeve gastrectomy is the anatomical structure. In gastric bypass surgery, the stomach is reduced, the gallbladder and intestinal arms are replaced, and the patient’s food intake is restricted. In the tube stomach, a part of the stomach, including the part where the hunger hormones are secreted, is removed, no changes are made in the intestines, the anatomical structure does not change.

If the patients are not followed well after both surgeries and do not receive supportive treatment, weight gain can occur at a rate of 20%. At the point of weight gain, it is possible to revise and repeat sleeve gastrectomy surgeries, but gastric bypass cannot be repeated because it changes the anatomical structure.

Ulcer in the stomach-jejunum junction, risk of entanglement in the intestines, etc. While there are complications specific to gastric bypass such as gastric bypass, the complication rate in sleeve gastrectomy surgery is very low. In addition, diarrhea, vitamin & mineral, protein deficiencies are seen at a higher rate after gastric bypass surgery compared to sleeve gastrectomy surgery.

What are the Risks of Gastric Sleeve Surgery?

Although very rarely, life-threatening complications may develop in gastric reduction surgeries. These interventions can cause complications such as bleeding or leakage after sleeve gastrectomy surgery, which can be observed in 1% of cases, but can threaten the life of the patient if they occur. The important thing is that if these complications occur, they should be understood immediately and the necessary corrections should be implemented immediately by the surgical team.

Gastric sleeve surgery is major surgery, that is, major surgery. As with all other major surgical operations, there are various risks after surgery. The risks of gastric sleeve surgery increase as the patient’s age and weight increase.

However, when we consider the risks of sleeve gastrectomy and gastric bypass surgery, the risk of death is one of the least risky surgeries. This risk is as much as gallbladder surgery.

According to scientific studies, the risks of appendicitis and gallbladder surgery in obese people are slightly higher than in thin people. However, this risk does not mean death. For example, while the mortality rate in the early period is around 2 percent in cardiovascular surgery, it is 1 in a thousand in gastric reduction surgery.

Before sleeve gastrectomy, patients are informed in detail about these risks by doctors at hospitals performing sleeve gastrectomy surgery.

Obesity surgeries are not surgeries performed for aesthetic purposes! Since the life expectancy of morbidly obese patients is shortened by 10-15 years due to obesity, the risks related to obesity are much higher than the risks of sleeve gastrectomy surgery.

Risks related to other health problems such as fatty liver, risk of kidney diseases, diabetes or high blood pressure are eliminated in morbidly obese people who have gastric sleeve surgery. Therefore, gastric reduction surgery is an operation that is not only risky but also reduces the risk of other surgeries.

Leakage Risk and Symptoms of Leakage After Gastric Sleeve Surgery

After obesity surgeries, patients are given a radio-opaque liquid by mouth and it is checked whether there is any leakage in the stomach. All patients are followed very closely while they are in the hospital for the first 3 days after surgery.

Those who have sleeve gastrectomy or gastric bypass surgery should pay attention to the following two points in order to understand leaks after discharge:

Unexplained fever and new onset abdominal pain.

Against the risk of leakage after sleeve gastrectomy; All patients who experience fever or abdominal pain after discharge should consult their doctor immediately.

Nutrition After Gastric Surgery

In the success of gastric surgery, it is of great importance that the patient adopts a new lifestyle, adheres to the diet program created in cooperation with metabolism and endocrinology specialists, and regularly uses nutritional, vitamin and mineral supplements if necessary.

Although a special program is created for each patient, the following principles are important in nutrition after sleeve gastrectomy surgery:

Protein will be the most important nutrient in your diet from now on. You’ll need to get about 60g of protein per day (like 1 serving of chicken, turkey, fish, or 1 serving of low-fat cheese).

Take great care not to skip meals. Consume at least 3 main meals a day. In addition, it would be appropriate to consume 2 snacks. Thus, you do not overload your stomach and help your metabolism work faster.

After sleeve gastrectomy, always eat your meals at the table by setting a table. Allocate at least half an hour for main meals. Never eat on kitchen counters, in front of the TV or computer.

Prepare your meals both in small portions and in small portions. Use small plates and small cutlery to avoid overeating. Eat your food very slowly and chew it thoroughly. Do not keep serving dishes and pots on the table and never take a second serving.

Drink at least 6-8 glasses of decaffeinated, calorie-free and still non-carbonated beverages per day. Do not drink anything half an hour before meals. This way you will avoid getting nauseous.

Take the vitamins and minerals recommended by the doctor following you after sleeve gastrectomy surgery on a regular basis. Do not use any other medication or dietary supplement without asking him or her.

