Gastric Sleeve Procedure

  Gastric Bypass is a restrictive and malabsorptive procedure that has been performed worldwide for over 35 years. Gastric bypass involves cutting and stapling a small piece of the stomach so that it becomes separate from the other portion.

How it works

Gastric bypass surgery makes the stomach smaller and allows food to bypass part of the small intestine. You will feel full more quickly. Bypassing part of the intestine also results in fewer calories being absorbed.
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Is the Gastric Sleeve right for me?

Most people who have gastric bypass surgery quickly begin to lose weight and continue to lose weight for up to 12 months. One study noted that people lost about one-third of their excess weight (the weight above what is considered healthy) in 1 to 4 years. Some of the lost weight may be regained.
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Gastric Sleeve Surgery is a relatively new bariatric procedure. But quickly it is becoming a popular weight loss surgery option.

Laparoscopic gastric sleeve resection procedure involves the removal of the lower two-thirds of the stomach, which results in a stomach pouch that is smaller and more tube-shaped. This causes patients to become full after eating much less food than before surgery. With the laparoscopic technique, small holes are made in the abdomen instead of larger, more traditional, surgical incisions.

The laparoscopic approach results in a much shorter recovery period. After the laparoscopic gastric sleeve resection procedure, eating and other lifestyles habits must be permanently altered. Required changes include eating smaller quantities of food more frequently in order to prevent sudden attacks of hunger and to ensure that the body obtains sufficient proteins, minerals, and vitamins. 

• Sleeve gastrectomy may be safer than gastric bypass for patients who have a number of health risks.
• It lowers the risk of ulcers compared to gastric bypass.
• The surgery cuts away the part of the stomach that produces grehlin, a stomach hormone that stimulates hunger.
• Though the stomach is smaller, the openings are left intact, so digestion can go on as normal.
• The body is free of foreign objects.

• Sleeve gastrectomy is more common in Europe, but most American health insurance carriers still consider it an investigational procedure and
  do not cover the cost.
• Anytime you have anesthesia or surgery, there is a risk of blood clots, other complications or death.
• Do not smoke. Smoking would put you at high risk for infection, blood clots, slow healing and other life-threatening complications.
• Complications can occur with the stapling, such as leaks or bleeding.
• You may need malabsorptive surgery – intestinal bypass or duodenal switch – in addition to your sleeve gastrectomy in order to lose all the weight you need and want to lose.
• The smaller portion of the stomach may stretch.
• Foods that you eat now may cause discomfort, nausea or vomiting after your surgery.
• Gastric surgery puts you at higher than normal risk of developing gallstones and gallbladder disease.
• You will not lose weight or maintain your weight loss unless you eat a healthy diet and exercise regularly. This is the reason we stress long-term follow-up with our center and your doctor.

• You have been obese for at least 5 years.
• You do not have an ongoing problem with alcohol.
• You do not have untreated depression or another major psychiatric disorder.
• You are between 18 and 65 years of age.

All surgeries have risk, and it is important for you and your health professional to discuss your treatment options to decide what is best for your situation.

1. Maintenance of the VSG?
2. How much protein per day should I be eating?
3. What kind of diet will I be on Post-op? Do you send me information?
4. Should I be taking a Vitamin everyday?
5. Will I lose my hair?
6. Will I have nausea?
7. Will this fix my heartburn?
8. What are the long-term results of VSG?
9. Can I drink alcohol?
10. How much time off work?
11. What kind of staples do you use? Will they sound off the alarm if I cross the metal detector in an Airport?
12. How would I know if I had a leak?
13. What kind of follow-up do I need with my primary care doctor/lab tests?

1. Maintenance of the VSG?
VSG procedure differs from Lap-band surgery because it is free of “maintenance”. Meaning, you will not need any band adjustments or “fills”, nor will you have any erosions or slippage because you have no band. The VSG does not need regular checking (blood work, vitamin screening, etc.) as with the Roux en Y Gastric bypass or Duodenal switch because you have no mal-absorption.
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2. How much protein per day should I be eating?
Studies show that you should take between 40 to 70 grams of protein daily, especially in the first 6 to 12 months post-op.
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3. What kind of diet will I be on Post-op? Do you send me information?
We take our patients by the hand step by step. We will inform you pre surgery what will be required of you. This includes your post-op diet guide, any special instructions you may need as well as aftercare directions.
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4. Should I be taking a Vitamin everyday?
Although there are no reported vitamin deficiencies, we recommend a multivitamin (chewable) to our patients once daily.
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5. Will I lose my hair?
Hair loss is the result of bad eating habits. You can prevent it by eating enough protein and taking your vitamin supplement.
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6. Will I have nausea?
There are people who are very sensitive to the anesthesia. These people tend do be a bit more nauseated than others. The manipulation of the stomach during surgery may also produce some nausea in some patients. The post-operative VSG patient that does present with nausea, is around 15-20%. Nausea does subside in the next few hours post-op. All of our patients receive medications to prevent nausea in the recovery room.
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7. Will this fix my heartburn?
Probably. Heartburn or acid reflux (GERD) is directly related to being overweight (there are other causes of GERD). Once you start losing those pounds you should notice that the heartburn starts to disappear. We give each patient who undergoes the VSG a treatment to reduce the acid production in the stomach, which also reduces the heartburn.
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8. What are the long-term results of VSG?
Since it is a quite new procedure, there are no long-term studies (10 years) yet. But studies have shown that the VSG has similar results to the Lap-Band or Roux en Y but without their complications at 5 years.
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9. Can I drink alcohol?
Yes, but it is not recommended. Alcohol has many calories and will not help on your progress with your weight loss. Alcohol intoxication will also hit you a lot faster with the VSG than other surgeries.
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10. How much time off work?
After a bariatric procedure done through laparoscopy you will be able to do your regular activity once you get home. Drive in 3 to 4 days and return to work in 5 to 7 days. Some people who have desk-jobs return to work immediately. We restrict our patients on “heavy” weight lifting for 30 days.
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11. What kind of staples do you use? Will they sound off the alarm if I cross the metal detector in an Airport?
We use titanium staples made my Autosuture in the United States. We use these because they have 3 rows of staples. That gives the patient an added sense of security. We also over sew the staple line making our leakage rate % very low.
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12. How would I know if I had a leak?
Our leakage rate is at 0.32% with over 400+ patients. But say you did have a leak, symptoms would be fever, abdominal pain, tachycardia (elevated heart beat), intolerance to liquids, etc. For this reason, a barium swallow is done the day after surgery to check for any leaks that may appear.
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