Sleeve Gastrectomy Operation is the removal of a large part of the stomach that acts as a depot. Normally, the stomach, which has a volume of 1.5-2 liters, is converted into a thin tube with a volume of roughly 100-150 ml. The aim is to reduce the amount of food that can be eaten at one time, but there is no intervention in the natural flow of the digestive system to reduce absorption.
The most applied operation in obesity in the world and Turkey is the Sleeve Gastrectomy.
While the main advantages of sleeve gastrectomy are that it does not change the natural flow of the digestive system, thus causing less vitamin and mineral deficiency, it causes much less reflux complaints compared to the gastric band, and no foreign body is placed in the body; The most important disadvantages are that it is an irreversible method, unlike the tape, with the risk of bleeding and leakage from the stapler line since it includes a long incision line.
Complaints such as nausea, vomiting, and pain are very few if the patient’s compliance with the nutritional rules is good after sleeve gastrectomy performed in accordance with the technique.
The only obvious effect of sleeve gastrectomy that can affect life comfort after surgery is reflux. 20% of the patients have these complaints in the first year. Over time, most of them regress. Moreover, the process of getting used to the tube stomach of the patients’ body is better than the gastric band and bypass. Side effects of sleeve gastrectomy are less than gastric bypass and larger surgeries. Average weight loss has been shown to be equivalent to gastric bypass, much better than gastric banding. It has a lower risk than other obesity surgeries in terms of long-term risks.
The effectiveness of sleeve gastrectomy in the improvement of type 2 diabetes is close to or equal to gastric bypass. However, there are studies showing that diabetes can recur in the long term. In terms of operation time, sleeve gastrectomy is much more advantageous than bypass. Both operations have similar effects in terms of quality of life.
As approximately 2/3 of the stomach is removed in gastric sleeve surgery, the amount of food eaten decreases significantly and a feeling of satiety occurs earlier. Another effect of the surgery is where the Ghrelin hormone, which triggers the hunger, is produced. Thus, the hormone that triggers the appetite decreases in the blood and the appetite is suppressed.
Since the natural flow of the digestive system is not interfered with, digestion and absorption continue normally after sleeve gastrectomy. Therefore, there is much less risk of vitamin and mineral deficiency than in surgeries that interfere with absorption.
When supported by a healthy nutrition system and exercise, it can be ensured that you lose 60-80% of your excess weight within one year after surgery. Of course, when the rules are not followed and old bad habits are returned, there is a risk of not losing enough weight, or even gaining weight again.
Gastric sleeve surgery is performed by laparoscopic method, that is, 5 small incisions are made in the abdomen. The operation takes an average of 45-60 minutes. Of course, this also relates to previous surgeries or anatomy. Generally, the length of stay in the hospital is 3 or 4 days.
Since reflux complaints increase in 20% of patients after sleeve surgery, great care should be taken when making the decision for sleeve in patients with reflux. The condition associated with chronic reflux, called Barett oesophagus, is a definite contraindication to sleeve gastrectomy. In other words, gastric sleeve surgery should not be performed on patients with Barett oesophagus and bypass should be preferred.