The vertical gastrectomy in gastric sleeve (also known as gastric sleeve or gastrectomy in sleeve) operations is a relatively new procedure that produces weight reduction by diminishing the amount of food that can be eaten in one sitting. In a gastric sleeve operation, approximately 80% of the stomach is removed, thereby considerably reducing the capacity to store food. In other words, this is a type of restrictive obesity surgery.
The gastric sleeve operation was originally designed for super-obese patients or for patients who presented high surgical risks, with the intention of realizing a potential second obesity surgery in the future. However, patients most patients initially lost enough weight and were content with the results and did not need a second operation.
In actuality, gastric sleeve surgery is recommended for people who eat big portions of food or people who need to lose a large quantity of weight. The operation can be completed using a laparoscopic surgery technique or through conventional open surgery.
The gastric sleeve functions similarly to the gastric band. With this technique, the individual eats smaller portions of food, feels full and stops eating sooner, thus losing weight without having to feel hungry. The stomach is reduced in size although stomach nerves and the part of the stomach that connects to the intestine remains intact. Consequently, the stomach’s function and digestion capabilities are preserved. An individual may eat anything and not need nutritional supplements after the operation. Just like a gastric bypass surgical procedure, the gastric sleeve operation is not reversible.
All patients undergoing a gastric sleeve surgical procedure are given antithrombotic and antibiotic medications before surgery. As an added precaution and to avoid the formation of blood clots in the legs, antithrombotic stockings and a pneumatic compression system are used until the patient is completely recuperated.
The gastric sleeve technique by laparoscopic surgery requires five small incisions, through which a small camera is inserted into the stomach. The surgery itself takes about an hour and a half and requires general anesthesia.
A tube placed down the esophagus to the duodenum (the first portion of the small intestine) will calibrate the diameter of the portion of the stomach that will remain. The stomach is cut in a vertical direction, removing the part of the stomach that “grows” when an individual eats. Only a thin portion of the stomach (in the form of a cylinder or a sleeve) remains. The surgeon will use sutures to reinforce staples that close the ends of the remaining stomach portion together, reducing the risk of leaks or bleeding. The small intestine is left completely intact.
Unlike gastric bypass surgery, the gastric sleeve procedure does not require a reattachment of the stomach portion to the small intestine. Consequently, there is less risk of complications. Also, since the amount of time the patient is required to be under anesthesia is lessened in comparison to a gastric bypass procedure, the patient is at less risk, and benefits from a faster reincorporation, reducing pulmonary complications.
The gastric sleeve operation by conventional open surgery is reserved for patients for whom laparoscopic surgery is contraindicated, or for patients with a history of prior multiple abdominal surgeries or for patients with a gastric band, which have recuperated part of their lost weight. Open gastric sleeve surgery is begun with an incision from the sternum to the belly button. The same instruments used in the laparoscopic surgery are used for the open surgery, which also requires general anesthesia. However, this surgical method may be completed in about an hour.
Regardless of which technique was used for the gastric sleeve, patients generally are allowed, and able, to get out of bed within 24 hours. However, patients are advised not to drink water until 48 hours post-op. All medications and liquids are administered intravenously.
You will stay under observation for 24 additional hours in order for your doctor to be assured that you have no problems drinking water and then the patient is released to his or her hotel room with a recommended nutritional diet. Patients are generally able to engage in normal activities in about 6 to 8 days after the operation.
After the gastric sleeve operation, patients have a strict follow-up schedule with the nutritionist. The next day, a liquid diet will be commenced, which includes protein supplements for two weeks in order to improve the healing process and provide substrates to form a defense against infections.
Diets are advanced to pureed foods for three weeks. Depending on progress, the reintroduction of solid foods will happen about five weeks after the operation. It is not necessary to take nutritional supplements after the gastric sleeve operation.
In the more than 245 procedures that we have participated in, our experience allows us to recommend the gastric sleeve. Unlike the gastric bypass, it is not necessary to take food supplements following the procedure. Post surgical complications are very few and easy to control. The most common include leaks along the staple lines, bleeding, and infection.
At our center, we specialize in gastric band, gastric sleeve, gastric bypass and intragastric balloon procedures. We pay careful attention to the patient 24 hours a day while under our care. We are recommended by our warmth and quality of attention with each and every one of our patients, which is why we recommend our center as the best option of treatment for these procedures.