Sleeve gastrectomy is a bariatric surgery procedure performed for obesity treatment. In this procedure, approximately 80% of the stomach is removed, leaving a thin, tube-shaped stomach. This reduces the stomach volume, provides satiety with less food, and decreases the level of the hunger hormone ghrelin, which helps with weight loss. Sleeve gastrectomy may be an option for individuals who are overweight due to genetic predisposition, unhealthy eating habits, or other medical conditions and who cannot lose weight with conservative methods.
What is Sleeve Gastrectomy?
Sleeve gastrectomy is a surgical procedure in which a large part of the stomach (usually the left side) is removed laparoscopically, leaving a banana-shaped stomach tube with a volume of approximately 150-200 ml. This procedure significantly reduces stomach volume and provides a feeling of fullness more quickly. Also, since the removed part of the stomach produces the hunger hormone ghrelin, a decrease in appetite is also observed after the surgery.Before undergoing sleeve gastrectomy, patients should understand the potential benefits and risks of the surgery, lifestyle changes, and the need for long-term follow-up. In consultations with the doctor, the patient's health status, eating habits, weight loss goals, and post-operative expectations are evaluated in detail.
Why is Sleeve Gastrectomy Preferred?
Sleeve gastrectomy is generally preferred for the following reasons:- Morbid Obesity: It is an effective method for weight loss in individuals with a very high body mass index (BMI) and serious health problems related to obesity.
- Failure of Other Weight Loss Methods: It may be an option for individuals who cannot lose enough weight with conservative methods such as diet, exercise, and medication, or who regain the weight they lost.
- Obesity-Related Health Problems: It can help improve or control obesity-related health problems such as type 2 diabetes, high blood pressure, sleep apnea, heart disease, and joint problems.
- Desire for Long-Term Weight Loss: Sleeve gastrectomy has the potential to provide significant and long-term weight loss.
- Lower Risk of Complications: It may carry a lower risk of complications in some patients compared to gastric bypass.
- Less Impairment in Nutrient Absorption: Compared to gastric bypass, nutrient absorption is less affected, so the need for vitamin and mineral supplements may be less.
How Does the Pre-Sleeve Gastrectomy Selection Process Work?
Sleeve gastrectomy surgery should be performed by an experienced bariatric surgeon. The general process consists of the following steps:- Evaluation and Consultation: Before sleeve gastrectomy, a comprehensive evaluation is performed by a team consisting of a surgeon, dietitian, psychologist, and other specialists. The patient's general health status, medical history, eating habits, psychological condition, and weight loss goals are evaluated.
- Anesthesia Application: Sleeve gastrectomy surgery is usually performed under general anesthesia. This way, the patient does not feel pain during the operation.
- Surgical Procedure: Sleeve gastrectomy is usually performed laparoscopically (closed surgery). Small incisions are made in the abdominal area, and with the help of special surgical instruments and a camera, a large part of the stomach is removed, leaving a tube-shaped stomach.
- Recovery Process: The patient's recovery process after the operation may take several weeks. Symptoms such as pain, nausea, and fatigue are normal in the first few days and will pass over time. It is important to follow the doctor's recommendations to speed up the recovery process and prevent possible complications.
What are the Types of Sleeve Gastrectomy?
Sleeve gastrectomy basically has one standard (Sleeve Gastrectomy). However, there may be minor differences in technical details depending on the surgeon's preference and the patient's condition.- Laparoscopic Sleeve Gastrectomy: This is the most commonly applied method. It is performed with small incisions in the abdominal area.
How much weight do I need to lose before sleeve gastrectomy?
Although there is no requirement to lose a certain amount of weight before surgery, your doctor may set a weight loss goal to improve your overall health and reduce surgical risks. This is usually personalized and depends on the patient's initial weight and health status.
How long does sleeve gastrectomy take?
Sleeve gastrectomy usually takes between 1 and 2 hours. The duration of the surgery may vary depending on the patient's general health condition, degree of obesity, and the surgeon's experience.
Is there a risk of death in sleeve gastrectomy?
Since sleeve gastrectomy is a major surgical operation, it involves certain risks, as does any surgery. These may include infection, bleeding, blood clots, stomach leakage (leakage from the staple line), and anesthesia-related complications. However, these risks can be minimized when performed by an experienced surgeon and a specialist team.
What is the suitable age range for sleeve gastrectomy?
Sleeve gastrectomy is generally considered for obese individuals between the ages of 18 and 65. However, the patient's general health status, obesity-related health problems, and psychological evaluation results are also important factors in addition to age.
Am I a suitable candidate for sleeve gastrectomy?
If your body mass index (BMI) is 40 or above, or if your BMI is 35 or above and you have serious obesity-related health problems (type 2 diabetes, high blood pressure, sleep apnea, etc.), and conservative weight loss methods have failed, you may be a suitable candidate for sleeve gastrectomy. However, the final decision will be made by your doctor after a comprehensive evaluation.
In which cases is sleeve gastrectomy not recommended?
