Gastric sleeve surgery; Medically known as Sleeve Gastrectomy; It is a type of obesity surgery used to help people with obesity problems lose weight. This practice, also known as weight loss surgery, is of course preferred as a component of the general diet or as an additional measure. Although the operation is not as challenging as operations such as open heart surgery, it is a serious and clinical practice and must of course be performed by operating surgeons who are experts in the field.
Depending on the obesity level, sleeve gastrectomy surgery may be preferred. At this point, the consultation of the physician will be effective and the final decision will be made based on this. Metabolic surgery procedures are preferred when the patient is severely obese. There are many types of these applications, and the sleeve gastrectomy operation is known to be one of the most preferred ones.
It has been medically proven that obesity is a precursor to many other health problems. Therefore, after people are diagnosed as obese, they are considered patients and treatment procedures are applied to eliminate this problem. All operations have certain risks, such as obesity; Since obesity is a bigger problem than the risks of surgical operations, it is a common method for people to undergo obesity surgery operations to eliminate these health problems.
What are the Gastric Reduction Surgery Methods?
Stomach reduction (RNY Gastric bypass, gastric sleeve) surgeries have begun to be used for obesity surgery after a significant weight loss was observed in obese cancer patients after stomach surgery.
What is Gastric Sleeve Surgery?
Gastric sleeve surgery is an obesity surgery that has become popular in recent years. This surgery is usually performed by the closed (laparoscopic) method. During this surgery, approximately 80% of the stomach is removed with the guidance of a tube temporarily placed into the stomach through the mouth and the stomach volume is reduced. The aim of stomach shrinkage is to reduce the volume of food taken. In addition, since the secretion of the hormone (Gharelin), which is secreted from the removed part of the stomach and triggers the feeling of hunger, decreases, a feeling of satiety occurs with a small amount of food after the surgery. After the surgery, weight control is achieved through a new diet and exercise.
History of the Surgery
Duodenal Switch, the operation closest to type stomach surgery, was first performed by Dr. Implemented by Doug Hess. The operation was transformed into Sleeve Gastrectomy method in 2001. Canadian surgeon; Dr. Gagner and his team announced it as the result of a study that started in 1999. Currently, many different obesity surgery applications have been carried out and are being implemented effectively.
Differences Between Gastric Sleeve and RNY Gastric Bypass
Gastric sleeve surgery is a weight loss surgery that takes approximately 1 hour. RNY Gastric Bypass surgery takes longer due to multiple interventions.
Gastric sleeve surgery is a very effective surgery in reaching the target weight. By removing a large portion of the stomach, the patient eats less and gets full much faster.
RNY Gastric Bypass surgery, unlike sleeve gastrectomy surgery, does not only target the stomach. At the same time, the small intestines are also involved, reducing both the amount of eating and the absorption of nutrients.
In RNY Gastric Bypass surgery, the remaining small part of the stomach is reconnected to the small intestine, while in sleeve gastrectomy surgery, the part to which the intestine is attached is not removed.
After sleeve gastrectomy surgery, patients experience less appetite after surgery, as an appetite-increasing hormone is released on the cut side of the stomach. RNY Gastric Bypass has a similar effect as the stomach shrinks.
Compared to gastric sleeve surgery, in RNY Gastric Bypass surgery, a larger part of the stomach is disabled and satiety is at a higher level by eating very little. In sleeve gastrectomy surgery, 80% of the stomach is removed.
How is Gastric Sleeve Surgery Performed?
Gastric sleeve surgery (stomach insertion surgery) is the practice of entering the abdomen laparoscopically and removing 75-80% of the stomach. Laparoscopy; It is a form of application performed through small incisions, and the procedure is performed by intervening with the patient through these small holes using special tools. Considering the ease of application and low complications, this is considered one of the great advantages of the operation.
Various examinations and tests are required before the operation is performed. These are consultations with tests and medical imaging evaluation tools.
If you have decided to have sleeve gastrectomy surgery, the surgery team receives support from blood tests, x-ray, ultrasonography, endoscopy, endocrinological, cardiological, pulmonology, evaluation by a psychologist and anesthesiologist, and other branches deemed necessary. Weight will be monitored by meeting with a dietitian both before and after the surgery. Smoking should be stopped at least 3 months before the surgery. All medications and nutritional support products used should be reported to the surgical team.
Following all preparations, surgery is performed under general anesthesia. Although the open method is rarely used, today this surgery is performed closed (laparoscopic). During the surgery, the stomach is shaped into a tube with the help of a tool called a gastric stapler. The surgery takes approximately 45 minutes to 1 hour. After the cutting process is completed during the surgery, safety is checked by performing a leak test (blue dye test) according to the surgeon's preference. After the surgery, you will be taken to your bed after 1-2 hours of waking up.
How to Lose Weight with Gastric Sleeve Surgery?
