What Is a Sleeve Gastrectomy?
Vertical sleeve gastrectomy is surgery to help with weight loss. The surgeon removes a large portion of your stomach.
The new, smaller stomach is about the size of a banana. It limits the amount of food you can eat by making you feel full after eating small amounts of food.
You will receive general anesthesia before this surgery. This will make you sleep and keep you pain-free.
The surgery is usually done using a tiny camera that is placed in your belly. This type of surgery is called laparoscopy. The camera is called a laparoscope. It allows your surgeon to see inside your belly.
Why the Procedure Is Performed
Weight-loss surgery may be an option if you are very obese and have not been able to lose weight through diet and exercise.
Vertical sleeve gastrectomy is not a quick fix for obesity. It will greatly change your lifestyle. You must eat healthy foods, control portion sizes of what you eat, and exercise after this surgery. If you do not follow these measures, you may have complications from the surgery and poor weight loss.
This procedure may be recommended if you have:
A body mass index (BMI) of 40 or more. Someone with a BMI of 40 or more is at least 100 pounds over their recommended weight. A normal BMI is between 18.5 and 25.
A BMI of 35 or more and a serious medical condition that might improve with weight loss. Some of these conditions are sleep apnea, type 2 diabetes, and heart disease.
Vertical sleeve gastrectomy has most often been done on patients who are too heavy to safely have other types of weight-loss surgery. Some patients may eventually need a second weight-loss surgery.
This procedure cannot be reversed once it has been done.
Before Your Surgery
You may want to visit with a counselor to make sure you are emotionally ready for this surgery. You must be able to make major changes in your lifestyle after surgery.
If you are a smoker, you should stop smoking several weeks before surgery and not start smoking again after surgery. Smoking slows recovery and increases the risk of problems. Ask your doctor or nurse for help quitting.
Your surgeon will ask you to have tests and visits with your other health care providers before you have this surgery. Some of these are:
- A complete physical exam
- Blood tests, ultrasound of your gallbladder, and other tests to make sure you are healthy enough to have surgery
- Visits with your doctor to make sure other medical problems you may have, such as diabetes, high blood pressure, and heart or lung problems, are under control
- Nutritional counseling
- Classes to help you learn what happens during the surgery, what you should expect afterward, and what risks or problems may occur afterward
After the Procedure
You can probably go home 2 days after your surgery. You should be able to drink clear liquids on the day after surgery, and then a puréed diet by the time you go home.
When you go home, you will probably be given pain pills or liquids and a medication called proton pump inhibitors.
Your doctor, nurse, or dietitian will recommend a diet for you. Meals should be small to avoid stretching the remaining stomach.
The final weight loss may not be as large as with gastric bypass. And this may be enough for many patients. Talk with your doctor about which procedure is best for you.
The weight will usually come off more slowly than with gastric bypass. You should keep losing weight for up to 2 to 3 years.
Losing enough weight after surgery can improve many medical conditions you might also have. Conditions that may improve are asthma, type 2 diabetes, arthritis, high blood pressure, obstructive sleep apnea, high cholesterol, and gastroesophageal disease (GERD).
Weighing less should also make it much easier for you to move around and do your everyday activities.
This surgery alone is not a solution to losing weight. It can train you to eat less, but you still have to do much of the work. To lose weight and avoid complications from the procedure, you will need to follow the exercise and eating guidelines that your doctor and dietitian gave you.
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Woodward G, Morton J. Bariatric surgery. In: Feldman M, Friedman LS, Brandt LJ. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 7.
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