Gastric Sleeve Surgery - The Expert's Guide. Table Of Contents. Gastric Bypass Versus Gastric Sleeve Surgery. Individuals who are considering bariatric surgery for weight loss have multiple options. From traditional gastric bypass. Section for topics about gastric sleeve in the news, press releases from doctors, new medical breakthroughs relating to gastric sleeve surgery. Gastric sleeve surgery removes ~80% of the stomach, causing patients to feel less hungry, eat less, & lose up to 3/4 of their excess weight. Gastric sleeve surgery, also known as the sleeve gastrectomy, has become a popular choice for patients seeking excellent weight loss in a straightforward procedure that doesn’t require the maintenance and long- term complication rates of a Lap Band. History. On January 1st, 2. United Healthcare added gastric sleeve surgery to their list of covered surgeries for weight loss. Over the following two years, almost every other major insurance company followed suit. From 2. 01. 0 to the 2. Success Stories: Gastric Sleeve Surgery (Vertical Sleeve Gastrectomy) Patient Success Stories, Before and After Photos. Gastric bypass surgery makes the stomach smaller and causes food to bypass part of the small intestine. You will feel full more quickly than when your stomach was its. Why? It’s very difficult to get insurance companies to approve new procedures. So why would they approve gastric sleeve surgery? Advertisement. The evidence showed significant weight loss with low complication rates. Surgeons were already performing the procedure and insurance was paying! Number 2 deserves some explanation. Super Obese individuals (people with a Body Mass Index over 4. And the longer the time under anesthesia, the greater the risk. Gastric bypass surgery can last over 2 hours. Duodenal switch surgery often takes over 4 hours. That’s a long time to be under anesthesia. So surgeons started breaking the procedure up into two stages. The first stage was to reduce the size of the stomach. The second stage would be done a year later after the patient lost some weight. The second stage of the procedure would include bypassing some of the intestines to reduce calorie absorption. So surgeons started coding the first part of the procedure as the first half of a duodenal switch. Insurance was paying. When patients came back a year later, they had lost so much weight that a second procedure wasn’t necessary. Studies like this one started to emerge (Randomized clinical trial of laparoscopic Roux- en- Y gastric bypass versus laparoscopic sleeve gastrectomy for the management of patients with BMI < 5. Complication rates were low and weight loss was as good, if not better, than gastric bypass. And because the surgery took less time and was less complicated to perform, surgeons liked it. Patient Feedback. Patients also liked the procedure. After surgery and often for months after the procedure patients noticed they weren’t hungry. Some patients had to remind themselves to eat. Soon patients were asking their doctors about gastric sleeve surgery. Later, research showed that the hunger producing hormone ghrelin was significantly lowered in gastric sleeve patients. It’s believed that the area of the stomach removed during gastric sleeve surgery produces much of the hormone ghrelin. While gastric bypass patients experienced less hunger, it seemed to be more pronounced in gastric sleeve patients. Potential Benefits to Patients. Gastric sleeve surgery has the benefits below: May reduce hunger. The Lap Band requires regular adjustments (doctor visits). No foreign objects are left in the body. The Lap Band leaves a silicone band around the upper portion of your stomach. Weight loss occurs over 1. The majority of weight loss occurs in the first year. Lap Band is gradual and requires major lifestyle changes for success. The majority of weight loss occurs over 3 years. Why Your Surgeon Prefers Sleeve Gastrectomy Over Lap Bands. Guess what? Your surgeon may prefer gastric sleeve or bypass over Lap Bands. Surgeons want you to be successful. Most surgeons care about getting you healthy. But, they also know that you’re a future referral source. You are a future success story. If your surgeon has been performing bariatric surgery for long enough he or she has seen patients that lose little or no weight with a Lap Band. This doesn’t mean the band isn’t working. It just means that certain patients cannot implement the lifestyle changes (3 small meals a day, high protein, exercise, low carbs, etc.) that are needed to be a success with the Lap Band. The failure to lose weight is significantly less with gastric bypass or gastric sleeve surgery. Granted, after the weight comes off, it’s up to the patient to keep it off. For a surgeon that is trying to help, it’s difficult to identify patients that are truly dedicated to implementing exercise and healthy, nutrient dense foods into their diet. It’s a much better bet and ? Expect to be scared, nervous, and expect everything to go well. Again, gastric sleeve surgery is a very straightforward procedure with low complication rates. When serious complications do happen, they usually occur the first few days after surgery. So rest easy for your procedure. You’ll likely be scheduled for an early morning surgery. However, this depends on the surgeon’s and hospital’s schedule. Prior to surgery you will have followed your two week pre- op diet. You should know what to