The gastric sleeve, also referred to as a sleeve gastrectomy, is a minimally invasive treatment that involves the removal of a portion of the stomach. The surgery develops a new stomach that is similar in size and shape to a banana, and the rest of the stomach is removed from the body through a small abdominal incision. The sleeve-shaped section is stapled closed and reinforced. This reduces a person’s dietary consumption while still allowing for complete nutritional absorption.

The stomach continues to produce acid after gastric sleeve surgery, but it does not churn or break down food in the same way. This allows some food to remain intact in the stomach and as it enters the intestine, which contributes to feeling fuller for longer periods between meals. Patients usually feel less hungry after the surgeon removes the portion of the stomach that causes hunger and lowers the body’s level of the appetite-regulating hormone ghrelin, also known as the “hunger hormone.”

One of the most surprising effects of a gastric sleeve is a reduced appetite – in fact, you may need to be reminded to eat! This is because a gastric sleeve reduces the size of your stomach, which reduces overall hunger as well as limits the amount of food that can be eaten in one sitting. As a result, you will likely find that eating smaller portions after a gastric sleeve is less stressful because your hunger has dramatically decreased.

Gas pain after gastric sleeve is a common side effect – but there are many easy, at-home ways to help manage trapped or excess gas. To relieve gas pain, try: 

• Drinking plenty of water to support digestion throughout the day. 

• Avoiding foods that create gas, such as beans, cauliflower, or cabbage. 

• Eating multiple small meals throughout the day instead of one or two large ones. 

• Walking regularly to help support your digestive system and avoid trapped gas.

• Using a heating pad to alleviate discomfort from excess gas.

Over-the-counter medications can also help relieve trapped gas and make your day-to-day activities more comfortable after gastric sleeve. Most importantly, make sure to talk to your doctor about any gas pain you experience after gastric sleeve – especially if pain becomes severe, persistent, or is combined with symptoms like nausea or vomiting.

A small amount of weight gain following a gastric sleeve procedure is normal, as it will take time for your body to adjust and for you to create new eating habits. If you find yourself regaining lost weight after gastric sleeve, it may be time to re-evaluate: 

• Lifestyle. Regular physical activity and changing eating habits are key to experiencing long-lasting results. Exercising and getting the proper nutrition can make all the difference in avoiding weight gain after gastric sleeve. 

• Diet. Although a gastric sleeve will decrease hunger, the types of food you eat will be crucial to maintaining weight loss. Avoid sweets and overprocessed food, and keep each meal to small portions. A high-protein diet will help you feel fuller throughout the day while eating smaller portions.

• Hormones. Even if you lead an active lifestyle and are mindful about diet, a hormonal imbalance may still cause you to gain weight. Your doctor can help measure levels of hormones like insulin or leptin to determine whether a hormonal imbalance may be at play.

Some patients also find that joining a support group (either in person or online) is an incredibly helpful tool in avoiding weight gain after gastric sleeve. Connecting with others who have gone through the same procedure can not only provide a sense of community, but also be a source of tips, tricks, and encouragement for making healthy, long-term lifestyle changes.

Generally speaking, foods to avoid include: calorie-dense foods like cookies, chips, and ice cream, as well as high-fat foods like sausage, cream, and butter. In the months following your gastric sleeve procedure, your doctor will likely advise you to stay away from carbonated beverages, caffeine, and alcohol. You may also find a newfound sensitivity to certain foods following a gastric sleeve. For example, spicy foods or fried foods may create discomfort and stomach upset, as many patients develop a sensitivity following their gastric sleeve. 

The value of listening to your body cannot be understated: pay attention to how you are feeling after eating certain foods, and avoid the foods that cause discomfort or upset to minimize side effects and support long-lasting results.

Recovery from gastric sleeve typically requires waiting at least one week before driving – though your doctor may ask that you refrain from driving for as long as two to three weeks. The length of your recovery time will depend on your overall health, your pain level, your body’s natural healing process, and any pain medications post-surgery.

Once your gastric sleeve procedure is scheduled, your doctor will prescribe a liquid diet in the days leading up to your surgery. The liquid pre-op diet for gastric sleeve typically starts two or three days prior, and can include any of the following:

• Beef, chicken, or vegetable broth 

• Water, tea, or decaffeinated coffee 

• Sugar-free sports drinks or Jell-O

• Protein shakes

Your doctor may also recommend supplementing with a multivitamin during your liquid pre-op diet to ensure that you are getting the proper nutrition.

Exercise after gastric sleeve surgery should be gradual and slow, especially within the first few weeks. Low-impact activities such as walking around the house, walking on a treadmill, or using a stationary bike can be slowly increased in intensity and duration. As your body heals – and with the green light from your surgeon – you can start incorporating light resistance training or weight lifting three to five days a week.

First, your surgeon will look to get a thorough understanding of your current health, including any medications, pre-existing conditions, and weight loss goals. They will also give a detailed overview of what to expect from the procedure and recovery, as well as provide an opportunity for you to ask any questions that you might have.

A gastric sleeve consult may include taking measurements and photos to help track progress over time. Your surgeon may also ask about anything you’ve done in the past to lose weight, such as diets, exercise regimens, or lifestyle habits to help determine whether a gastric sleeve is right for you.

Gastric sleeve surgery is less invasive, simpler, faster to recover from, and generally safer than other bariatric procedures. People with health conditions that may not be suitable for a longer procedure, or who have had other weight loss options fail, may benefit from this surgery as a weight loss alternative and health benefit. By creating a smaller stomach through gastric sleeve surgery, patients may lose a significant amount of weight and health problems associated with excess weight such as type 2 diabetes or high blood pressure, may resolve.

