What Is The Sleeve Gastrectomy? To Whom and How Is It Make?

An increase in the number of obese individuals is seen together with the consumption of unhealthy and fast foods more frequent. Therefore, obesity and surgical methods improve day by day.

The most preferred obesity surgery is the sleeve gastrectomy laparoscopic thy name is the sleeve gastrectomy. The sleeve gastrectomy surgery which was first applied in 1988, is a surgical operation applied by patients who can not lose weight although diet and exercises.

Basically, the operation is performed by turning the stomach into a tube by applying surgical processes. The structure of digestive system organs is like a tube or pipe, except the stomach. However, the stomach is saclike to take more nourishment. In sleeve gastrectomy surgery, a big amount of stomach is extracted and the stomach becomes the continuation of the oesophagus. In this surgery, no external substance is not placed in the stomach but because the form of the stomach resembles a tube at the end of the operation the name of the operation is called sleeve gastrectomy surgery.

In obesity treatment, diet, exercise and using medicals are not as effective as the sleeve gastrectomy operation. Sleeve gastrectomy surgery provides to recovers the health of obese patients by getting less food by shrinking the stomach, and losing weight. In this operation, a decrease in the level of ghrelin hormone released by the stomach is seen. Thus, the eagerness for eating foods of the patients that had this operation decreases, and the process of weight-loss gains speed.
Many surgical operations are applied in obesity treatment.

Sleeve gastrectomy surgery is more advantageous among the operations that are applied according to the need of the individual. Since it does not ruins the normal course of food passage after the operation it is a more appropriate treatment method for human anatomy and the digestive system. Also, being shorter and easier than the other applications is one of the advantages of sleeve gastrectomy surgery. Through short anaesthesia time, the risk of complication depending on anaesthesia is low. Because of all these advantages, sleeve gastrectomy is the most applied surgical obesity method all over the world.

As in every surgery and surgical intervention, sleeve gastrectomy has its own sets of disadvantages. In sleeve gastrectomy surgery, the shape of the stomach is deformed beyond recall. This is the biggest disadvantage of sleeve gastrectomy surgery. However, the stomach is an enlargeable organ. Therefore, although the shape of the stomach is turned to a tube, it may widen in further years and its weakening effect may be decreased.

Besides that, in the patients who are addicted to calorie-rich sugared drinks and solid foods, the weakening effect of it can be low. In the individuals who adapted to the calorie-rich dietary habit, over weakening may not be seen after sleeve gastrectomy. Therefore, the patients should make a habit of a balanced diet and sport after the surgery.

Sleeve gastrectomy surgery is as risky as all other surgeries since it is a surgical operation. Hence, various complications may be seen in patients that had this operation. The complication incidence rate during the surgery is related to the age, weight and other diseases of the patient. Despite all of them, sleeve gastrectomy surgery is one of the low death risked operations.

Also, the vital risks that obesity brings are more than the surgery risks. Sleeve gastrectomy decreases the risk of obesity caused diseases such as liver fattening, diabetes, hypertension and kidney diseases.

Moreover, obese patients are at risk of undergoing surgery. These risks which do not depend on only sleeve gastrectomy surgery, are problems such as heart, lung and kidney failure because of the weight of the patient.

There are risk factors in all surgical interventions. In every surgery, bleeding or infection can be seen in the patient.

The general disadvantages of sleeve gastrectomy surgery are:

• Advanced stage reflux can occur after the surgery.
• There is a gastric bleeding or intraabdominal bleeding risk during the surgery.
• Early-stage leakage problem may occur.
• Nausea, vomiting, abdominal swelling or gastric emptying difficulty problems may occur.
• The stomach that shaped like a tube can expand in further stages.
• With expanding stomach, gaining weight may be observed in the patient again.

Gastric sleeve surgery does not apply to every obese patient. For this, there are some criteria and foremost among them is body mass index. The body mass index which is calculated by dividing the weight by square of the height of the patient is accepted as normal if it is between 18-25 values. If the result is more than 30, it indicates obesity.

However, every obese individual is not fit for sleeve gastrectomy surgery. Gastric sleeve surgery can be applied to individuals who has a body mass index of more than 35 and live obesity based diseases. In patients with a body mass index is above 40 sleeve gastrectomy surgery can be applied even if no obesity based disease observed.

For obese patients, having tried a balanced diet and steps of exercises is suggested before applying to sleeve gastrectomy surgery or similar surgical operations. Surgical intervention can be performed for patients who can not lose weight although diet and exercise. Nevertheless, there are some requirements to apply the sleeve gastrectomy. Especially, patients must be between the ages of 18-80 and be able to tolerate the anaesthesia. The patients that have risk in applying the anaesthesia are not appropriate for the sleeve gastrectomy. This surgery is appropriate for individuals with a body mass index above 35 and has additional diseases.

A sleeve gastrectomy surgery is not applied to patients who comply with all criteria but also addict to alcohol and drugs or have psychological disorders. Besides, applying this surgery for patients who can’t control their eating habit and not tend to change their dietary habits after the surgery is not suggested.

Gastric sleeve surgery is performed by applying general anaesthesia to the patient. In this surgery which is applied as laparoscopic, that is, closed, the patient’s abdomen is entered by opening several holes. In some circumstances, a robotic hand is used. The small holes that opened in the abdomen are preferred since they are trackless and invisible in further stages. Firstly, a calibration tube is placed at the entrance of the stomach to prevent narrowness or blockage. After that, the shape of the stomach is turned into the tube and approximately 80% of it removed by cutting.

At the end of the operation, the calibration tube that was placed at the beginning is removed and the patient is checked for leakage through various methods. Protecting the entrance and exit of the stomach during the surgery ensures that there is no problem in the continuity of the digestive system.

Sleeve gastrectomy surgery is one of the low risked surgeries. The death risk during the surgery is one in a thousand for this surgery.

Since gastric sleeve surgery is applied as laparoscopic in general, the healing process of the patient is quite short. In gastric sleeve surgeries that the abdominals and peritoneums are not cut, feeling dull ache and pressure in the stomach is normal for the first day. For the patients that become walk on the first day, the average full recovery period is 15 days.

After gastric sleeve surgery, a balanced and proper dietary program should be applied. Gaining weight again is inevitable for patients who do not eat low-calorie, fat-free and healthy foods, do not exercise regularly. So, adhere to the given diet program is necessary after the surgery.