bring to the hospital. And you’ll know that you can’t eat anything after midnight the night before. Surgeries get cancelled all the time because people eat or drink prior to surgery. And if you vomit during your procedure you can get pulmonary aspiration. This is when the contents of your stomach regurgitate and get stuck in your airways. This can be fatal or cause aspiration pneumonia. Don’t chew gum, drink water, chew tobacco, or take any medications not approved by your surgeon. These may cause your surgery to be cancelled. You’ll check into pre- op and meet your nurse and your Anesthesiologist. You’ll change into your hospital gown, removing any jewelry, watches, etc. You’ll then sign the needed consents and get an IV. You’ll be given medication to help you relax. Your circulating nurse (the nurse that will be with you in the OR) will come meet you and wheel you back to the OR. Then you’ll be asked to breath in from a face mask and count backwards. When you wake up you’ll be in recovery and your family will be invited in shortly thereafter. Once cleared, you’ll be wheeled up to your room where the TV and your pain pump will be your new best friend for the night. Typically, within the first 5 hours after surgery, you’ll be asked to get up and take a few steps. This helps reduce the risk of blood clots and help alleviate some of the shoulder pain associated with the CO2 left in your abdomen from the surgery. Recovery. Recovery from gastric sleeve surgery is painful for some and . Each person experiences pain differently and different pain medications work better than others for different individuals. Some sleeve procedures are outpatient (you can leave the same day as your procedure) and many require 1 or 2 days in the hospital to recover. Some surgeons prefer 3 days while others are comfortable letting you leave the day after surgery. As always, it’s important that you follow the doctors orders. Below are some general guidelines after you are discharged from the hospital. You should have more specific guidelines to follow in your discharge instructions or post- op manual. Sip your liquids constantly. You aren’t getting any liquids from food your first week post- op. Sip slowly, but makes sure you drink plenty. Bowel movements. Bowel movements may be difficult or painful. This is normal. However, don’t hesitate to call your surgeon if you are having issues. Constipation is normal the first week post- operative. Your pain medications can increase constipation. Medications. Don’t be a tough guy. Take your pain medication when you need them. You may receive a prescription for Protonix to decrease the acidity in your stomach. This helps with heartburn and may reduce pressure on your healing pouch. Unless otherwise advised by your surgeon, you can resume taking your medications. All non- time- released medications will likely need to be crushed. Any medication that is time- released should be switched, if possible, to non- time released. Do not crush time- released medications. Ask your doctor about your diabetes medication. Activity. Walk, walk, walk. This helps the healing process and starts you on the path to include exercise daily. Don’t lift anything heavy. This can put undue pressure on your stitches and torso which will be sore. You will feel fatigued and tired for up to a month after surgery. Your body is adjusting. Showering & Bathing. Don’t bathe or sit in a hot tub for the first 3 weeks after surgery. Showering is typically OK. Going back to work. You’re not bothering them. This article walks you through the details of recovery from gastric sleeve surgery. Pre and Post- op Diet. Your diet is going to change after gastric sleeve surgery. In fact, your diet has to change 2 weeks prior to surgery. So if you’re planning on having a . The pre- op diet is important because it helps to reduce the size of your liver prior to surgery. This makes surgery easier for your surgeon and reduces your intra- operative risks. Details on a typical pre- op diet can be found here. Post- Op Diet. They say it takes tasting a food 2. Keep that in mind as you struggle through the first few months of adopting a new diet after surgery. With a small stomach, it’s utterly important that the food you do eat is nutrient dense. This means you should be eating foods like vegetables, lean protein sources and whole grains. Most doctors recommend you eat a good portion of your calories via lean meat. However, it should be noted that there are some very successful vegetarians that have had gastric sleeve surgery. Dr. Garth Davis at The Davis Clinic in Houston is a bariatric surgeon and a vegetarian. Many of his patients have become vegetarians with great success. Your post- op diet greatly depends on how far out you are from surgery. The stages below are typical recommendations after gastric sleeve surgery. For a more detailed look what you can and can’t eat after surgery, we recommend this article. Stage 1 – The first week after surgery. Clear liquids only. These include. Water. Decaf Tea. Sugar- free Posicles. Broth. Stage 2 – Week 2. Full liquid diet with protein shakes. Stage 3 – Week 3. Soft- pureed foods. These include. Soups. Scrambled Eggs. Cottage Cheese. Stage 4 – Week 4. Soft foods. This is also true for gastric bypass (slightly more supplements are required) and true for Lap Band patients (less vitamins are required).
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