One of the most common treatment methods applied to obesity patients today is tube stomach surgery, which means sleeve gastrectomy. Although this procedure is commonly referred to as stomach reduction surgery, sleeve gastrectomy is only one of the gastric reduction methods. If you wish, let’s move on to the answers to questions such as what is sleeve gastrectomy surgery, how is it performed, and whether there is a scar after sleeve gastrectomy surgery.
What is Sleeve Gastrectomy Surgery?
What is Sleeve Gastrectomy surgery? The question is asked a lot. As the name suggests, gastric sleeve surgery, when the stomach is normally in the form of a pouch, is transformed into a thin and long tube. In the laparoscopic (closed surgery) procedure, 80% of the stomach is cut and removed. The remainder turns into a system that continues with the esophagus and intestines. With the stomach becoming a tube, the patient’s food intake is reduced. In addition to the reduction in the volume of the stomach, the hunger hormone secreted from the stomach also decreases to a low level, thus reducing the desire to eat in the brain. In short, we can say it as stomach reduction.
To Whom Is Sleeve Gastrectomy Surgery Applied?
It is applied to morbidly obese, that is, severely obese patients. The body mass index of morbid obesity patients is 40 and above. In addition, patients with a body mass index between 35-40 and who have obesity-related diseases such as type 2 diabetes, sleep apnea and hypertension can also be accepted for surgery.
How is Sleeve Gastrectomy Surgery Performed?
It is important how much the stomach volume is in the continuous weight gain. While the stomach volume in normal people is around one hundred and two hundred milliliters, this number goes up to a thousand milliliters in obesity patients. Obesity patient does not feel satiated due to the fact that the stomach volume is quite large and the appetite hormone is constantly secreted. Due to this state of numbness, more calories are taken into the body than it should be. In order to eliminate this problem, it is necessary to reduce the stomach, that is, to turn it into a tube stomach. Thanks to tube stomach surgery applied to obesity patients, the stomach is reduced to a volume of fifty milliliters, and the part that secretes the appetite hormone is also removed. In this way, long-term healthy and compulsory weight loss is ensured. We have prepared the answer to the question How is Sleeve Gastrectomy surgery done? for you in articles.
- No artificial materials are used in the application of the surgery, that is, no medical equipment is placed in the stomach during the surgery. The main reason why it is called a tube stomach is that the stomach looks like a tube after the surgical operation.
- Within the scope of the surgery, a connection between the stomach and the intestine is provided in a thickness close to the thickness of the esophagus. The stomach area, where the esophagus is connected, is cut from the area outside the connection point of the esophagus, that is, the connection of the esophagus and intestine takes the form of a straight tube.
- In obesity patients, the stomach, which is in the range of one thousand milliliters when empty and two thousand milliliters when full, is reduced to fifty milliliters when empty and to two hundred milliliters when full after surgery.
- Before starting the operation, patients are anesthetized. In this way, they do not feel pain or suffering.
- The operation is performed with a closed technique, that is, large incisions are not made in the abdomen. Small holes are made for surgical imaging and intervention tools to enter. The number of these holes is six. The diameters of the holes are fixed with special devices, and the devices are easily moved.
- In order to separate the internal organs from each other, carbon dioxide gas is given into the abdomen. In this way, the intervention area is relaxed.
- The hormone-secreting part of the stomach is removed from the enlarged area. A gastric tube of the same size as the diameter of the esophagus is left behind and the remaining area is stapled to each other with a special stapler.
- As in all gastric reduction surgeries, the risk of leakage should be controlled in this surgery. After the punching is completed, it is checked whether there is any leakage from the area, if not, the operation is terminated.
Is There Any Scar After Sleeve Gastrectomy Surgery?
The main reason underlying the application of sleeve gastrectomy surgery is not aesthetic concerns, but the closed method used in the application of the surgery also includes aesthetic concerns. Thanks to the technique used in the method, as small as possible incisions are made in the abdomen. In other words, the two factors that are the main cause of scarring are reduced to minimum levels.
Patients who have undergone sleeve gastrectomy surgery have a body mass index between thirty-five and forty-five when they undergo surgery. After the operation, it is possible to lose eighty percent of these weights within two years. In some special patients, it has been observed that the ideal weight is reached at the end of two years. After reaching the ideal weight, the patient applies to plastic surgery in order to remove the sagging skin. During the stretching and removal of these sagging skins, surgical scars that occur during the operation and begin to fade from the second month after the operation are also removed.
Many patients do not directly apply to plastic surgery for these scars, because the scars of the surgery become very faint. It covers the scars with various make-up tricks and other methods and completely cleans them in the long run. In short, after sleeve gastrectomy surgery, scars remain, but the remaining scars do not constitute an obstacle to the continuation of life. From the second month, it is not even possible to see them unless they are carefully looked at. For this reason, it would be appropriate for patients who want to have surgery not to worry about the scar problem.
How to feed after sleeve gastrectomy?
The patient can only consume liquid foods for the first two weeks after the surgery. Then, in the transition to pureed solid food, liquid and solid foods should be consumed together. Carbonated drinks are prohibited for life. In the nutrition plan consisting of natural and healthy foods, foods rich in minerals, vitamins and protein should be consumed. In the nutrition plan created under the control of a dietitian, if the patient needs it, it may be necessary to take vitamins and other supplements as supplements.
What are the Tests Performed Before Sleeve gastrectomy Surgery?
- Blood and biochemistry tests
- Hormone tests
- Hepatitis tests
- Whole abdominal ultrasound
- Gastric endoscopy
- Lung X-ray
- Heart radiography
- Lung breathing test
- Insulin resistance detection
In addition to these tests, it is checked whether the patient has any condition that prevents the operation or whether there is any other underlying condition that causes the disease before the operation, with the examination of the physicians from the internal medicine, cardiology, chest diseases and endocrine units, especially the anesthesiologist. Thanks to these tests and examinations, risks such as bleeding, coagulation, leakage and anesthesia reactions that may occur after the operation are largely prevented.
Healing Process After Gastric Sleeve Surgery
There are some rules that affect the healing process of patients who are discharged about 4 days after the operation. Patients with a special nutrition program must be under the control of a dietitian. In this program, where there is a gradual transition from liquid food to solid food, patients can switch to a normal diet within an average of 2 months. It should not be forgotten that alcohol and smoking should not be used, the consumption of carbonated drinks is prohibited and foods that are not allowed by the dietitian should not be consumed. If the patient needs vitamin and mineral supplements, again, it is possible to take supplements as recommended by the physician. With regular health checks and exercise, the patient’s quality of life will reach the desired level.
Complications That May Occur After Gastric Sleeve Surgery
As in many surgical applications, there are possible complications after surgery. Among the most common complications are bleeding, partial separation of the suture line, and accordingly, the escape of both the food and gastric fluid into the abdominal cavity, and embolism, that is, clot.