Additionally, the procedure can improve or eliminate the following conditions:

• Relief from other conditions such as sleep apnea, joint pain, and heart health improvements with a decrease in heart attacks and strokes over time

• Reduces feelings of hunger

• Lower risk of vitamin deficiency or ulcers

• Preserves normal stomach function allowing the digestion process to fully occur

Gastric Sleeve surgery may be considered for patients that meet the following criteria:

• Body mass index (BMI) of 35 kg/m2 and above with an obesity related disorder such as high blood pressure, diabetes, or sleep apnea

• Body mass index (BMI) of 40 kg/m2 above with or without obesity related disorders

• Have tried to but not succeeded in losing weight prior to surgery

• Have realistic expectations of the results

If you have qualified for gastric sleeve surgery, a two-week liquid diet will be required before the procedure to encourage fat loss in your abdomen and liver, making the surgery safer. Your surgeon will give you specific guidelines to follow. Twelve hours prior to surgery, you will be asked to not eat or drink anything, making sure the stomach is empty before the procedure.

Step One – Anesthesia

You will be administered one of the following for your gastric sleeve surgery based on your doctor’s recommendation:

• Intravenous sedation

• General anesthesia

Step 2 – The Incision

Your surgeon will start by making four or five small incisions in your abdomen (about ½ inch long). The incisions allow entry for a laparoscopic camera to survey the abdomen, while the other incisions are used to insert small surgical instruments to perform the surgery.

A long flexible tube or additional ports will be inserted as a sizer to ensure that an appropriate amount of stomach is left in place. The surgeon will measure out the gastric sleeve, leaving a banana shaped pouch, and up to 80% of your stomach will be removed.

Step 3 – Closing the Incisions

Using a surgical stapler, the surgeon will staple the remaining stomach to allow the tissue to hold together. After the incisions are closed, you’ll be taken to a recovery room, where you may need to stay overnight to monitor any complications.

Step 4 – See the Results

You will have a smaller stomach preventing you from eating large amounts and making you feel fuller faster. The gastric sleeve surgery will reduce the amount of hunger hormones produced by your stomach and help to decrease appetite, cravings, and impulses that cause people to regain the weight they’ve lost.

Gastric Sleeve surgery usually takes around an hour to two hours depending on your surgeon and the complexity of the procedure. Your surgeon may want you to stay in the clinic for a night afterwards to help manage your pain and any temporary side effects of surgery.

After a gastric sleeve surgery, there is some pain the first day. The pain subsides by the next day, and most people feel sore and fatigued as their bodies work to recover.

Most doctors recommend anywhere between two to six weeks of recovery, downtime from work, and avoiding strenuous activities while you heal. Your doctor will give you detailed instructions for recovery, including dietary changes. These are some common recommendations:

Day 1-2:

After your surgery, you will continue with a liquid diet, over the next few days you will be able to gradually progress to a soft diet such as pureed foods. Any pain or nausea will be managed by your doctor’s recommended prescription.

Day 3-4:

By this time, you will be able to remove any bandages over your incisions, unless your doctor advises you otherwise. You may gently shower, but avoid baths, soaks in a hot tub, or swimming for one month. Pat your incisions dry, but do not rub them.

Day 5-7:

You will be able to start light activity such as walking. Continue with a liquid or soft meal diet unless advised otherwise by your doctor.

Week 2:

After two weeks, your doctor may request a follow-up consultation to make sure you are healthy and healing well. During this time, the incisions should be healing and may no longer need bandages and the pain should have subsided. You may slowly start to implement pureed and soft solid foods in your diet and continue with light physical activity.

Week 3:

By this time, pain should no longer be an issue. You should be able to start slowly testing solid foods and continue with light physical activity. Nausea or vomiting is common during the first few months following surgery, adjusting your diet will usually make you feel better.

Week 4-6:

During weeks 4-6, you will be able to transition into your normal activities and begin your new diet and exercise maintenance routine.

Patients lose most of their excess weight within the first six to nine months post-procedure. The amount of weight lost is dependent on current weight and compliance with the doctors’ orders. The average weight loss is 25% to 30% of your body weight in the first one to two years. There may be loose skin once the extra fat is gone, which may be surgically removed 18 months or after fully healing from gastric sleeve surgery.

As long as you maintain a healthy diet and exercise regime, the results of your surgery will be permanent. However, based on the lifestyle habits you adopt after surgery, some people may lose less weight or regain some weight.

Gastric Sleeve surgery is a minimal invasive procedure, however, with any surgery there are potential risks. Some gastric sleeve risks, side effects, or complications include:

• Leakage from the staple line

• Staple separation

• Bleeding/ infection

• Emergence of acid reflex

• Can worsen or create new heartburn issues

• Gallstones

• Nutritional or vitamin deficiencies

The cost of gastric sleeve surgery depends on factors such as geographic location, the surgeon & their experience, and the complexity of your surgery. Typically, the surgery ranges from $11,000 – $20,000.

325/331 people who received Gastric Sleeve Surgery rated the treatment “Worth It” (98%)

• Source- Realself.com

Sources:

https://www.bariatric-surgery-source.com/bariatric-surgery-canada.html

Gastric Sleeve Surgery

Sleeve Gastrectomy

https://my.clevelandclinic.org/health/treatments/22931-gastric-sleeve-surgery

https://www.360sleeve.com/recovery/

https://www.realself.com/surgical/gastric-sleeve