Gastric sleeve surgery – also known as vertical sleeve gastrectomy (VSG) and sleeve gastrectomy – is a type of bariatric surgery (AKA weight loss surgery). This surgery helps people lose weight. This laparoscopic surgery is minimally invasive and is performed when a small tube is inserted into the upper abdomen through small incisions while you are unconscious under the effect of anesthesia. The doctor also uses a laparoscope during this operation, a tiny device equipped with a camera and a source of light to help the surgeon see. In addition, the reason we use the term “minimally invasive” is that there will only be small incisions, which makes the healing process much faster.
During this procedure, surgeons remove 80% of the stomach and attach the remaining parts. As a result, the new banana-shaped stomach would now be one-fifth of its original size, so now it will become full faster. This helps the patient lose weight by reducing the amount of food they consume. Furthermore, hunger hormones will also decrease due to the removal of the left part of the stomach, causing the patient to lose their appetite to some degree.
The operation normally takes an hour, then you will likely wake up after another hour. You will be discharged from the hospital after you have been monitored for two to three days.
How Much Weight Can You Lose By Having Gastric Sleeve?
Gastric sleeve is successful 80-90% of the time. Most patients can lose 60-70% of their excess weight in 1-2 years, but you’ll also need to exercise and have a healthy diet to lose the excess weight and to keep it off. In other words, committing to a new lifestyle is key in the weight loss procedure. Your surgeon will give you the necessary instructions regarding exercise and diet after your sleeve gastrectomy.
What Makes a Good Candidate?
A gastric sleeve is only recommended in certain cases. If someone has the conditions below, they may be qualified for bariatric surgery.
- People who are obese with a body mass index (BMI) of 40 kg/m2 and above
- Individuals who have a BMI of 35-39 along with severe weight related health problems, such as:
- diabetes type 2
- sleep apnea
- high blood pressure
- hypertension
- heart disease
- stroke
Remember that this surgery is not for everyone. Only people who have severe cases of obesity who couldn’t improve their conditions by diet or exercise should have this operation.
The Benefits of Gastric Sleeve
The most significant benefit of bariatric surgery is the fact that it reduces the odds of death due to the aforementioned health problems. Moreover, it also improves the health problems that accompany obesity. Here is a list of conditions that can be improved by vertical sleeve gastrectomy:
- diabetes type 2
- sleep apnea
- high blood pressure
- high cholesterol
- hypertension
- low levels of testosterone
- heart disease
- cancer
- loss of fertility
- stroke
Further advantages of sleeve gastrectomy include:
- Dumping syndrome happens much less frequently after gastric sleeve compared to gastric bypass.
- This procedure is also less invasive and complicated than gastric bypass surgery – since in gastric bypass they create a pouch that is connected to your small intestine, and it remains in your body for the rest of your life.
Does Insurance Cover Gastric Sleeve? How much does it cost?
In the United States, insurance companies usually do cover gastric sleeve expenses since they regard obesity as a life-threatening danger. Of course, you should first be qualified according to the conditions mentioned above.
The cost of vertical sleeve gastrectomy ranges from 9000$-26000$. Different places may do the same surgery for different prices, so be sure to make inquiries from various clinics and surgeons to find the most suitable one for you.
What Should I Know Before My Bariatric Surgery?
- What type of bariatric surgery it is. As you already know, there are different procedures and types for this surgery. Some of the most common ones include sleeve gastrectomy, roux-en-y gastric bypass (RYGB), adjustable gastric band (AGB), biliopancreatic diversion with duodenal switch (BPD/DS).
- Why you have to undergo surgery.
- The risks that come with the operation and the benefits.
- The expected results of having the surgery and the results of refusing to have the surgery.
- The costs of the procedure.
- The person who is going to perform the operation and their qualifications.
How to Prepare for Sleeve Gastrectomy
Preparing properly for your surgery will mitigate the risks of the surgery and maximize the results. It will make the procedure safer and easier for you. Significant lifestyle changes are required to have a successful gastric sleeve and these are not limited to the stage prior to the surgery, some of them will be everlasting.
You will need to stop smoking and drinking alcohol at least a month, preferably several months, before the operation. Moreover, your doctor will likely ask you to shed some pounds before your gastric sleeve to make the surgery safer. Keep your calorie intake in check to see how much you are consuming every day. If you have any bad eating habits such as mindless or binge eating, try to break them. Do not drink or eat anything after midnight before your surgery.
Exercise
Start exercising before your gastric surgery and make it an everyday routine. This helps you stick to exercising even after your sleeve gastrectomy, which is a must. It is true that most people who wish to have bariatric surgery are diagnosed with obesity; therefore, strenuous exercises wouldn’t work for them. As a result, we recommend starting slowly with light exercises such as walking.
- Start by walking 10-20 minutes per day, 3 days a week. Try to reach 30 minutes per day, 4-5 days every week.
- Increasing your physical daily activities can be regarded as exercise. Take the stairs instead of the elevator, walk more distances, get up from your seat and walk around after sitting for too long and etc.
- For people diagnosed with obesity, exercises that put too much pressure on the joints can be dangerous. Thus, you should avoid jogging and jumping. In case you experience any joint pain, modify or change the exercise in a way that the pain stops.
- Moderate aerobic exercises are the best option for losing weight.