- In individuals with severe uncontrolled psychiatric problems,
- In individuals with active substance addiction,
- In individuals with serious health problems such as advanced liver or heart failure,
- In individuals who are pregnant or planning pregnancy soon,
- In individuals who cannot comply with long-term follow-up and lifestyle changes after surgery,
- In some cases with large hiatal hernia or reflux disease in the stomach (gastric bypass may be more appropriate).
Will I be able to eat normally after surgery?
For the first few weeks after surgery, you will need to consume liquid and pureed foods. Over time, you can transition to solid foods with the guidance of your doctor and dietitian. However, your portions will be much smaller than before, and you may need to limit some foods (high-calorie, fatty, sugary foods) as they can negatively affect your weight loss process.
Will I need to take vitamin and mineral supplements after surgery?
Since your nutrient intake will decrease after sleeve gastrectomy, it is generally recommended to take multivitamins and, in some cases, supplements such as iron and vitamin B12. Your doctor and dietitian will create a personalized plan for you in this regard.
How much weight can I lose after surgery?
Weight loss after sleeve gastrectomy varies from person to person, but patients generally lose a significant portion of their excess weight (60-70%) within the first 1-2 years. The rate of weight loss may slow down over time, but significant weight loss can be achieved in the long term.
Can I regain weight after surgery?
Yes, it is possible to regain weight after sleeve gastrectomy. Weight gain can be seen, especially if post-operative nutritional and lifestyle recommendations are not followed, portion control is not maintained, and regular exercise is not done. Long-term follow-up and adherence to lifestyle changes are important.
What are the Advantages of Sleeve Gastrectomy?
Sleeve gastrectomy offers many significant advantages for individuals with obesity and obesity-related health problems:- Significant and Long-Term Weight Loss: It can help patients lose a significant portion of their excess weight and maintain this weight for a long time.
- Improvement or Remission in Obesity-Related Health Problems: It can contribute to the improvement or complete resolution of many health problems such as type 2 diabetes, high blood pressure, and sleep apnea.
- Increased Quality of Life: With weight loss, patients' physical activities become easier, their energy levels increase, their self-confidence increases, and their overall quality of life improves.
- Decreased Hunger Hormone: Since the removed part of the stomach produces the hunger hormone ghrelin, a decrease in appetite is observed after surgery.
- Less Impairment in Nutrient Absorption: Compared to gastric bypass, nutrient absorption is less affected, so the need for vitamin and mineral supplements may be less.
- Technically Simpler Procedure: It is a technically simpler and potentially shorter surgery compared to gastric bypass.
What does sleeve gastrectomy aim for?
The primary goal of sleeve gastrectomy is to achieve significant and long-term weight loss in obese patients, thereby improving or eliminating obesity-related health problems, and thus increasing patients' quality of life and life expectancy.- ✔ Significant Weight Loss: The goal is to lose a large portion of excess weight.
- ✔ Improvement in Health Problems: The aim is to control or improve obesity-related diseases such as type 2 diabetes and high blood pressure.
- ✔ Reduced Hunger Sensation: Appetite control becomes easier by reducing hunger hormone levels.
- ✔ Increased Quality of Life: The goal is for patients to feel better physically and psychologically.
Can other procedures be performed during the surgery?
Yes, in some cases, other accompanying surgical procedures such as hernia repair or gallbladder removal can be performed during sleeve gastrectomy. This depends on the patient's needs and the surgeon's assessment.
Will I experience skin sagging after surgery? What can I do?
Skin sagging may occur after significant weight loss, depending on skin elasticity. This varies from person to person. Regular exercise and adequate water intake can be beneficial in reducing skin sagging. However, for significant sagging, correction with plastic surgery methods (tummy tuck, arm lift, etc.) may be necessary.
Will the surgical scars be prominent?
Since sleeve gastrectomy is usually performed laparoscopically, there are small (0.5-1 cm) incisions in the abdominal area. The scars resulting from these incisions usually fade over time and become less noticeable. In the case of open surgery, a larger scar may remain.
Will I feel pain during and after the surgery?
You will not feel any pain during the surgery as you will be under general anesthesia. After the surgery, you may feel pain for the first few days. This pain can usually be controlled with painkillers and will decrease over time. Pain after laparoscopic surgery is generally less than after open surgery.
Will a drain be placed after the surgery? When will it be removed?
In some cases, a drain may be placed in the abdominal area after surgery to prevent fluid accumulation. When the drain will be removed depends on the amount of fluid accumulated and your doctor's assessment. It is usually removed within a few days. Removing the drain is generally not a painful procedure, apart from a slight pulling sensation.
When can I return to my normal activities after surgery?
The recovery process after surgery varies from person to person. It is generally recommended to avoid heavy lifting and strenuous activities for the first few weeks. Most patients can return to most of their normal activities after 2-4 weeks. Full recovery and reaching full physical capacity may take several months.
Do I need to stay in the hospital after the surgery?
After sleeve gastrectomy, you will usually need to stay in the hospital for 2 to 3 days. This period may vary depending on the course of the surgery, the patient's general condition, and the presence of possible complications. Doctors and nurses will monitor you closely during your hospital stay.
How soon can I get up?
You can usually get up and walk on the same day or the next day after sleeve gastrectomy. However, it may take several weeks to fully return to your normal activities. It is important to follow your doctor's recommendations.
