Sleeve Gastrectomy as medically entitled; is a type of obesity surgery used to help people with obesity problems and lose weight. This practice, also known as weight-loss surgery, is of course preferred as a component of the general diet or as an additional measure. Although the operation is not as challenging as operations such as open heart surgery, it is a serious and clinical practice and of course should be performed by field specialist surgeons.

Sleeve gastrectomy may be preferred depending on the level of obesity. At this point, the consultation of the physician will be effective and the final decision will be made through this. Metabolic surgery applications are preferred with the patient being highly obese. There are many types of these applications, sleeve gastrectomy is known as one of the most widely preferred.

It has been medically proven that obesity is a leading problem to many other health problems. Therefore, people are considered patients after being diagnosed as obese and treatment procedures are applied to eliminate this problem. All operations have certain risks; since obesity is a bigger problem than the risks of surgical operations, it is common for people to be subjected to obesity surgery operations to eliminate these health problems.

What are the methods of Sleeve Gastrectomy? 

Gastric reduction (RNY Gastric bypass, sleeve gastrectomy) surgeries have also started to be used for obesity surgery after gastric surgery for gastric cancer surgery in obese cancer patients after a significant weight loss is observed in patients.

  • It is carried out primarily by opening 5 small incisions to the abdomen. 
  • The stomach and intestines are treated from the incisions.   
  • The name of the surgical method is laparoscopic surgery. 
  • The remaining surgery scar performed by laparoscopic method does decrease quite well.. 
  • Surgery is not performed openly and is applied to each patient with single-use-only tools. 

What is Sleeve Gastrectomy?

Gastric reduction (RNY Gastric bypass, sleeve gastrectomy) surgeries have also started to be used for obesity surgery after gastric surgery for gastric cancer surgery in obese cancer patients after a significant weight loss is observed in patients.

  • It is carried out primarily by opening 5 small incisions to the abdomen. 
  • The stomach and intestines are treated from the incisions.   
  • The name of the surgical method is laparoscopic surgery. 
  • The remaining surgery scar performed by laparoscopic method does decrease quite well.. 
  • Surgery is not performed openly and is applied to each patient with single-use-only tools. 

The History of the surgery

Duodenal Switch, the closest surgery to sleeve gastrectomy surgery, was first performed by Dr. Doug Hess. The transformation of surgery into Sleeve Gastrectomy method was in 2001. Canadian surgeon; Dr. Gagner and his team announced it as the work of a study that began in 1999.  Currently, many different obesity surgery applications have been performed with the application and are applied effectively.

The differences between Sleeve Gastrectomy and RNY GastriC Bypass

  • Sleeve gastrectomy is a weight-loss surgery that lasts about 1 hour. RNY Gastric Bypass surgery takes longer than with multiple interventions. 
  • Sleeve gastrectomy is a very effective surgery to reach the target weight. With the stomach largely taken, the patient eats less and is satiated much faster. 
  • RNY Gastric Bypass surgery does not target the stomach only, as being different from sleeve gastrectomy surgery. On the other hand, small intestines are involved, reducing both the amount of eating and nutrient absorption.
  • In RNY Gastric Bypass surgery, the small side of the stomach left is re-attached to the small intestine, while the part of the intestine is not taken in the sleeve gastrectomy surgery.
  • After sleeve gastrectomy, patients have less appetite after surgery because there is an appetite-boosting hormone release on the cut side of the stomach. RNY Gastric Bypass has a similar effect because of the stomach reduction.
  • According to sleeve gastrectomy surgery, the larger part of the stomach is disabled in RNY Gastric Bypass surgery and saturating is high by eating very little. In sleeve gastrectomy surgery, 80% of the stomach is taken. 

How Sleeve Gastrectomy is done?

Sleeve gastrectomy is the application of laparoscopically entering the abdomen and taking 75-80% of the stomach. Laparoscopy; it is a form of application with small incisions and the patient is treated through special tools from these small holes. It is considered one of the great advantages of this operation considering ease of application and low complications.

Various examinations and tests must be carried out before the surgery is carried out. These are consultations done through analyses and medical monitoring evaluation tools.

