What is a gastric sleeve ?

 

The sleeve is the name commonly given to a surgical operation performed on the stomach to help the patient lose weight. It is also called the "gastric sleeve" or the "sleeve gastrectomy". This is a surgical operation intended for people suffering from severe obesity (Body Mass Index greater than 35) or morbid obesity (BMI greater than 40).

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During a sleeve, the stomach of the obese person is reduced by 85% from its initial size. The new stomach is therefore only about 15% of the original stomach size.

Your smaller stomach (after removal) limits the amount of food you can eat and feel full after barely consuming small amounts of food.

The reduction by surgery of a large portion of the stomach is done along the greater curvature. The open confines of the stomach are then reattached (often with surgical staples) to form a sheath or tube (shaped like a banana).

The gastric sleeve surgery procedure permanently reduces the size of the stomach. It is performed by laparoscopy (also called laparoscopy, it is a minimally invasive surgical technique for diagnosis and intervention) and is not reversible.

 

For patients suffering from obesity but who are not extremely obese (BMI less than 40), the sleeve alone is an adequate operation with minimized risks. Sleeve gastrectomy as a single procedure is currently an acceptable weight loss surgery option for obese patients. Anesthesia is done before the operation to make you unconscious and unable to feel pain. The operation is usually performed using a tiny camera placed in your stomach. This type of surgery is called a laparoscopy or laparoscopy. The camera is called a laparoscope. It allows your surgeon to see inside your belly.

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During a gastric sleeve:

• Your surgeon will make 2 to 5 small incisions in your abdomen. The surgeon will pass the laparoscope through one of these openings. The camera will be connected with a video monitor in the operating room. Your surgeon will look at the monitor to see inside your belly. Your surgeon will insert fine surgical instruments through the other openings,

• Your surgeon will remove most (about 80% to 85%) of your stomach. The remaining portions of your stomach are connected using surgical staples. This creates a long vertical tube. The new stomach will be shaped like a banana,

• The surgery does not involve cutting or changing the sphincter muscles that allow food to enter or leave the stomach.

• Your sleeve gastrectomy operation may take as little as 30 to 60 minutes if your surgeon has already performed a lot of these procedures.

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Avantages:

 

• When you eat after the operation, the small pouch will fill up quickly. You will feel full after eating only a very small amount of food

• Sleeve gastrectomy is an option if you are very obese and cannot lose weight thanks to a balanced diet and a physical exercise program,

• The operation is performed laparoscopically, significantly reducing the risk of infection,

• This surgery will require you to make a major lifestyle change since it is not a quick fix to obesity. You will be forced to adopt a specific diet and exercise after having a gastric sleeve to avoid post-operative complications or poor weight loss. This surgical operation therefore puts you back in a way "on the right track" from a nutritional and physical point of view,

• Losing enough weight after the sleeve can improve or even treat many illnesses you may be suffering from. Diseases that can be improved or even cured are asthma, type 2 diabetes, hypertension, obstructive sleep apnea, high cholesterol, gastroesophageal reflux disease (GERD),

• Losing weight after a gastric sleeve should also make your travel and daily activities easier,

• This operation does not require the introduction and maintenance of a foreign body (as is the case with the gastric band),

• Vomiting (when the capacity of the new stomach pouch is exceeded) occurs less than with gastroplasty,

• The sleeve reduces the level of ghrelin, and consequently the feeling of hunger (just like the gastric bypass would).

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Disadvantages and risks:

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• This surgical operation is not reversible,

• Patients with a very high BMI may need a second operation to continue losing weight,

• Leakage of the line where the parts of the stomach have been stapled together,

• Vomiting if you eat more than your new stomach pouch can hold.

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Who is this operation intended for ?

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The gastric sleeve procedure may be considered if you have:

 

• BMI of 40 or more: Someone with a BMI over 40 is at least 45 kilograms over their recommended weight. A normal BMI is between 18.5 and 25,

• A BMI between 35 and 39.9 AND a serious illness whose symptoms may improve with weight loss. Some of these diseases are sleep apnea, type 2 diabetes, heart disease.

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The sleeve is often performed on patients who weigh too heavy to be able to choose other types of anti-obesity surgery. A second slimming surgery (see the second step in the “Procedure” section) may be necessary for some patients.

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Perspective and post-operative prognosis:

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The final weight loss may not be as great as with a gastric bypass. However, weight loss may be sufficient for many patients. Because gastric sleeve surgery is a newer procedure, there is less data on the long-term benefits and risks. Talk to your doctor about what procedure is recommended.

 

Weight comes off more slowly than with a gastric bypass. You normally continue to lose weight for 2 to 3 years after the operation.

 

Despite the lack of scientific perspective on the benefits and risks after a sleeve, experts estimate that after 5 years, weight loss is equivalent to about 60% of the initial excess weight. These are intermediate results compared to those of gastric bypass surgery and gastric bypass surgery.

 

The sleeve is not an easy solution to lose weight. It is not to be taken lightly at all. It can cause you to eat less, but you still have to do a lot of work on yourself. To lose weight and avoid post-sleeve gastrectomy complications, you should follow the physical activity and eating guidelines that your doctor and dietitian have given you.

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