Gastric Sleeve Surgery
Reasons for the procedure
Gastric sleeve surgery is a form of bariatric, or weight-loss, surgery. (It is also known as sleeve gastrectomy or vertical sleeve gastrectomy.)
Your doctor may recommend this procedure if you have severe health problems related to obesity. Gastric sleeve surgery restricts your food intake, which leads to weight loss. It’s often performed before you undergo a more complex and riskier weight-loss surgery known as biliopancreatic diversion with duodenal switch, or BPD-DS for short. Gastric sleeve surgery may help you to lose weight before a BPD-DS. However, your doctor may perform gastric sleeve surgery only, without any additional procedures.
Risks of the procedure
Bleeding, infection, and blood clots in your legs are possible side effects that may occur shortly after the procedure. Over time, you may also experience difficulty absorbing certain nutrients, or you may develop strictures (narrowing) in your intestine. People who have bariatric surgery are also at risk for abdominal hernias.
Before the procedure
Before undergoing gastric sleeve surgery, your doctor will perform a complete physical exam. You may also need blood tests and nutritional counseling. If you smoke, you should stop several weeks in advance. Besides the many other health risks of tobacco use, smoking slows wound healing and can cause a number of issues after your surgery. Your doctor may tell you to stop taking aspirin, ibuprofen, and other blood-thinning drugs in the days before your surgery. The night before your operation, you should not eat or drink anything after midnight.
During the procedure
Your doctor will give you anesthesia before your surgery to help you sleep and offset pain. Your surgeon will perform a laparoscopy for your gastric sleeve surgery. In this procedure, your surgeon makes a few small cuts, or incisions, in your abdomen. Into one of these incisions, he or she inserts a thin, narrow tube (a laparoscope), with a video camera attached. This camera allows your surgeon to view your internal organs. The surgeon inserts additional surgical instruments into the other incisions. The laparoscope guides the use of these instruments. During the operation, your surgeon reduces the size of your stomach. With the remaining tissue, he or she creates a vertical tube, or sleeve, that can only hold a small amount of food. Unlike BPD-DS, this surgery will not affect your intestines.
After the procedure
After gastric sleeve surgery, you will probably spend several days in the hospital. You may be able to eat only a pureed diet for the first few days. You will need to change your eating habits to compensate for your smaller stomach. Each meal needs to be very small, and you should take care to eat slowly, thoroughly chewing each bite. You may also find it easier to avoid hard-to-chew foods, which can cause vomiting. If you eat too many sugary or fatty foods, the contents of your stomach may rapidly empty into your small intestine, causing unpleasant symptoms like nausea and cramping. This is known as “dumping syndrome.” Work with your medical team to figure out what is best for you to eat.
People who have weight-loss surgery are more susceptible than others to nutritional deficiencies, because they absorb fewer nutrients. Ask your doctor if nutritional supplements are appropriate for you; many experts recommend a daily multivitamin, plus a calcium-vitamin D supplement. Additional nutrients, such as vitamin B12 or iron, may also be necessary.
You’ll need to have regular blood tests every few months in the year after surgery, to make sure you don’t have anemia, high blood glucose, or low calcium levels.
Keep in mind that it is possible to regain weight that you lose after surgery. To avoid this, be sure to follow a healthy diet and get plenty of exercise. A support group for people who have had bariatric surgery can help you stick with your new healthier habits.
- Fraser, Marianne, MSN, RN
- Jones, Niya, MD, MPH