Gastric sleeve surgery; It is an application that helps reduce stomach volume. In obesity and metabolic surgery applications, the principle of shrinking the enlarged stomach and consuming less food as a result is essential. However, patients need to pay attention to their diet after the operation and use their willpower not to consume excessive food. Otherwise, complications may occur after the operation and the patient will not be able to lose weight due to consuming excessive amounts of food.
Obesity and Metabolic surgery operations are more than a direct solution for weight loss, they are a physical measure used to support the person's will. If the person does not pay attention to the warnings made with the operation, does not eat properly, does not do the necessary exercises and neglects his examinations, it is very difficult to achieve weight loss results.
Nutrition and exercise conditions after the operation are the most important issues to pay attention to. Since there is a change in the structure of the stomach, it is extremely important to pay attention to food consumption amounts. In addition, the consumption of certain foods will be prohibited in case of diet. Since almost all of those with obesity problems have hormone, diabetes and related diseases, the diet should never be disrupted. Because these diets are developed specifically for the individual.
Exercise program is another vital factor. Both the body's ability to continue functioning effectively and the ability to lose weight after the operation are directly related to these factors.
How Long Does It Take for Those Who Had Gastric Sleeve Surgery to Lose Weight?
After gastric sleeve surgery, patients begin to lose weight rapidly. In this process, where the food eaten and appetite decrease in direct proportion, it is possible to lose an average of 10 kilos per month, although this varies from person to person, and even exceed these figures. Doctors' expectation is to lose approximately 15 or 20 kilos in the first month. After the surgical intervention, patients feel less hungry as the area that triggers the hunger hormone in the large part of the stomach is removed. Accordingly, weight loss actually begins immediately after surgery. Patients lose 70-80% of their excess weight in the first 2 years after surgery.
Who Can Have Gastric Sleeve Surgery?
Body mass index (BMI) must be 40 and above, patients with a BMI between 35-39.9 and one or more of the following heart disease, diabetes (Type 2 Diabetes), hypertension, high cholesterol, sleep apnea and reflux diseases.
In addition, as with all operations, this operation may not be suitable for people who have certain risks when it comes to surgery. In order to make this decision, the physician must make a consultation and make a decision after an evaluation using the necessary analysis and medical imaging tools.
In any case, this operation cannot be applied to all people with weight problems. Especially, it is not possible to perform a stomach reduction operation arbitrarily. This is decided by the doctor and if it is confirmed that it is really necessary, it may be possible for you to have weight loss surgery.
Performing stomach reduction surgery without an evaluation of trying other ways to lose weight is not a common choice and is not included in the protocols. This operation is a preferred operation for severely obese people to support their slimming process, and as we mentioned above, it is supported by many additional measures.
To whom does it not apply?
Tüp mide ameliyatının uygulanması ve uygulanmaması kararı bütünüyle yapılacak konsültasyona bağlı olarak verilebilecek bir karardır. Yaş kriteri dışında birçok sebeple operasyon kararından vazgeçilebilir. Bunların başında kişinin operasyon geçirmek için uygun kiloda olmaması durumu gelebilir. Süper obezlik durumunda hastaya bir diyet uygulanarak belli bir süre operasyonun ertelenmesi mümkün olabilir. Bunun yanında sistemik hastalıkları bulunanlar, pıhtılaşma sorunu olanlar ile kanser hastalarının bu operasyona tabi olabilme durumu, yine hekimin kararı olacaktır.
What Age Is It Suitable For?
Gastric sleeve surgery; It is an operation that can be performed on adults. While surgery is generally not preferred for people over the age of 70, surgery is not the primary choice for children in their developmental age. Of course, in both cases, the operation can be performed if there is a serious necessity.
The age limit for the operation can be relaxed depending on the extent of obesity and its effect on the patient. Serious tests are required to decide this. If you have a severe obesity problem at an early age, you should see a doctor and ensure that other measures are taken as soon as possible before the situation becomes more serious. Because it may not be possible to use this method at an early age. Similarly, at older ages, the application may not be available due to age-related risks.
What are the advantages of Gastric Sleeve Surgery?
Gastric sleeve surgery does not change the natural pathways of the digestive system. In this regard, the person's risk of experiencing digestive system problems is lower than some other operations. Although the operation time is shorter, the recovery time is similar to many other operations.
What are the Risks and Complications?
Since sleeve gastrectomy is a major surgery, it carries some risks both in the short term and in the long term.
It is performed to prevent life-threatening situations that may occur in the course of some diseases associated with excess weight in obese individuals through weight control. Found with excess weight; The risk of death caused by conditions such as heart disease, diabetes (Type 2 Diabetes), hypertension, high cholesterol, sleep apnea, reflux disease decreases after this surgery.