If you have decided to perform sleeve gastrectomy, blood tests, X-rays, ultrasonography, endoscopy, endocrinological, cardiological, chest diseases, evaluation by psychologist and anesthesiologist and other branches deemed necessary are obtained by the surgical team. Weight monitoring will be performed by the help of the dietician both before and after the surgery. Smoking should be quit at least 3 months before surgery. All medications and nutritional support products used should be reported to the surgical team.

Following all preparations, surgery is performed under general anesthesia. Although rarely open method is used, today this surgery is performed laparoscopically. In surgery, the stomach is shaped like a tube with the help of a tool called surgical stapler. Surgery takes an average of 45 minutes-1 hour. After the cutting process is finished during the operation, the safety is checked by performing the leak test (blue dye test) according to the preference of the surgeon. After 1-2 hours of waking up after surgery, you are taken to bed.

How to lose weight with Sleeve Distrectomy?

Sleeve gastrectomy is an application that reduces stomach volume. Throughout obesity and metabolic surgery applications, the principle of reducting the enlarged stomach and as a result consuming less nutrients is essential. However, patients should pay attention to their diet after the surgery and use their willpower to avoid consuming excess nutrients. Otherwise, complications may occur after the surgery, and that the patient will not be able to lose weight because he consumes excessive amounts of foods.

Obesity and Metabolic surgery operations are far from being a direct solution for weight loss, they are a physical measure used to support one’s will. If the person does not pay attention to the warnings made during the surgery process, does not eat properly, does not perform the necessary exercises and neglects his examinations, it will be quite difficult to reach the weight-loss result.

Post-operative nutrition and exercise conditions are the most important considerations. Since there is a change in the structure of the stomach, it is extremely important that the patient pays attention to the amount of food consumption. In addition, the consumption of certain foods in the case of diet will also be prohibited. Since almost all those with obesity problems also have hormones, diabetes and related diseases, the diet to be given should never be spoiled. Because these diets are developed for individuals peculiarly.

Exercise program is another vital factor. Both the maintenance of the body’s effective functioning and the weight-loss result after the surgery are directly related to these elements.

How Long Does It Take For Those Who Have Sleeve Gastrectomy Surgery to Lose Weight? 

After sleeve gastrectomy surgery, patients quickly begin to lose weight. In this process, where the food and appetite are reduced in direct proportion, it is possible to lose an average of 10 kilos per month and even go beyond these figures. Doctors’ expectation regarding weight-lose is about 10 or 15 kilos from the first month. After the surgical intervention, patients feel less sense of being hungry because the part that triggers the hunger hormone in most of the stomach is thrown away. Accordingly, immediately after the surgery, weight-lose actually begins. The patient gets rid of 70-80% of their excessive weight in the first 2 years after surgery.

Who can get Sleeve Gastrectomy?

Body mass index (BMI) must  be 40 kg/m2  and above, patients between 35-39.9 BMI and have a serious weight-related health problem, such as type 2 diabetes, high blood pressure, hypercholesteremia or severe sleep apnea.

In addition, as with all surgeries, this surgery may not be suitable for people who have certain risks at the point of surgery. In order to make this decision, it is the case that the physician consults and decides after the evaluation using the necessary analyses and medical monitoring tools.

This surgery cannot be applied to all weight problems unconditionally in any way. Especially it is out of the question to perform a stomach reduction surgery arbitrarily. This is decided by the physician and it may be possible to have weight loss surgery if it is confirmed that it is really necessary.

Performing stomach reduction surgery without making an assessment at the point of trying other ways to lose weight is not a common choice but is not included in the protocols. This operation is the preferred operation for advanced (excessively) obese people to support the weightloss process and, as we mentioned above, is supported by many additional measures.

Who can’t get Sleeve Gastrectomy?

Body mass index (BMI) must  be 40 kg/m2  and above, patients between 35-39.9 BMI and have a serious weight-related health problem, such as type 2 diabetes, high blood pressure, hypercholesteremia or severe sleep apnea.

