Bariatric Surgery

Although obesity is perceived as a cosmetic problem in many respects, it is an extremely important health problem that ranks second only to smoking-related lung cancer among preventable diseases leading to death worldwide. Obesity is a chronic and complex disease picture that affects the general health status of the person, especially cardiovascular diseases, diabetes and depression. The World Health Organization defines obesity as “a disorder of energy metabolism characterized by an increase in body fat mass compared to lean mass such as muscle and bone tissue and excessive fat storage, which can lead to physical, mental and social problems in the person” and is considered to be associated with many diseases from cancer to metabolic syndrome. Behavior-based traditional treatment of obesity, which is caused by unhealthy eating habits and sedentary lifestyle, can be quite challenging for the patient. Since this situation makes it difficult for the patient to adapt to the treatment process, there are disruptions in treatment and the general health status of the person may worsen in this process. For this reason, the gold standard for obesity treatment today is bariatric surgical treatment methods such as sleeve gastrectomy.

Who Can Have Gastric Sleeve Gastrectomy?

Sleeve gastrectomy is one of the most suitable treatment methods for advanced obesity patients with a body mass index higher than 50 kg/m2 and defined as super obese. In addition, it is also safely preferred for obese people who want this method although their body mass index is lower than 50 kg/m2. Almost all patients who undergo sleeve gastrectomy surgery get rid of approximately 55% of the excess weight within the first 1 year. The complication rate related to the operation is reported to be only 8% and therefore sleeve gastrectomy is considered one of the safe methods for almost all obesity patients. In 66% of the patients, the symptoms associated with diabetes disappeared completely and the general health condition improved very quickly. In line with all this information, it is possible to say that laparoscopic sleeve gastrectomy is the most preferred application for people diagnosed with morbid obesity alone or in combination with other treatment methods.

What is the Duration of Stomach Reduction Surgery?

Bariatric surgery is considered to be the most effective treatment option for obesity treatment that provides sustainable weight loss over a long period of time. The first study on the surgical treatment of obesity was conducted by the Swedish Obese Study Group (SOS) in 2004 and patients who underwent surgical treatment were followed closely for 10 years after treatment. In line with the successful results obtained from this study, bariatric surgery methods such as sleeve gastrectomy have become widespread all over the world; today, with the publication of the 20th year results of the study, surgical applications have been accepted as the most effective method in the treatment of obesity. Obesity disease occurs when a person adopts unhealthy eating habits and a sedentary lifestyle, and with the disease, it becomes much more difficult to perform exercises that require effort. For this reason, it becomes difficult for patients to comply with non-surgical treatment and the psychological problems that arise in addition can lead to various eating disorders. Therefore, it is possible to say that the most effective method for the definitive treatment of obesity is gastric sleeve and other bariatric surgical treatment methods.

How is Sleeve Gastrectomy Surgery Performed?

Sleeve gastrectomy, which restricts the amount of food and calorie intake that a person can consume at one time by reducing the volume of the stomach, is one of the most preferred methods among the surgical treatment applications of obesity. In this method, which is called Sleeve Gastrectomy in medicine, starting from the lower part of the stomach called antrum and along the stapler line ending at the proximal his angle, approximately 85% of it is cut out and the stomach capacity is reduced to a maximum of 100 ml. Since the new appearance of the stomach after the operation resembles a tube, this procedure is also called sleeve gastrectomy.

Sleeve gastrectomy surgery is performed laparoscopically through a small incision in the abdominal wall. The fact that it does not require open surgical intervention is extremely advantageous for the patient as it shortens the recovery period and reduces the risk of surgical infection. This application, which provides significant weight loss even in advanced obesity cases, also protects the integrity of the sphincter muscles around the stomach valve. In this way, sleeve gastrectomy surgery, which manages to maintain the separation between the stomach and esophagus, is considered a much more advantageous method compared to other bariatric surgery methods.

How Much Weight Do People Who Have Gastric Sleeve Gastrectomy Lose?

