Gastric sleeve is a surgical weight loss procedure which your stomach is reduced by removing the lateral to about 25 percent. This surgery reduces your stomach size of a tube or sleeve like structure. The holding capacity of the stomach is about 1.54 liters of liquid and food down to about 200 ml. The normal movement of food from your mouth into your stomach and then into the intestinal tract is not altered. There’s no malabsorption to nutrient as there’s with the bypass gastric procedure. Despite the stomach being smaller, the sleeve of your stomach still functions normally. Nutrients and food continue to enter and leave in the same manner. Acid is made to help digestion continuously, and essential minerals and vitamins such as calcium, folate, B12 and iron can be absorbed normally.
Gastric Sleeve procedure
The procedure entails a longitudinal resection of the stomach (starting from the antrum) at the point 5 to 6 centimeters from the pylorus and finishing at the funds close to the cord. Gastric sleeve that remain is calibrated with a surgical instrument (bogie). Most medics prefer to employ a bulge between 36-40 Fr. The ideal size of your stomach that remains after the surgery is about 160 ml.
The selection rationale is as follows:
- Age between 18 and 65
- Body mass index of 40, or Body mass index greater than 35 with at least one major obesity related disorder or disease, for example diabetes, hypertension, arthritis, and sleep apnoea
- Acceptable operative risk
- Reasonable attempts at other weight loss methods in the past
- A capacity to understand and know the commitment and risks associated with the procedure or surgery
- Dedicated to lifestyle follow up and change.
How does gastric sleeve work?
The sleeve gastrectomy procedure appears to function in 3 distinct ways:
- The major reduction in your stomach capacity lets patients to become satisfied and full with a much smaller meal. Offering portion control.
- Levels of the hunger hormone (ghrelin) are reduced by 50 to 65 percent. The removed portion of the stomach contains cells that produce the hormone. Patients report feeling less hungry between their meals.
- There is a change in the manner that fatty food intakes are handled by your digestive track. Patients report losing their taste for foods that are rich in sugar and fat, such as fried food, soft drink, and fried food, which appear to make them queezy, unsettled, or feel more bloated. Dietitians like this facet of the sleeve because it assists patients take on healthier eating habits.
Safety and efficacy
Endorsed by ASMB (The American Society for metabolic and Bariatric surgery) and IFSOMD (International Federation for the Surgery of Obesity and metabolic Disorders). This surgery is gaining popularity in adolescents and children. Recent research has found that it’s effective and safe, resulting in weight loss.
Benefit of sleeve gastrectomy
- Reduction of hunger – The inducing hormone (ghrelin) is reduced in size by removing a part of your stomach that is responsible largely for its production.
- Shorter operating time compared to gastric bypass.
- Does not re route intestines (reduces the risk of nutrient deficiencies).
- No dumping syndrome (the pylorus remains intact and sugars have enough time to digest because your intestine remains untouched).
- Weight loss occurs over eighteen months.
- No foreign object is left in your body (a silicone band is left by the lap band around the upper part of the stomach).
- Less daily vitamins are required after surgery when compared to gastric bypass.
Recovery from surgery is not too bad for some and painful for others. Patients experience pain differently and different pain medications function better than others for different individuals. You will remain in the hospital after surgery for two days. Some medics prefer three days whilst others are comfortable allowing you to leave the hospital after surgery if you pass the gas test.
When you are able to flatulate you have passed the gas test. This means that your intestines have fully recovered from the anesthesia and they’re working properly again.
Risk or complications
- Standard risk that is associated with surgery
- Leakage at the suture place
- Blood clot
- Esophagael pain or spasm
- Damage of your vagus nerve (which will cause constant nausea)
- Blood infections and clot
- Aversion to nausea and food
Daily supplements and vitamin
You will need to ensure you’re getting enough supplements and vitamins after surgery. Below is collection of typical protein and vitamins for the patients.
- Multivitamin with minerals – You will need to use chewable vitamins for the 1st month after surgery.
- Iron Ferrous fumarate 29mg is recommended
- Calcium citrate taken three times. Begin one month after surgery
- Vitamin B12-1500 to 2000 mg daily
- Protein supplement is imperative after surgery. It is recommended that you have 60 grams of protein each day after surgery
In the long term, gastric sleeve procedures are better than open methods, with a much lower risk of formation of adhesions under your abdomen. This reduces the risk of bowel obstruction