Gastric sleeve surgery (stomach reduction surgery), which is used by those who cannot lose weight despite diet and exercise, is a method that allows the patient to feel satiety with less food. Well, can this surgery be applied to everyone? How much weight can be lost after the operation? Are there risks? Here are the things to know about this subject ..
Obesity is a common problem in our country as well as all over the world ... Therefore, the demand for stomach reduction surgeries is increasing day by day. However, life-threatening is inevitable if the operations in question are not performed in expert hands. What method is it? In tube stomach (stomach reduction) operations, also known as Sleeve Gastrectomy, it is aimed to make the patient feel full with very little food by reducing the stomach volume. In this operation, a certain part of the stomach (the part that stretches the most, expands and manages the appetite) is surgically removed and a tube-shaped stomach (about the size of a banana) is left. Due to the hormone called ghrelin secreted from the part of the stomach, appetite control and a feeling of satiety are provided. Gastric sleeve surgeries are also performed by laparoscopic method. Surgery is performed by entering the abdominal cavity through small incisions. Can it be applied to anyone with weight problems? No, there are some criteria for this. First of all, the patient must have tried non-surgical methods such as diet and exercise for a while, but still failed to lose weight. The patient must be between 18-80 years old and able to handle anesthesia. If the Body Mass Index is above 40 or between 35-40, there must be an additional disease related to obesity.
For example, diabetes, high blood pressure… Besides, the patient should not have an untreated psychiatric disorder and should not be addicted to drugs or alcohol. Patients who meet these criteria can undergo surgery. How is body mass index calculated? Obesity is assessed by Body Mass Index (BMI), which is calculated by dividing weight by the square of height value (kg / m²). In obesity, reference range of the World Health Organization is taken as basis. According to Body Mass Index results; 18.5-24.9 normal, 25-29.9 pre-obesity, 30-34.9 obese I, 35-39.9 obese II, over 40 obese III. Who is not recommended? Tube stomach for cosmetic weight loss requests, patients outside the age limit of 18-80, patients who do not pay attention to their diet after surgery, who cannot control eating, alcohol or substance addicts, serious heart or lung disease that prevents anesthesia surgery is not recommended. Is it dangerous? Laparoscopic Sleeve Gastrectomy (banana stomach-stomach reduction) is a 60 percent successful method for weight loss. This surgery does not cause any harm in the long term. If the patient does not pay attention to his diet, they may have difficulties in losing weight, they may encounter nutritional difficulties, and even gain weight.
What should be considered?
Some important points to be considered in surgery are as follows:
- Before gastric outlet, an average of 7 cm line should be maintained.
- The tube we call a gatric tube (39 French diameter) must be used and stomach reduction must be performed under its control. If this is not done with a tube, technical problems occur, there are strictures in the stomach or the stomach can be closed completely. Then leakage from the suture line may occur and result in mortality. This is one of the main causes of stomach leakage.
- Another reason is the importance of the material to be used. Using 3-row stapler reduces the complication. In addition, it is important to consider the small cruiser angle of the stomach. In this way, the stomach is prevented from drowning in the shape of an hourglass. Bleeding in the strain line and inability to control the bleeding are the causes of leakage.
- When the operation is over, it is important to control the surgery, to test it by giving blue dye into the stomach, to detect any leakage, and to close the open points by placing a suture accordingly.
- One of the most important points in surgery is the peak point, which we call the fundus, and the complete separation of the stomach from the spleen is technically difficult. This is the most important and dangerous leak point that can occur in the stomach. Proper differentiation of this area is a factor affecting the success of the surgery. Failure to remove or inadequate removal of the part of the stomach called the fundus (which is the region where the hormone of the ghre is secreted) causes the ghrene hormone to remain high, and this causes the feeling of satiety to disappear.
- Patients should not be discharged immediately after surgery. If they are discharged early, it may cause delayed intervention as complications will be difficult to detect. This increases mortality and morbidity.
How many pounds can be lost?
Slow weight loss occurs in the first 3 weeks and rapid weight loss within the next 1 month. The full weight loss process is completed in an average of 6 months. Generally, there is a total weight loss of 25 to 35. This surgery does not cause any harm in the long term. If the patient does not pay attention to his diet, he may have difficulties in losing weight and may encounter nutritional difficulties.
Can you regain weight?
After the operation, patients who do not comply with their diet (for example: consuming high-calorie liquid food, incompatible patients who cannot control eating) also gain weight again. Therefore, "Gastric By-pass Surgery" would be a more appropriate treatment method instead of "Sleeve Gastrectomy" for patients who are found to have dietary incompatibilities. (95% success)