Inability to lose sufficient weight or regain weight may occur after this surgery. Incompatibilities in diet and sports habits after surgery are the most important reasons for these. High-calorie liquid intake, junk food habits and alcohol consumption are common mistakes.
Short Term Risks;
- Leakage (leaking through seams)
- Bleeding
- Infection
- Anesthesia complications
- Respiratory problems
- Clotting problems
- Although rare, sleeve gastrectomy surgery can be fatal.
Long Term Risks;
- Nausea-vomiting
- Bowel obstruction
- Reflux disease
- Malnutrition
- Herniation from incision sites
There is a judgment that the risk of complications will decrease if the patient follows the instructions given by the physician. However, it is not possible to comment that there is no risk at all. However, risks can be reduced by applying treatments under the supervision of a specialist physician.
Things to Do Before and After Gastric Sleeve Surgery
Recommended for all surgical methods; The do's and don'ts should also be applied during the sleeve gastrectomy step. Gastric sleeve surgery, which is performed to protect against obesity and obesity-related or risky diseases, is not a type of diet. It is subject to surgical procedure. The second most curious issue for patients who want to have sufficient data about sleeve gastrectomy surgery is the do's and don'ts before and after sleeve gastrectomy surgery. For this reason, we will try to provide answers to frequently asked questions in our article.
Things to Do Before Gastric Sleeve Surgery
Genel sağlık için sigarayı bırakmak şarttır. Tüp mide ameliyatı ya da ameliyat türü ne olursa olsun hekiminiz sigarayı bırakma konusunda ısrarcı olacaktır. Sigarayı bırakma zamanı ameliyat tarihinden bir ay önce başlar ve ameliyat sonrasında da kullanılmaması önerilir. Sigara solunum yolu enfeksiyon risklerini arttırdığı gibi hastanın ameliyat sonrasında daha bunaltıcı bir iyileşme evresi yaşamasına da neden olabilir. Üstelik iyileşme süresini de uzatıcı en büyük faktördür. Aynı şeyi kesinlikle alkol içerikli maddeler için de söyleyebiliriz. Tüp mide ameliyatlarında alkol tüketiminin bırakılması de sigaranın bırakılması kadar önemlidir. En az ameliyattan bir hafta önce alkol sonlandırılmalı ve ameliyattan sonra da alınmamalıdır.
Let's Prepare What You Will Use After Surgery
Your doctor will provide information after the surgery. Since the surgical intervention is directly aimed at the stomach, most of this information will be focused on nutrition. Therefore, it is important that the deficiencies are corrected before surgery and that it is ready for post-operative consumption. It is essential to have all the recommended food types on your shopping list, from kefir to yoghurt, from sugar-free pudding to protein powder, if possible. Particular attention should be paid to any beverage containing low calories. You can prepare soy milk, multi-vitamins, nutritional supplements in chewable form, and red or white meat, provided that it is lean. You should definitely stay away from products such as fried foods, fatty foods, pastries and snacks.
Let's Learn About Medicines
You should fully inform your doctor about any disease you have, the medications you need to use regularly, and even the foods and beverages you consume regularly. You need to stop taking blood thinning medications such as aspirin. Also avoid substances such as cherry stems, fish oils and green tea. In addition, inform your doctor if you are taking medications for diabetes, heart disease, etc. Depending on your situation, some medications may need to be discontinued or the dosage reduced by rearranging them.
Weight Loss Before Surgery
Gastric sleeve surgeries are procedures focused on obesity. The patient who will undergo gastric sleeve surgery does not have a fit body. Therefore, if you are going to have this surgery, you must be very overweight. For this reason, your doctor may tell you that you need to lose weight at a certain rate before the surgery. Overweight patients may not be able to undergo direct surgery. You may need to lose weight at the rates and methods specified by your doctor. During this weight loss process, eating after 7 pm should be avoided, and protein, vegetable and fruit-oriented nutrition should be increased.
Preoperative Nutrition
After making all your mental and physical preparations, do not forget that you should come to the surgery hungry. For this reason, you should not eat or drink anything, including water, 8 to 12 hours before the operation. After the end of the operation, you can prepare as if you will stay in the hospital for 2-3 days. For example, you can add books, magazines, notebooks, clothes, etc. to your preparation.
Mental Preparation
Mental preparation may also be required in some very overweight patients. You may find your psychological state inadequate and you may be receiving treatment for it. Therefore, you need to prepare mentally for the surgery. Meet with your consultants and inform them that you will have gastric sleeve surgery and try to be as mentally prepared as possible. Postoperative diet and eating habits need to be adjusted. Consumption of snacks, excessive carbohydrate products, and any food that may tire the stomach should be minimized. You can take care to focus on these issues with your psychological counselor. You can consult a dietician. All detailed information about all these processes will be shared by your surgeon and he will direct you to the necessary units if necessary.
