The Sleeve Gastrectomy




The sleeve gastrectomy  is an operation where 85% of your stomach is removed laparoscopically. The operation works by restricting the volume of food that you eat and making you feel full sooner. It also causes a release of gut hormones that makes you feel full and helps patients with diabetes.

For this operation the stomach is fully mobilised and divided using a special laparoscopic stapler/cutting device. A plastic tube is placed in your stomach so that we can measure the size of the stomach  left behind. We test for leaks by squirting blue dye down the stomach. The stomach that has been detached is then removed by making one of the key hole incisions slightly bigger.

Several weeks before your sleeve gastrectomy is performed a camera test of your stomach (gastroscopy) is arranged to ensure that the stomach being stapled off is healthy.

When you see the pharmacist for your pre-operative assessment you may have your regular medications converted to liquid form and /or given instructions to crush tablets to allow easier ingestion.

The inpatient stay is 2-3 days and the operation usually takes 1-2 hours. It is anticipated that you will loose 60-70% of your excess weight at 2 years.

Eat slowly and follow the advice of the dietitians wrt type of food, texture, speed of eating and volume of food ate.

Complications

The sleeve gastrectomy operation is not without complications and it is important that you fully understand the risks and discuss this matter with us before you decide to have this operation.

Death The sleeve gastrectomy has an anticipated death rate between 1 in 1000 and 1 in 3000 operations.

Bleeding and infection (chest, wound, urine) common to any operation performed.

Deep Venous Thrombosis and Pulmonary Emboli  Obese patients have a higher risk of deep venous thrombosis (DVT) which are blood clots developing in the leg veins. These clots can break away and circulate into the lungs as a pulmonary embolus (PE). We do our best to significantly reduce the chance of this happening by prescribing medicine to thin the blood. This is given before your operation, whilst an inpatient and up to 7-10 days after you have left hospital. We will teach you to give it yourself as an injection or make arrangements for it to be given. You will also be fitted with special gradated calf stockings.

Staple line leaks  Any surgery that involves the cutting bowel is at risk of leaking. Even if the blue dye test is ok leaks can occur that may require a return to the operating theatre. The risk is 3-7%

Hair loss  Not a major problem but can occur following this type of operation.

Vitamin deficiencies  All patients need to take an A-Z multivitamin tablet twice a day, iron, vitamin D and calcium supplements and B12 injections every 3 months.

Acid reflux  Patients with a known hiatus hernia and reflux disease can often have a worsening of their symptoms following this type of operation. Other patients (10%) may develop acid reflux when prior to surgery they had none. 

Pregnancy Woman within the child bearing age should NOT become pregnant for at least 2 years following surgery.

Contraception The best means of contraception for females is either an intrauterine coil or a depot injection.