Sleeve Gastrectomy – what is it and how is it performed?
Sleeve gastrectomy is a weight loss procedure. It is going to help you lose weight in two ways. First, it’s a restrictive procedure. Second, it’s a hormone restrictive procedure. We take off the part of the stomach where the ghrelin hormone is produced. So patients are going to eat less and have less appetite.
We use bougie to calibrate the sleeve surgery. After the surgery we make suture reinforcements to help prevent leaks. Once we finish the sleeve gastrectomy procedure, we leave a drain for two days. After the surgery, the patient begins to walk for the first two hours and after that, the patient begins eating crushed ice. Overall, it’s a very secure procedure with very good results.
Lap Band Surgery Revision to Gastric Sleeve Surgery?
In the past we had a lot of patients with lap-band surgery because it was a very common procedure. Now the most common procedure is the gastric sleeve. Why? Because it is safe, we don’t have to put any implant into the body. When there are complications with the band, like slippage, that requires a change to gastric sleeve and it needs to be done in two procedures. Remove the band, and resolve the complication first. Then perform the gastric sleeve surgery. It requires preparation, like endoscopy; but can be performed safely. In general, the conversion of Lapband to Sleeve is a very good revision option.
How Much Does the Average Patient Lose?
It depends on each patient and their natural propensity, but most patients will lose roughly 65-90% of their excess body weight. Excess weight loss will be affected by a patient’s dedication to the post-surgery diet and exercise.
Will My Hair Fall Out or Become Thinner?
This may or not happen, but it isn’t something to worry about. After massive weight loss, patients will begin to grow their hair back – if your hair falls out. Patients can exacerbate their hair loss by eating low-quality food with little to no nutrients. If your hair starts falling out it’s important to consume supplements to help combat hair loss.
Can I get pregnant After Gastric Sleeve Surgery?
Yes, most surgeons recommend getting pregnant after the first 12 months post-surgery. There are several risk factors that pregnant obese women face including polycystic ovarian syndrome. Be sure to take your vitamins and supplements.
Will My Gastric Sleeve Stretch Out?
Yes, most patients’ stomachs will stretch out with time. The stretch will not be as large as gastric bypass. Studies have shown that if you use a 32 Fr bougie, you will good weight loss without being stretched out too much. No patient should have their stomach stretched out to the size it was before. Commonly used bougies for the gastric sleeve surgery can range between 28-60 Fr.
What is “Bougie”? And Why is it Used?
Bougie is a tube for calibration, something that aids the surgeon in removing the appropriate amount of the stomach in a gastric sleeve procedure. When the patient undergoes anesthesia, the bougie is inserted through the mouth, down the esophagus, and into the stomach. This bougie is a basic pattern (image a cookie-cutter), to allow the surgeon to remove excess stomach – while keeping a necessary portion left for nutritional needs. Bougies are measured in “French,” or “Fr.”
1 Inch = 76.2 French
1 French = 0.333 millimeters.
If Gastric Sleeve Doesn’t Work For a Patient, What Are the Options?
Gastric Sleeve is a powerful weight loss surgery, but sometimes patients will fail to lose adequate weight loss. If patients fail to lose weight, patients can revise to gastric bypass or duodenal switch.
What is the Age Required to Undergo Gastric Sleeve Surgery?
The minimum age is typically 18, but special cases can be made for persons under 18. If the prospect has threatening co-morbidities, then special circumstances can be made. The maximum age is typically 65 because as patients get older the risk of undergoing the surgery does not outweigh the potential rewards.