In addition, as with all surgeries, this surgery may not be suitable for people who have certain risks at the point of surgery. In order to make this decision, it is the case that the physician consults and decides after the evaluation using the necessary analyses and medical monitoring tools.

This surgery cannot be applied to all weight problems unconditionally in any way. Especially it is out of the question to perform a stomach reduction surgery arbitrarily. This is decided by the physician and it may be possible to have weight loss surgery if it is confirmed that it is really necessary.

Performing stomach reduction surgery without making an assessment at the point of trying other ways to lose weight is not a common choice but is not included in the protocols. This operation is the preferred operation for advanced (excessively) obese people to support the weightloss process and, as we mentioned above, is supported by many additional measures.

Suitable for people of what age?

Tüp Mide ameliyatı; yetişkin bireylere uygulanabilen bir operasyondur. Çoğunlukla 70 yaş üzerine uygulama tercih edilmezken, gelişim çağındaki çocuklar için de operasyon öncelikli tercih olmamaktadır. Tabii her iki durumda da, eğer ciddi bir gereklilik var ise operasyon gerçekleştirilebilir.

Operasyon yaş sınırı, obezitenin boyutu ve hastaya olan etkisi ile esnetilebilir. Buna karar verebilmek için ciddi testler yapılması gereklidir. Eğer erken yaşta ileri düzey bir obezite sorunu var ise, durum daha da ciddileşmeden hekime görünmeli ve diğer tedbirlerin bir an önce alınmasını sağlamalısınız. Zira erken yaşta bu yöntemin kullanılması mümkün olmayabilir. Bunun gibi ileri yaşlarda da, yaşa bağlı riskler nedeniyle uygulama kullanılamayabilir.

What are the advantages of Sleeve Gastrectomy?

Sleeve gastrectomy; is an operation that can be performed to adult individuals. While application over the age of 70 is mostly not preferred, operation is not a priority choice for children who are in development age. Of course, in both cases, if there is a serious requirement, the surgery can be carried out.

The surgery can be extended by the age limit, the extent of obesity and its effect on the patient. Serious tests are required to decide this. If there is an advanced obesity problem at an early age, you should see the physician before the situation gets more serious and ensure that other measures are taken as soon as possible. Because it may not be possible to use this method at an early age. At older ages like this, the application may not be available due to age-related risks.

What are the risks and compications?

Since the sleeve gastrectomy is a major surgery, it carries some risks both in the short term and in the long term.

It is carried out to prevent life-threatening situations that may occur in the course of some diseases found with overweight in obese individuals with weight control. Found with overweight; the risk of death caused by conditions such as heart disease, diabetes (Type 2 Diabetes), hypertension, high cholesterol, sleep apnea, reflux disease decreases after this surgery.

After this surgery, it is a possibility that you cannot lose enough weight or gain weight back. Incompatibility with post-operative diet and sports habits is the most important reason for these. High calorie fluid intake, junk-food habits, alcohol consumption are common mistakes.

Short term risks;

  • Leakage (leaking from the staple line)
  • Bleeding
  • Infection
  • Anesthesia complications
  • Respiratory problems
  • Clotting problems
  • Rarely, but still sleeve gastrectomy can be fatal.

Long term risks;

  • Leakage (leaking from the staple line)
  • Bleeding
  • Infection
  • Anesthesia complications
  • Respiratory problems
  • Clotting problems
  • Rarely, but still sleeve gastrectomy can be fatal.

There is a judgment that the risk of complications will decrease if the patient follows the instructions given by the physician. However, it is not possible to say that there is no risk at all. However, the risks can be reduced by applying treatments under the supervision of a specialist physician.

What to do before sleeve gastrectomy

What is recommended in all surgical methods; what to do before and after in other surgeries should be followed in sleeve gastrectomy step too. Sleeve gastrectomy surgery, which is carried out for treatment of obesity, obesity-related diseases or diseases that pose risk, is not a type of diet. It is subject to surgical procedure. The second most curious issue of patients who want to have sufficient data about sleeve gastrectomy is what should not be done before and after sleeve gastrectomy. Therefore, we will try to provide answers to the curious questions about our article.