Recovery Process After Gastric Sleeve Surgery
You can get out of bed and start walking within 2-6 hours after the surgery. Then, after 48 hours, the diet is started, first with sugar-free liquids. Depending on the patient's ability to tolerate nutrition, a new diet is started in stages such as liquid, puree and eventually normal nutrition. The majority of patients are discharged within 2-3 days.
Although there is generally no need for vitamin support after gastric sleeve, some patients can take multi-vitamin and mineral supplements temporarily. Starting from the 10th day after the surgery, sports activities such as walking can be gradually started.
Starting from the 1st month, walking exercise is started 5 days a week and for an average of 30 minutes a day. Walking pace should be at least 3 km in half an hour.
1st week after surgery, 1-3-6-12. Routine checks are carried out every month. During these checks, weight status, regression of existing diseases, regulation of previously used medications and blood tests are performed. , ,
Nutrition After Stomach Surgery
Nutrition after gastric sleeve surgery; can be classified as short term and long term. In the first phase of the recovery process, that is, within the first one and three months, the patient should consume foods that will not cause excessive stomach strain. It is extremely important to comply with the diet given during this process. In addition to naturally following a diet after the operation, it is necessary to stay away from foods that are difficult to digest and comply with the protein, carbohydrate and fat balance specified in the diet list.
In the short term, consumption of liquid foods will return to a normal diet within a few weeks, and starting from the 3 month period, foods consumed before the operation can be consumed. However, in this process, a nutrition period appropriate to the diet should be preferred. Moreover, the doctor may not allow the consumption of certain foods.
Vitamin and mineral support during the recovery process is standard for almost every obesity and metabolic surgery operation. Taking your medications and nutritional supplements as prescribed is extremely important for the results of the application.
Recommended Exercises After Surgery
Gastric sleeve surgery; It is a preferred operation for losing weight. Of course, losing weight is possible not only by reducing food intake, but also with an exercise program. For this reason, people need to do certain exercises even during the recovery process. After all surgical operations, it is necessary to move to restore the routine balance of the digestive system. Immobility is always a problem for people, and the postoperative care guide states that relevant medical personnel should be careful about these issues.
However, of course, heavy sports exercises are not suitable after the operation. Walking is the most appropriate exercise in the 3-6 month period after obesity surgery operations. After 6 months, the person can do certain physical exercises if the doctor approves. However, choosing sports with equipment in the short term can be considered a risk. For this reason, this type of exercise is generally not recommended. In addition, if overweight people do sports that require excessive effort, there is a risk of complications from cardiovascular diseases. In this regard, controlled sports and more physical education are a better approach.
Diet and exercise are extremely important to get rid of obesity. If these two factors are adopted appropriately and obesity surgery, that is, sleeve gastrectomy surgery, is performed, the success rate can be quite high. At this point, it is mentioned that there are different amounts of weight loss depending on the person's current weight, and it has been reported that patients who comply with the rules can reach normal body mass index from super obesity.
What are the Risk of Leakage and Symptoms of Leakage After Gastric Sleeve Surgery?
This very serious condition should be checked during surgery after the procedure is completed. Even if there is no problem during this check-up, it may occur after the surgery. The main reason for this is disorders in wound healing. Vomiting attacks can increase stomach pressure and cause leakage. Another factor that may cause the risk of leakage is not following the given diet correctly and therefore exposing the stomach to heavy eating conditions. The leak, which is initially accompanied by a complaint of severe pain by the patient, can show much more obvious symptoms in cases where it is noticed late. Gastric fluid and bile flowing into the abdominal cavity cause infection, and if this infection is not detected quickly, it can progress to other organs and push the patient into a serious intensive care unit. This life-threatening condition causes complaints such as abdominal pain, fever and hiccups. In this case, a doctor should be consulted immediately.
When to Drink Alcohol After Gastric Sleeve Surgery?
It is recommended that the patient does not consume alcohol for the first 6 to 8 months after surgery. All alcoholic beverages should be avoided and even carbonated drinks should not be approached. Since a large part of the stomach is removed, alcohol mixes with the blood faster and has much greater effects than expected. The reason why it is not desirable to consume alcoholic beverages is that alcohol is harmful to the stomach and has very high calories. An individual who consumes alcoholic beverages may gain weight without realizing it.
When can sports be done after gastric sleeve surgery?
After the surgery, depending on the patient's recovery, walking and sports can be started after the 10th day. According to the doctors' recommendations, the patient should spend the first 10 days resting and allow his body to adapt to this new life. The patient, who gets used to the new stomach and new eating pattern, can do small exercises at the end of the first month. However, it should be noted that heavy sports activities should be avoided in order to avoid complications. Any adverse move within the first month may cause greater damage than expected. In this context, you should follow your doctor's advice and strictly follow the sports exercise recommendations.
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