Currently, sleeve gastrectomy is the most common bariatric surgery in the world. This is due to its high effectiveness in terms of weight loss and the resolution of obesity-related diseases.
What is sleeve gastrectomy? It is one of the so-called restrictive procedures in which a significant portion of the stomach is removed to achieve weight loss. During sleeve gastrectomy, the stomach is divided vertically into two parts: the left portion, which makes up about 80% of the organ, is removed after being separated from its vascular connections with the spleen. The remaining part of the stomach resembles a long sleeve, hence the name, and continues to function as before. In fact, sleeve resection does not change the physiological transit of ingested food. Only the residual stomach volume changes, which after surgery is approximately 100–150 ml, corresponding to the amount of food that can be consumed postoperatively.
How does it work? The goal of sleeve gastrectomy is to significantly reduce the amount of food that can be eaten and to promote early satiety. This dual effect is achieved through two mechanisms: mechanical — by reducing the stomach volume, which fills and stretches more quickly, creating an earlier feeling of fullness; hormonal — by influencing ghrelin secretion and hypothalamic centers regulating hunger, as well as counteracting emotional overeating.
Who is this procedure for? Sleeve gastrectomy is indicated for patients with severe obesity who have: a body mass index (BMI) over 40; a BMI over 30 or 35 combined with obesity-related conditions (type 2 diabetes, hypertension, dyslipidemia, sleep apnea, joint diseases). As with any bariatric surgery, indications must be evaluated and discussed with a surgeon at MC “Bogolyuby”.
Are there risks? Complications are rare. The most common include: fistula — a small opening in the gastric suture, which in severe cases may be treated with an endogastric prosthesis; bleeding along the suture line; dilation of the remaining stomach; gastroesophageal reflux.
How is it performed? The procedure is performed under general anesthesia and laparoscopically. Instruments required for resection and suturing are inserted through four small incisions in the abdomen. The patient can move within a few hours after surgery. The next day, they may begin eating after a routine examination to confirm proper sleeve positioning. Discharge from the center usually occurs after 2–3 days.
In the immediate postoperative period, it is crucial for the success of the procedure that the patient strictly follows medical instructions. It is also important to adhere to the follow-up schedule provided by the surgeon and, if necessary, coordinated with a dietitian and psychologist. If the patient follows all recommendations correctly, weight loss results are estimated at about 60% of the initial excess body weight, with resolution or significant improvement of associated conditions. Otherwise, there is a risk of weight regain over time, which may require repeat surgery.
What to eat after surgery?
After discharge, the patient should follow a dietary program lasting about a month and consisting of several stages: a liquid diet based on fruit juices, drinking yogurt, and broths; a semi-liquid diet based on baby food and pureed meals; solid food, where everything can be eaten but in limited quantities. Regarding beverages, both during this period and afterward, carbonated sugary drinks are strictly not recommended, as they may cause bloating and stomach stretching.
Following dietary recommendations is very important to prevent overstretching of the remaining stomach walls and, consequently, to avoid complications, as well as to achieve the expected weight loss results
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