Gastric sleeve gastrectomy, which restricts food and calorie intake only by reducing stomach capacity, does not affect the absorption of nutrients in the intestines as in some other surgical methods. Treatment methods that affect nutrient absorption predispose the person to many diseases, especially iron deficiency anemia. For this reason, sleeve gastrectomy is a more reliable option compared to other methods because it not only treats obesity but also protects the general health integrity of the person. In addition, ghrelin, also known as the hunger hormone, is secreted from a part of the stomach called the gastric fundus, and a large part of the gastric fundus is removed with sleeve gastrectomy. As a result, the amount of hunger hormone secreted from the stomach decreases and the appetite of the person decreases considerably after the operation. Thanks to all these effects, gastric sleeve surgery provides extremely fast and permanent weight loss. The physical and mental relief brought by weight loss increases the quality of daily life noticeably. Most of the excess weight can be lost within 1 year. This can correspond to a weight loss of almost 40-50 kilograms for a morbidly obese patient. After surgery, three-quarters of obesity-related diseases such as type 2 diabetes and sleep apnea, more than half of high blood lipids and high blood pressure problems, half of knee pain and most leg varicose veins improve. These improvements occur spontaneously with the onset of weight loss, without the need for any other treatment. There is a rapid improvement in the person’s general health.

Is Gastric Sleeve Gastrectomy Risky?

Gastric sleeve gastrectomy is a mild to moderate risky surgery among all surgeries in general. The majority of patients do not experience any additional problems. The complication rate is around 2%. Since the surgery is performed with closed technique, it is possible to stand up on the same day. Hospitalization for 3-4 days is sufficient. You can return to normal daily life within a few weeks. Follow-up results are close to perfect. Patients start to lose weight within days after surgery. The weight loss becomes evident within a few months. Long-term medical follow-up results of thousands of patients show that patients with sleeve gastrectomy lose 70-80% of their excess weight.

Is There Pain After Gastric Sleeve Gastrectomy?

Gastric sleeve operation, which is performed under general anesthesia and laparoscopically (closed surgical intervention), is one of the most reliable methods compared to many other surgical interventions. However, gastric sleeve surgery is an extremely advantageous method, especially compared to applications such as handcuffs, both because it has less risk of complications and provides permanent weight loss for a much longer period of time. In fact, with the discovery of gastric sleeve treatment, handcuffs and similar applications have almost completely disappeared, and gastric sleeve operation has become the most preferred bariatric surgery method thanks to all its advantages. Patients continue their normal life with a new diet after a few days of hospitalization.

Does the stomach enlarge again after sleeve gastrectomy?

With sleeve gastrectomy, 80-85% of the stomach is removed and the stomach volume is reduced to approximately 100 ml. After the surgery, the stomach capacity increases slightly, but if the patient does not eat in accordance with the physician’s recommendations, the stomach may become larger than necessary. As a result, the patient quickly regains the weight lost after surgery. In order to get the best benefit from sleeve gastrectomy surgery, it is extremely important to strictly follow the nutrition recommendations planned by the physician in the postoperative period.

Nutrition After Gastric Sleeve Gastrectomy

Diet is very important after sleeve gastrectomy operation. In the first weeks of the operation, the period of completely liquid nutrition is switched to puree and solid period respectively. Since the stomach is an organ that renews itself quickly, following the nutritional recommendations your doctor will give you will both ensure correct weight loss and make it difficult to regain the weight. In order to maintain your advantage of being full quickly and eating less throughout your life, it is very important to put half an hour between the consumption of solid products and liquid products both to prevent the expansion of your stomach volume and to prevent malnutrition. In the first months after the sleeve gastrectomy operation, protein, vitamin and various food supplements may also be recommended by your doctor. Again, doing simple exercises prescribed by your doctor during the weight loss phase will prevent sagging and contribute to your bowel and stomach order.

15 Frequently Asked Questions and Answers About Gastric Sleeve Gastrectomy

1. Is weight gain possible after sleeve gastrectomy?

With sleeve gastrectomy, 80-85% of the stomach is removed and the stomach volume is reduced to approximately 100 ml. After the surgery, the stomach capacity increases slightly, but the stomach may grow again if the patient does not eat in accordance with the physician’s recommendations. As a result, the patient may regain some of the weight lost quickly after surgery. In order to get the best benefit from sleeve gastrectomy surgery, it is extremely important to strictly follow the nutrition recommendations planned by the physician in the postoperative period.