Do not see stomach surgery as a cure or diet. These healthy eating habits you will acquire will be your new lifestyle from now on. Make sure that this view is also embraced by your family and friends.

Exercise After Gastric Surgery

It is known that adopting a regular sports program under the supervision of experts plays a role in the success of bariatric surgeries and accelerates recovery. However, it may not be easy to adopt such a program for people who have not had the habit of exercising before. It can be easier to gain the habit of doing sports as the extra weight is lost and the person does the exercises he likes.

Although a special program is created for each patient, the following principles are important in doing sports after stomach surgery.

Never start exercising without your doctor’s approval. And tell him about all the exercises you plan to do.

Exercise 3 months after the surgery, start doing it slowly and never do longer than recommended or different exercises or movements for the fear of losing weight fast.

The most ideal type of exercise for you in the early period will be walking. Take care to walk at the time and pace recommended by your doctor and exercise consultant.

After surgery, if your doctor approves – usually within 6 weeks – avoid abdominal movements and weight lifting.

Choose the exercises you love. Try to combine the types of exercises that will improve both your muscle and bone structure and also increase your fitness.

Swimming and fitness are extremely ideal exercises. If you have the opportunity to do these, tell your exercise counselor about it and ask him to create a program that includes them for you.

Are Vitamin and Mineral Supplements Taken After Gastric Sleeve Surgery?

After sleeve gastrectomy, multivitamin use is taken as dissolving in the mouth for the first month, 2 times a day for the next year, and once a day after the first year. The blood values ​​of patients who have gastric sleeve surgery and gastric bypass surgery are monitored periodically by doctors in hospitals performing bariatric surgery.

After gastric sleeve surgery, all patients are followed by nutritionists and dieticians.

Those who have gastric sleeve surgery can switch to solid foods after 1 month. A protein-heavy diet is preferred because patients are full of small portions. This process is also followed by dietitians.

Foods such as carbohydrates, bread, pasta, rice should be avoided.

Those who have sleeve gastrectomy should do sports regularly, eat small meals frequently and less frequently, and stay away from calorie liquid foods.

If the nutritional rules are violated after sleeve gastrectomy surgery, the desired success from the operation cannot be achieved.

Sports After Gastric Sleeve Surgery

After sleeve gastrectomy, sports are recommended by experts after the first 3 months.

As the patients lose weight after the surgical operation, they move more easily, their lungs relax and the lungs allow the person to exert better effort, the condition increases, and the risk of injury decreases with the loss of weight.

Sports, especially fitness and swimming, are recommended for the development of striated muscles in the first three months after sleeve gastrectomy surgery.

Will there be sagging after sleeve gastrectomy? How is it tightened?

After the sleeve gastrectomy operation, which is one of the bariatric surgery operations, loosening, sagging and crack formations may occur on the skin due to rapid weight loss. While these complications can be eliminated in a short time with sports and the right exercises, it is also possible to tighten with many aesthetic options, especially liposuction, for more intense sagging that may occur in morbidly obese patients. It should not be forgotten that following the diet and exercise recommended by your doctor and dietitian will help the skin to recover more tightly, prevent sagging and provide rapid tightening.

Will diabetes end with sleeve gastrectomy operation?

Gastric sleeve surgery has been accepted as one of the safe methods for almost all obesity patients. Obesity is a serious disease that causes many chronic problems from fatty liver, diabetes, heart and lung diseases, psychological disorders. It has been observed that 66% of the patients who underwent sleeve gastrectomy surgery completely disappeared and the general health status improved extremely quickly. On the other hand, many obese patients have insulin resistance. It is possible to prevent insulin resistance before diabetes develops with obesity surgery applications, especially tube stomach, in patients who have not yet fully developed diabetes mellitus, which is called prediabetes, and only the initial level of insulin resistance is observed.

Gastric Sleeve or Gastric Bypass?

Gastric sleeve surgery is the most effective treatment option among all bariatric surgery methods. While reducing the volume of the stomach and restricting the amount of food, not just the absorption of nutrients, calorie loss is achieved, while at the same time, adequate nutrition of the cells is maintained. In this way, weight loss occurs without weakening the person’s body resistance. However, sleeve gastrectomy surgery is an extremely advantageous method, especially as it has less risk of complications compared to applications such as clamps, and provides permanent weight loss for a much longer period of time. So much so that with the discovery of sleeve gastrectomy, clamps and similar applications have almost completely disappeared, and sleeve gastrectomy operation has become the most preferred bariatric surgery method thanks to all its advantages. Gastric Bypass operations are the most common configuration after sleeve gastrectomy. The physician, who is a specialist in the field, decides which operation the patient is suitable for, according to the patient’s age, type of malnutrition, and body structure.