Tüp Mide Ameliyat Öncesi Yapılması Gerekenler

Smoking cessation is essential for general health. Regardless of the type of sleeve gastrectomy or surgery, your doctor will be insisting on you quitting smoking. The time to quit smoking begins a month before the date of surgery and is recommended not to be used after surgery. Smoking increases the risks of respiratory infections as it can also cause the patient to experience a more overwhelming healing phase after surgery. Moreover, extending recovery time is the biggest factor. We can definitely say the same thing about alcohol-containing substances. Quitting alcohol consumption in sleeve gastrectomy is just as important as quitting smoking. Alcohol consumption should be terminated at least a week before surgery and should not be taken after surgery.

Let’s Prepare What You Will Use After Surgery

Your doctor will inform you about what to do after surgery. Since the surgical intervention is targeted directly at the stomach, most of this information will be nutrition-oriented. Therefore, it is important that the shortages are dealt with before entering surgery and be ready for post-operative consumption. It is important to prepare all recommended types of food on your shopping list, from kefir, yogurt, sugar-free pudding to protein powder if possible. In particular, all kinds of drinks which contain low calories should be given importance. Soy milk, multi-vitamins, nutritional supplements in the form of chewing, you can prepare red or white meat types, provided that they are lean. You should definitely stay away from products such as frying, fatty foods, pastries, snacks.

Let’s Learn About Medicines

You should fully inform your doctor about any diseases, medications you need to use regularly and even the foods – drinks you consume constantly. You need to stop using blood-thinner drugs such as aspirin. At the same time, stay away from items such as cherry stalks, fish oils, green tea. In addition, inform your doctor if you use medications for diabetes, heart disease, etc. Depending on your situation, some medications may need to be discontinued or re-regulated and their dosage reduced.

Weight loss before surgery

Sleeve gastrectomy are obesity-oriented procedures. The patient who will have sleeve gastrectomy would not have a fit body. Therefore, if you are going to get this surgery, you must be quite overweight. Therefore, it can be said by your surgeon before surgery that you need to lose in certain weight. Overweight patients may not be able to get direct surgery. You may need to weight loss with the rates and methods reported by your surgeon. During this weight loss process, eating after 7 p.m. should be avoided, protein, vegetables–fruit-oriented nutrition should be increased.

Pre-Surgical Nutrition

Remember that you need to come hungry for surgery after you have made all your preparations mentally and physically. Therefore, you should not eat or drink anything, including water, 8 – 12 hours before the operation. You can prepare as if you will be in the hospital after the end of the operation for 2-3 days. For example, you can add your books, magazines, notebooks, clothes, etc. to this preparation.

Mental Readiness

Some very overweight patients may also need mental preparation. You may find your psychological state inadequate, you may be receiving treatment for it. Therefore, you need to prepare mentally for the surgery. Meet with your consultants to inform them that you will have sleeve gastrectomy and try to be mentally ready as much as possible. Post-operative diet and eating habits need to be regulated. Snacks, over-carbohydrate products, consumption of all kinds of foods that may tire the stomach should be minimized. You may care to focus on these issues with your psychological counselor. You can consult a dietician. In addition, all detailed information about all these processes will be shared by your surgeon and will direct you to the necessary units if needed.

Recovery process after Sleeve Gastrectomy

Within 2-6 hours after surgery, you get out of bed and start walking. Then, after 48 hours, the diet begins in the form of sugar-free liquids. According to the patient’s ability to tolerate nutrition, the new diet is started with stages such as fluid, mash and eventually switching to solid food. The majority of patients are discharged within 2-3 days.

In general, evenf if there may be no need for vitamin support after the sleeve gastrectomy, some patients may receive multi-vitamin and mineral supplement temporarily. From the 10th day after the surgery, sports activities are started in the form of walking slowly.

From the 1st month onwards, walking exercise begins 5 days a week and an average of 30 minutes per day. The walking pace should be at least 3 km in half an hour.

Routine checks are carried out in the 1st week after surgery, in 1-3-6-12 months. In these controls, weight status, regression of existing diseases, regulation of drugs used in the past and blood tests are performed. 