2. Is there sagging after sleeve gastrectomy? How is it tightened?

After the gastric sleeve operation, which is one of the bariatric surgery operations, loosening, sagging and stretch marks may occur on the skin due to rapid weight loss. These complications can be eliminated in a short time with sports and correct exercises, and tightening is possible with many aesthetic options, especially liposuction for more intense sagging that may occur in morbidly obese patients. It should not be forgotten that following the diet and exercise regimen recommended by your doctor and dietitian will allow the skin to recover more firmly, prevent sagging and provide rapid tightening.

3. Does a gastric sleeve operation end diabetes?

Sleeve gastrectomy has been recognized as one of the safest methods for almost all obesity patients. Obesity is a serious condition that causes many chronic problems such as fatty liver disease, diabetes, heart and lung diseases, psychological disorders. It has been observed that 66% of the patients who underwent sleeve gastrectomy operation completely disappeared the symptoms associated with diabetes and their general health condition improved extremely quickly. On the other hand, many obesity patients have insulin resistance. In patients with prediabetes, where diabetes has not yet fully formed and only initial insulin resistance is observed, it is possible to prevent insulin resistance before diabetes occurs with bariatric surgery applications, especially sleeve gastrectomy.

4. Gastric Sleeve Gastrectomy? Gastric Bypass?

Sleeve gastrectomy is the most effective treatment option among all bariatric surgery methods. Only by reducing the volume of the stomach and restricting the amount of food, not the absorption of nutrients, calorie loss is achieved while at the same time maintaining adequate nutrition of the cells. In this way, weight loss is realized without weakening the body resistance of the person. However, gastric sleeve surgery is an extremely advantageous method, especially compared to applications such as handcuffs, both because it has less risk of complications and provides permanent weight loss for a much longer period of time. In fact, with the discovery of gastric sleeve treatment, handcuffs and similar applications have almost completely disappeared, and gastric sleeve operation has become the most preferred bariatric surgery method thanks to all its advantages. Gastric Bypass operations are the most common procedure after gastric sleeve. The specialist physician decides which operation the patient is suitable for according to the patient’s age, type of malnutrition and body structure.

5. What is the age limit for Sleeve Gastrectomy surgery?

Sleeve Gastrectomy (Gastric Sleeve Gastrectomy) surgery, which is one of the most preferred operations by patients who want to lose weight, is frequently preferred by individuals between the ages of 18-65 who are in good health conditions. Since obesity is a serious health problem that leads to many chronic conditions, it is one of the conditions whose solution should not be postponed. For this reason, many experienced physicians recommend sleeve gastrectomy or other stomach reduction operations and obesity surgery operations before additional complications and chronic disorders occur in the patient.

6. Are there any scars after stomach reduction surgery?

Sleeve Gastrectomy (Gastric Sleeve Gastrectomy) operations are usually performed laparoscopically, that is, by closed method. The holes formed for the operation, which is performed by entering through a small incision in the abdominal wall, are not large enough to create an aesthetic problem and usually close spontaneously over time.

7. Is there a decrease in water consumption and chills after Sleeve Gastrectomy?

Gastric sleeve gastrectomy, which restricts food and calorie intake only by reducing stomach capacity, does not affect nutrient absorption in the intestines as some other surgical methods do. Treatment methods that affect nutrient absorption predispose the person to many diseases, especially iron deficiency anemia. For this reason, gastric sleeve surgery is a more reliable option compared to other methods because it not only treats obesity but also protects the general health integrity of the person. Although the patient may initially experience chills due to rapid weight loss, this problem disappears when adapting to the new weight. There is no effect on the person’s water intake. As long as the solid-liquid consumption rules given by the doctor and dietitian are followed, patients do not experience any permanent complications in any healthy food intake.

8. How much weight is lost in a month after gastric sleeve?

Surgical treatment of obesity is called bariatric surgery and among these methods, sleeve gastrectomy is one of the most common treatment options. This operation, which is performed under general anesthesia and laparoscopically (closed surgical intervention), is one of the most reliable methods compared to many other surgical interventions. The amount of weight to be lost varies depending on the patient’s current weight. Almost all patients who undergo sleeve gastrectomy get rid of approximately 55% of the excess weight within the first year. While very rapid weight loss occurs in the first months of the operation, as the weight rate decreases over time, the amount of weight lost per month will also decrease.

