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Sleeve Gastrectomy Surgery

Sleeve Gastrectomy is also known as Tube Gastrectomy and is an operation which has only recently been added to the field of weight loss surgery.

This operation would be beneficial in the following situations:

Geographic

Patients who live a long way from specialist follow up clinics and may encounter trouble attending regular reviews.

Medical

There are some situations where a Sleeve procedure might be preferable to a Gastric Band operation (eg. when the function of the oesophagus is reduced).

Further benefits:

Psychological

Research into this area is emerging, helping clinics to aid patient decisions.

Following unsuccessful Gastric Banding

Sleeve Gastrectomy might offer patients an alternative to replacement of the band.

Patient preference

After discussions between the patient and their Surgeon, patients may decide that the Sleeve Gastrectomy procedure suits them better than other surgical options and this may be related to their food tolerances.

This operation is a permanent procedure and cannot be reversed.

The Operation

The surgery is performed under general anaesthesia, Laparoscopic (keyhole) surgery is used to remove most of the stomach, leaving a narrow tube with a capacity of 150 mL, ie. about half a cup.

A stapling device is used to seal the incision as it is being made during the procedure. The incision line is thoroughly inspected during and after the procedure.

Because the stomach is much much smaller after surgery, the person feels full after a much smaller meal, but can usually eat a wide range of foods.

Weight-related co-morbidities such as Diabetes, Obstructive Sleep Apnoea and Hypertension resolve along with successful weight loss.

How Much Weight Will I Lose?

The initial weight loss after a Sleeve Gastrectomy is very impressive and it is quite common for patients to lose up to 70% of their excess weight in the first 2 years. The new stomach does stretch over time and patients will find they are able to eat slightly more. This does tend to result in some weight re-gain. We find that the majority of our patients are able to maintain 60% of excess weight loss.

bed-side

Surgery Risks

The general risks of surgery, and of rapid weight loss apply to this operation just like the Adjustable Gastric Band.

Specific risks of the operation include:

Leakage from the gastric staple line in 1.0 %, Postoperative bleeding in 0.5 – 1% of cases, Stricture (tight scar in the stomach tube) in 2%.

These risks are higher when the surgery is done in patients who have had previous gastric operations, or have a BMI greater than 50 kg/m2.

Long term risks & side effects include:

Vomiting in 20%, Gastro-Oesophageal reflux in 30%, Anaemia, Vitamin D deficiency, Inadequate weight loss or late weight re-gain can occur.

As this is quite a new operation, the results are limited to follow-up of up to 8 years. This makes it difficult to be certain of the long-term outcomes.

Post Operation Problems

Dizziness

This is due to the fact that you are probably not drinking as much liquid as you were able to before surgery; therefore the volume in your body is reduced.

Altered bowel habits

Bowel habits may be altered after the surgery. In the beginning, you may have watery bowel movements.

Do not expect your bowel movements to be regular until you start eating solid food.

Vomiting

During the first two months after surgery, you may experience a few episodes of vomiting. It is important to remember your new stomach is approximately 150 mL (just over half a cup) and can be easily overwhelmed.

You must eat slowly and stop when you feel full.

Please make sure you follow your dietary advice carefully.

body-outline

Nausea

This is the side effect of the operation that is responsible for some of the massive rapid weight loss. Even though you may experience severe nausea you should make an effort to eat at least three or four small meals a day and drink at least three to four cups of water a day.

Anorexia

Anorexia is a complete lack of appetite. Forgetting to eat is a problem some patients experience. Make an effort to eat at least three to four meals a day.

Revision Surgery

Sometimes further surgery may be necessary after the Sleeve Gastrectomy. If there is a problem with marked weight regain or reflux which doesn’t respond to medications, further tests are done to try to find a mechanical cause.

The revision surgery which is considered would either be repeat Sleeve Gastrectomy or conversion to a Roux-en-Y Gastric Bypass.

What is Life Like with a Gastric Sleeve

Any operation to help with weight loss is only as effective as the lifestyle changes that go with it. Good food choices as well as regular exercise are necessary to optimise outcome.

The Sleeve Gastrectomy reduces hunger and gives early satiety and so gives people a powerful tool to help with long term weight loss. It is unlike being on a diet.

Perth’s Western Surgical Health

Our care is unique in that we provide highly specialised professionals all at one location to support you in your surgery.

 

Our team includes:

– Specialised Bariatric Surgeons (both male and female)
– General Surgeons (both male and female)
– Bariatric Physicians
– Accredited Practising Dietitians
– Specialised Psychologists
– Exercise Physiologists

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