Will there be a decrease in water consumption and chills after Sleeve Gastrectomy operation?

Gastric sleeve surgery, which restricts food and calorie intake by only reducing stomach capacity, does not affect nutrient absorption in the intestines, as in some other surgical methods. Treatment methods in which nutrient absorption is affected make the person prone to many diseases, especially iron deficiency anemia. For this reason, sleeve gastrectomy surgery is a more reliable option than other methods, as it not only treats obesity, but also protects the general health integrity of the person. Although the patient may experience a cold problem due to rapid weight loss at the beginning, this problem disappears when he adapts to the new weight. There is no condition that affects the person’s water intake. As long as the solid-liquid consumption rules given by the doctor and dietitian are followed, patients do not experience any permanent complications in the intake of any healthy food.

Does Sleeve Gastrectomy provide a solution to infertility?

Obesity, which is one of the biggest health problems of the age, affects the reproductive system as well as causes many chronic diseases. Along with the loss of excess weight, it causes an increase in fertility as well as a healthy pregnancy process. Gastric sleeve surgery is one of the surgeries frequently preferred by individuals who are at risk of infertility due to obesity or who have decreased fertility due to sugar level. In addition, it has been determined that the rate of miscarriage is high in obesity patients.

 Sleeve Gastrektomi What are the foods that will never be eaten afterwards?

Ghrelin, also known as the hunger hormone, is secreted from a part of the stomach called the gastric fundus, and a large part of the gastric fundus is removed by sleeve gastrectomy surgery. As a result, the amount of hunger hormone secreted from the stomach decreases and the person’s appetite decreases considerably after the operation compared to the past. However, 1.5-2 years after the operation, the patient’s stomach capacity and appetite may increase. For this reason, fried foods with high calorie content and packaged ready-to-eat foods are not recommended. However, carbonated and alcoholic beverages that cause deformation and enlargement in the stomach are not recommended. Sauces, oils, and sugary drinks with a small volume but high calorie content are not recommended in the diet after sleeve gastrectomy.

What are the supplements after sleeve gastrectomy?

The first month after sleeve gastrectomy is very important. In this process, it is aimed to heal the stomach in a healthy way. In the first week after the surgery, the patient should be fed only with liquid foods. A personalized diet program is prepared to ensure adequate protein and mineral intake. In this process, protein and vitamin supplements are recommended. It may be recommended to increase collagen in skin sagging. In addition, after the solid period, patients are advised to have nutritional programs in which they arrange their portions to get maximum vitamins and protein.

Is it possible to get pregnant after gastric sleeve operation?

For a safe and healthy pregnancy, patients who have undergone sleeve gastrectomy prefer to wait at least 18 months for adaptation to their new body and balance of weight, and doctors often do not recommend pregnancy for the first two years after the operation. Most women can get pregnant shortly after gastric sleeve surgery. However, after the surgery, the body will go through many changes and considering the new changes in pregnancy and weight gain again, many women do not prefer to get pregnant right after the sleeve gastrectomy operation.

What should be considered before gastric sleeve surgery?

Before the sleeve gastrectomy operation, the patient undergoes a versatile screening and a series of tests. Examinations to be performed by endocrinology, psychiatry, anesthesia, chest diseases, cardiology and many other branches not only reduce all possible risks of the operation and help determine which operation the patient is suitable for. After the operation is decided, if there is no diet or diet recommended by the doctor according to the disease, weight and health status, no changes are made. Patients behave in their usual diets and as required by classical surgical procedures, and this is informed and followed up by the physician and the relevant bariatric surgery team.

Can gastric sleeve surgery be performed twice?

It may take 12-18 months to reach the ideal and healthy weight after sleeve gastrectomy. This period varies from patient to patient. The gender of the person in the weight loss process, age, whether they have chronic diseases, metabolic rate and many other things affect the time to reach the ideal weight. Revision sleeve gastrectomy surgery can generally be applied to all patients who have had sleeve gastrectomy surgery before and have not achieved the required results at the end of this period. The fact that the first operation is not performed correctly, as well as the fact that the patient does not pay attention to the next diet, can be effective here. In such patients, re-sleeve or revision sleeve gastrectomy operations may be preferred. In addition, a second sleeve gastrectomy or different surgical procedures can be applied in patients whose obesity level is so intense that they require two surgical procedures.