Gastric Sleeve-Weight Loss Surgery Experts

Gastric Sleeve Surgery (VSG)

Gastric Sleeve SurgeryGastric sleeve surgery is a restrictive weight loss surgical procedure that makes the stomach smaller and helps patients lose weight more efficiently. Because of a smaller stomach, patients will feel full quicker than they used to. This means that patients will eat smaller portions for the rest of their lives, which will lead to continued optimal health and weight loss.

Undergoing Gastric Sleeve Surgery

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Why Gastric Sleeve Surgery Is Done

This type of weight loss surgery is for those who are severely overweight and have not had luck losing weight with diet and exercise. This surgery usually is done on those with a body mass index (BMI) of 40 or more or for those with a BMI of 35 or higher with a comorbidity such as Type II Diabetes, high cholesterol, sleep apnea or high blood pressure.

How It’s Done

Surgery is administered by making a large incision in the abdomen. It also can be done with several small incisions and using a camera (laparoscopic approach) in order to guide surgery. More than half of the stomach itself is removed leaving a vertical sleeve or tube that is about the size of a banana. The sleeve will go from the esophagus to the small intestine. The pyloric valve, the outlet that controls the release of food from the stomach to the small intestine also will continue to function normally.

Surgical staples keep the stomach closed and intact for optimal healing. Because part of the stomach itself is removed, the surgical procedure is not reversible. Oftentimes gastric sleeve surgery is done as a part of a larger approach to weight loss. If a patient needs to lose a lot of weight before duodenal switch surgery, gastric sleeve surgery may be the first step. The surgery takes about an hour.

What to Expect After Surgery

You will remain in the hospital for one to three days following weight loss surgery. You may have some belly pain and pain medication will be needed for the first week or so post-operation. The cut that was made by the surgeon may also be tender or sore. Because this surgery made the stomach smaller, patients will get full quickly when they eat. Food may also empty into the small intestine too quickly. This condition is called dumping syndrome, which can cause the patient to feel shaky, faint, nauseous, and have diarrhea. The body may also have trouble getting enough nutrition. A nutritionist will discuss which supplements are required each day.

A strict diet will be followed. For the first month, the patient will only be able to eat small amounts of liquids or soft foods while healing. It’s beneficial to sip water throughout the day to avoid dehydration. Bowel movements also will not be regular immediately following gastric sleeve surgery. Don’t worry this is a normal post-op symptom. Try to avoid constipation from occurring as well as straining during bowel movements.

As time progresses, solid foods will be added back into the diet. When this occurs, it’s important the patient chews their food carefully and stops eating when they feel full. This behavioral change will take some getting used to. If you do not stop eating soon enough or chew food well enough, you may become nauseous, throw up, or feel discomfort. Also if you drink a lot of high-calorie liquids such as fruit juice or soda, you may not lose weight as fast or at all. If overeating continues to occur, the stomach may stretch and surgery will not be beneficial.

If a patient has open surgery, heavy lifting, and strenuous exercise should be refrained from for 4 to 6 weeks. The surgery is mostly done laparoscopically, which involves a faster recovery time and allows patients to get back to work or their daily routine quickly.

Advantages & Disadvantages of Gastric Sleeve

With this type of weight loss surgery, there are fewer food intolerances than patients report with gastric banding surgery. Also, weight loss is generally faster than with that same surgical procedure. Also, there is no implantable device so no erosion or slippage can occur. Hunger is reduced because the part of the stomach that produces ghrelin, the hunger hormone is removed.

The surgical risk overall is lower than with gastric bypass surgery, however the weight loss is similar. Also, the risk of developing ulcers is lower than with gastric bypass surgery. Also, gastric sleeve surgery is also less invasive, making recovery faster. Because there is no device installed, there are no needed adjustments and follow-up is much easier. This surgery can be converted to a duodenal switch or gastric bypass if necessary for additional weight loss in the future.

As for disadvantages, gastric sleeve surgery is not reversible and complication risks are slightly higher than with gastric band. The new stomach pouch can stretch if overeating occurs making the surgery ineffective. Leaks or bleeding can occur at the stomach staple line. Also, the procedure is not covered by many insurance companies.

Success Rates of Gastric Sleeve

Research has shown that patients who had gastric sleeve surgery can lose more than half of their excess weight. Most patients can expect to lose 30-50% of their excess weight in a 6-12 month period of time. Weight loss is slower than gastric bypass surgery. Also, success is higher in those who are more realistic about the amount of weight they can lose as well as those who follow up with their medical team post-operation fully. Following the recommended diet and embarking on regular exercise also contribute to a patient’s success overall.

Related: Compare to Gastric Bypass Surgery

Cost of Gastric Sleeve Surgery

The cost of gastric sleeve surgery (external) can range from $10,000 to $25,000 in the United States. The price is somewhere in the middle of the lap band surgery and the more expensive, gastric bypass surgery. The cost of the surgical procedure will depend on the geographical region, the surgeon’s fees, the medical facility, the level of care, and any complications that may arise.

Read: Cost of Gastric Sleeve Surgery

Risks With Gastric Sleeve Surgery

Some patients may have experience with poor nutrition. This means that some vitamins and minerals are not absorbed properly because a large part of the stomach was removed. Other less common risks with gastric sleeve surgery include stomach leakages, blood clots, gallstones, anemia, osteoporosis, and infection.

Diet After Gastric Sleeve Surgery

  1. For the first week following weight loss surgery, you can only have clear liquids. Things such as water, broth, Jell-O, decaf tea and coffee, sugar-free non-carbonated drinks, and sugar-free popsicles are acceptable. The second week will include a full liquid diet with protein. Patients will have non-fat yogurt, soup with soft noodles, sugar-free puddings, protein powder with clear liquids, sorbets, hot oatmeal, no-sugar juice, sugar-free ice cream, thin applesauce, thin creamed soups, and instant breakfast drinks.
  2. Week 3 is soft pureed foods. While some food is incorporated into the diet, it’s important that fats and sugars are limited. Patients should get 60 grams of protein a day. Foods should be introduced one by one and be eaten slowly. It’s important to understand that food may taste differently than before surgery. Patients also will find that dairy is harder to digest. Drink 1 protein shake per day with almond or coconut milk. Hummus, low-fat cottage cheese, soft cereal, soft vegetables, ground chicken or beef, soups, scrambled eggs, soft fish, canned tuna, mashed fruit, and soft cheeses are all acceptable.
  3. During week 4, real food will be introduced. Continue with daily protein shakes. Introduce meat slowly into the diet and chew carefully. Any type of fruit, fruits, vegetables, mashed and baked potatoes, and cereal are great for this week. Avoid soda, sugary drinks, candy, dessert, pasta, whole milk foods, nuts, or fried foods. Some healthy snacks include hard-boiled eggs, oatmeal, baked sweet potato, banana, strawberries or hummus with rice crackers.
  4. After Week 4, patients can continue to re-introduce new foods into their diet. Eat three small meals each day and stay hydrated. Stop drinking fluids 30 minutes before each meal or you will feel full from the fluids. Make sure to get 60 grams of protein. Take all recommended daily vitamins.

Ultimately gastric sleeve surgery will help patients control the portions they eat while losing weight. The commitment to a new lifestyle change is apparent and without remaining active weight loss won’t occur. It’s important to go to all follow-up appointments and discuss any concerns with a surgeon for optimal care. Whether you choose to have gastric sleeve surgery or any other weight loss surgery, it is not a quick fix for obesity. Rather it is a choice to live a healthier life and to remain committed to one’s health.

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