Restrictive operations like gastric sleeve surgery make the stomach smaller and help people lose weight. With a smaller stomach, you will feel full a lot quicker than you are used to. This means that you will need to make big lifelong changes in how you eat—including smaller portion sizes and different foods—in order to lose weight.
This surgery can be done by making a large incision in the abdomen (an open procedure) or by making several small incisions and using small instruments and a camera to guide the surgery (laparoscopic approach). More than half of your stomach is removed, leaving a thin vertical sleeve, or tube, that is about the size of a banana. Surgical staples keep your new stomach closed. Because part of your stomach has been removed, this is not reversible.
Sometimes this surgery is part of a larger approach to weight loss done in several steps. If you need to lose a lot of weight before you have duodenal switch surgery, gastric sleeve surgery may help you.
Why is gastric sleeve surgery done?
Weight-loss surgery is suitable for people who are severely overweight and who have not been able to lose weight with diet, exercise, or medicine.
Surgery is generally considered when your body mass index (BMI) is 40 or higher. Surgery may also be an option when your BMI is 35 or higher and you have a life-threatening or disabling problem that is related to your weight.
It is important to think of this surgery as a tool to help you lose weight. It is not an instant fix. You will still need to eat a healthy diet and get regular exercise. This will help you reach your weight goal and avoid regaining the weight you lose.
The day of surgery
Follow the instructions exactly about when to stop eating and drinking. If you don’t, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
Do not shave the surgical site yourself.
Take off all jewelry and piercings. And take out contact lenses, if you wear them.
At the hospital or surgery center
Bring a picture ID.
The area for surgery is often marked to make sure there are no errors.
You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
The surgery will take about 1 to 3 hours.
After surgery, the bowel usually “rests” for a few days before it starts working again. You may have a thin plastic tube in your nose that goes into your stomach. This tube drains stomach juices and prevents nausea. The drainage usually looks green, brown, or even black with flecks of blood. The tube will be removed in a few days, after your bowels start working again. After the tube is removed, you can start drinking and eating again.
What can you expect after gastric sleeve surgery?
Recovery from surgery
You will have some belly pain and may need pain medicine for the first week or so after surgery. The cut that the doctor makes (incision) may be tender and sore.
Because the surgery makes your stomach smaller, you will get full more quickly when you eat. Food also may empty into the small intestine too quickly. This is called dumping syndrome. It can cause diarrhea and make you feel faint, shaky, and nauseated. It also can make it hard for your body to get enough nutrition.
Depending on how the surgery was done (open or laparoscopic) you'll have to watch your activity during recovery. If you had open surgery, it is important to avoid heavy lifting or strenuous exercise while you are recovering so that your belly can heal. In this case, you will probably be able to return to work or your normal routine in 4 to 6 weeks. The surgery is most commonly done as a laparoscopic procedure, which means the recovery time is faster.
Eating after surgery
Your doctor will give you specific instructions about what to eat after the surgery. For about the first month after surgery, your stomach can only handle small amounts of soft foods and liquids while you are healing. It is important to try to sip water throughout the day to avoid becoming dehydrated. You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements.
Bit by bit, you will be able to add solid foods back into your diet. You must be careful to chew food well and to stop eating when you feel full. This can take some getting used to, because you will feel full after eating much less food than you are used to eating. If you do not chew your food well or do not stop eating soon enough, you may feel discomfort or nausea and may sometimes vomit. If you drink a lot of high-calorie liquid such as soda or fruit juice, you may not lose weight. If you continually overeat, the stomach may stretch. If your stomach stretches, you will not benefit from your surgery.
Your doctor will probably recommend that you work with a dietitian to plan healthy meals that give you enough protein, vitamins, and minerals while you are losing weight. Even with a healthy diet, you probably will need to take vitamin and mineral supplements for the rest of your life.
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