9. Does Sleeve Gastrectomy provide a solution to infertility?

Obesity, one of the biggest health problems of our age, not only causes many chronic diseases but also affects the reproductive system. With the loss of excess weight, fertility increases as well as a healthy pregnancy process. Gastric sleeve operation is one of the most preferred surgeries for individuals who are at risk of infertility due to obesity or who have a decrease in fertility due to sugar levels. It has also been found that the rate of miscarriage in obesity patients is high.

10. What foods should never be eaten after Sleeve Gastrectomy?

Ghrelin, also known as the hunger hormone, is secreted from a part of the stomach called the gastric fundus and a large part of the gastric fundus is removed with sleeve gastrectomy surgery. As a result, the amount of hunger hormone secreted from the stomach decreases and the appetite of the person decreases considerably after the operation. However, 1.5-2 years after the operation, the patient’s stomach capacity and appetite may increase, so fried foods with high calorie content and packaged ready-to-eat foods are not recommended. Also, carbonated and alcoholic beverages that cause deformation and enlargement of the stomach are not recommended. Sauces, oils, sugary drinks with small volume but high calorie content are also not recommended in the diet after sleeve gastrectomy.

11. What are the supplements after gastric sleeve?

The first month after sleeve gastrectomy is very important. In this process, it is aimed to heal the stomach in a healthy way. In the first week after the surgery, the patient should only be fed with liquid foods. A special diet program is prepared for individuals to ensure that they get enough protein and minerals. Protein and vitamin supplements are recommended in this process. Increasing collagen may be recommended for sagging skin. In addition, after the solid period, patients are advised to adjust their portions to get maximum vitamins and protein.

12. Can I do sports or exercise after a stomach reduction operation?

Exercise, especially swimming and muscle exercises, will be effective in improving sagging skin due to rapid weight loss. It is claimed that some creams and massages can help tighten the skin. Heavy sports immediately after the operation is not recommended by physicians. Simple walks should be preferred instead. However, in the following months, the person can regain the desired sports order and rhythm in a short time.

13. Can I get pregnant after gastric sleeve operation?

Patients who have undergone gastric sleeve surgery prefer to wait at least 18 months for a safe and healthy pregnancy, primarily to adapt to their new body and stabilize their weight, and doctors often do not recommend pregnancy for the first two years after the operation. Most women can become pregnant shortly after gastric sleeve surgery. However, the body will go through many changes after the operation and considering the new changes in pregnancy and weight regain, many women do not choose to become pregnant immediately after gastric sleeve surgery.

14. What should be considered before gastric sleeve surgery?

Before the gastric sleeve operation, the patient undergoes a multidimensional screening and a series of tests. Examinations by endocrinology, psychiatry, anesthesia, chest diseases, cardiology and many other branches both reduce all possible risks of the operation and help determine which operation the patient is suitable for. After the operation is decided, no changes are made unless there is a diet or diet recommended by the doctor according to the weight and health status of the disease. Patients behave in their usual dietary patterns and as required by classical surgical procedures, and the information and follow-up of this is provided by the physician and the relevant bariatric surgery team.

15. Can two gastric sleeve operations be performed?

It may take 12-18 months to reach the ideal and healthy weight after sleeve gastrectomy operation. This period varies from patient to patient. The gender, age, presence or absence of chronic diseases, metabolic rate and many other things affect the time to reach the ideal weight. Revision sleeve gastrectomy surgery can generally be applied to all patients who have had sleeve gastrectomy surgery before and have not achieved the required results at the end of this period. Here, the patient’s failure to pay attention to his/her diet after the first operation may be as effective as the failure to perform the first operation correctly. In such patients, re-sleeve, i.e. revision sleeve gastrectomy operations may be preferred. In addition, a second sleeve gastrectomy or different surgical procedures can be applied in patients whose obesity level is so intense that it requires two surgical procedures.

*Page content is for informational purposes only. Please consult your doctor for diagnosis and treatment.