Nutrition After Stomach Surgery

Nutrition after sleeve gastrectomy surgery can be classified as short term and long term. In the first stage of the healing process, that is, in the first three months, the patient must consume nutrients that will not over-tire his/her stomach. It is extremely important to comply with the measure to be given in this process. In addition to being naturally followed by a diet after the operation, it is necessary to avoid hard-to-digest foods and observe the balance of proteins, carbohydrates and fats indicated in the diet list.

In the short term, the consumption of liquid nutrients will change to normal diet in a few weeks, from the 6-month period onwards, the foods consumed before the operation will be consumed. However, in this process, the diet-appropriate feeding period should be preferred. Besides, the physician may not allow certain foods to be consumed.

Vitamin and mineral supplement during recovery is standard for almost every obesity and metabolic surgery operation. Taking your medications and nutritional supplements as described is extremely important in terms of the results of the application.

Recommended Exercises After Surgery

Sleeve gastrectomy is a preferred operation for weight loss. Of course, weight loss can be possible not only by reducing nutrients, but also by an exercise program to follow. For this reason, people need to do certain exercises even during the time of recovery process. After all surgical operations, it is necessary to act in the routine balance of the digestive system. Inactivity is always a problem for people, and the post-operative care guide states that the relevant medical staff should be careful about these issues.

But of course heavy sports exercises after the operation are not suitable. Walking is the most appropriate exercise in the period of 3-6 months after obesity surgery operations. In the process after 6 months, the person can do certain bodily exercises if the doctor approves. However, the preference of equipment sports in the short term can be considered a risk. Therefore, mostly such exercises are not recommended. There is also a risk of complications of cardiovascular diseases if overweight people do sports that require excessive effort. In this respect, controlled sports and more physical education are a more accurate approach.

Diet and exercise are extremely important to get rid of obesity. If these two factors are adopted appropriately together and obesity surgery, i.e. sleeve gastrectomy, the success rate may be quite high. At this point, it is mentioned that patients who comply with the rules can reach the normal body mass index from super obesity, depending on the current weight of the person.

What are the Leak Risks and Leak Symptoms After Sleeve Gastrectomy?

  • This situation, which is very serious, should be checked after the end of the procedure during surgery.
  • Even if there is no problem with this control, it may occur after surgery. 
  • The main reason for this is the disorders in wound healing.
  • Vomiting attacks can cause a leak as it increases stomach pressure a lot. 
  • Another factor that can cause the risk of leakage is that the diet given is not applied correctly and therefore the stomach is exposed to severe food conditions.
  • The leakage condition, which is initially accompanied by severe pain complaint by the patient, may show much more pronounced symptoms in cases where it is noticed late.
  • Gastric fluid and bile flowing into the abdominal cavity cause infection and if this infection cannot be detected quickly, it can also progress to other organs, pushing the patient into a serious intensive care process. 
  • This life-threatening condition causes complaints such as abdominal pain, fever, hiccups. In this case, a surgeon should be consulted quickly.

When to Drink Alcohol After Sleeve gastrectomy Surgery?

After surgery, it is recommended that the patient does not consume alcohol for the first 6 to 8 months. All alcoholic beverages should be avoided and even carbonated beverages should not be approached. Since a large part of the stomach is taken, alcohol enters the blood faster and has much greater effects than expected. The reason why alcoholic beverages are not desired to be consumed is that both alcohol is harmful to the stomach and has very high calories. The person who consumes alcoholic beverages can gain weight without being aware of it.

When can exercises be done after sleeve gastrectomy surgery?

After the surgery, sports are started with walks after the 10th day, depending on the patient’s recovery. According to the recommendations of doctors, the patient should spend the first 10 days resting and allow his body to adapt to this new life. The patient who is accustomed to the new stomach and new eating pattern can do small exercises at the end of the first month. However, it should be considered that heavy sports movements should be avoided so that no complications would occur. Any wrong movement in the first month may cause greater damage than predicted. In this context, you should follow your doctor’s word and follow the sports exercise advice to the letter.

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