- For strength training, go for three sets of 12-15 repetitions using only low to moderate weights.
- The goal of exercising is to keep your body challenged. Consequently, you should prevent your body from getting used to your exercise routines, otherwise your exercises will lose their effects. Change your exercise routine every six weeks to keep your body challenged and get the maximum effects from exercising.
Diet
Diet is one of the most influential factors in bariatric surgery. Try to eat healthily and focus on rich-protein foods with low calories. You need 60-70 grams of protein per day. This is a list of foods rich in protein:
- Chicken
- Skim milk
- Fish and seafood
- Low-fat cottage cheese
- Tofu
- Fish
Protein shakes can also be a good source of protein.
Avoid consuming too many carbohydrates as they contain too many calories and will mess with your weight loss procedure. Natural sugars found in fruits are ok, but refined sugars found in ice cream, pastries, and soda should be removed from your diet. Fats should also be avoided as much as possible, which is why low-fat foods and dairy are recommended. In addition, keep track of the number of calories you consume daily. We recommend a daily intake of 800-1000 calories before the surgery.
Furthermore, staying hydrated is essential in this procedure, so don’t forget to drink enough water and fluids. Since tea and coffee contain too much caffeine, try drinking decaf coffee and tea or even herbal tea.
Finally, don’t forget to eat enough vitamins and take multivitamins every day as they are one of the most important parts of one’s diet. Fruits and vegetables are great sources of vitamins. Calcium, iron, and B-12 supplements should also be part of your diet.
Medications
There are medications – whether pills or herbs – that can cause complications for a gastric sleeve patient, which is why you should inform your doctor about any medications that you are taking. You should, after consultation with your doctor, stop taking these medications mostly one week before your gastric sleeve. We have provided you with a list of such medications:
- Blood thinning medicine such as aspirin
- Non-steroidal anti-inflammatory drugs including aspirin, Ibuprofen, Naproxen, Motrin, Aleve and etc.
- Medicinal herbs
- Hormonal therapy drugs; birth control, for example.
Your doctor may also prescribe medications for you before the surgery.
The Risks of Gastric Sleeve Surgery
Although gastric sleeve has a success rate of 80-90% and is considered a safe procedure, we should still acknowledge the risks. Before we begin, remember that this procedure can seldom be fatal. The 30-day mortality rate is 0.8%, while the 1-year mortality rate is around 1%. It is worth noting that gastric sleeve is safer than gastric bypass surgery, according to a recent study.
Moreover, approximately 20% of patients develop complications.
This list includes the possible complications and risks caused by gastric sleeve gastrectomy:
- Gastric leaks from the staples that attach different parts of your stomach together
- Trouble with assimilating nutrients such as vitamins and minerals. Taking vitamin and mineral supplements can solve this issue.
- Infection
- Bleeding from the surgical spot
- You may experience nausea, vomiting and constipation
- Some foods may upset your stomach and evoke negative reactions
- Heartburn: This can be treated using over-the-counter medication.
- Excess skins caused by losing a relatively large amount of weight. Skin removal can help with this problem.
- Blood clots could form in your legs
- Stenosis: This is when the connection between the stomach pouch and the small intestine becomes narrow, resulting in the blockage of the pathway.
This surgery is irreversible and permanent.
Frequently Asked Questions
- Can I get back to work after gastric sleeve?
- Not immediately. You can get back to work 1-2 weeks after your surgery. This is where your surgeon can help you out with the information relevant to your particular case.
- Will I regain any weight after vertical sleeve gastrectomy?
- Although bariatric surgery helps lose 60-80% of the excess weight in one to two years, around 50% of patients eventually regain 5-10% of the excess weight that was once lost, which is completely normal. This happens especially when the patients reach their nadir weight. Moreover, most patients retain at least 50% of the weight they have lost even after 10 years. In fact, for bariatric surgery to be considered successful, the person has to be able to keep off half of the weight they have lost for at least five years. For example, if you have 150lbs excess weight and lose 80lbs due to the surgery, as long as you can keep 40lbs off for five years, you have had a successful operation.
- Gastric sleeve or gastric bypass? Which is better?
- There is no fixed answer to this question. Surgeons decided what is best for their patient depending on the patient’s specific case. For instance, in people who have moderate to severe reflux, gastric sleeve can worsenthe situation. Therefore,gastric bypass would be the better option in this particular case.
- Is having gastric surgery more risky than not having surgery at all?
- The dangers that come with obesity are much more life-threatening than gastric surgery. As we mentioned in the text, gastric surgery can rarely be fatal, unlike obesity. Hence, if you have tried dieting and exercise to no avail, bariatric surgery may help you lose some weight – provided you commit to a healthy lifestyle.
- How long is the recovery phase?
- Your incisions heal after 3 weeks, while it will take 6-8 weeks for your stomach to heal. You can get back to your routines after 6-8 weeks.
- Is it true that weight surgery results in hair loss?
- Temporarily, yes. This happens between 3-6 months following your operation. Although the cause of this phenomenon is unknown yet, consumption of protein, minerals, and vitamins will help the hair to regrow. Once your weight becomes stable, your hair will grow back.
- Will there be any pain after gastric sleeve?
- The surgical spot may feel a bit tender and even painful, so it wouldn’t be an irregularity. However, you should most definitely inform your surgeon and health team.
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