Gastric Sleeve Surgery
The gastric sleeve procedure, known in English as Sleeve Gastrectomy, is a surgical intervention designed to facilitate weight loss by reducing food intake. During this minimally invasive procedure, approximately 75% of the stomach is removed, resulting in a significantly altered stomach shape that resembles a banana or a tube. Post-surgery, the stomach can accommodate only 50-100 ml of liquid, roughly equivalent to half a cup of tea. Importantly, the pyloric muscle, which regulates the passage of food from the stomach into the intestines, is preserved. The reduced size of the stomach allows patients to feel full after consuming smaller amounts of food. Furthermore, this procedure eliminates a portion of the stomach that produces the hormone responsible for triggering hunger. Compared to gastric bypass surgery, gastric sleeve surgery is considered simpler as it does not require rerouting or reconnection to the intestines. The typical duration of the surgery is about one hour, with an average hospital stay of approximately two days.
Potential Risks of Gastric Sleeve Surgery
While no surgical procedure is free from potential complications, the introduction of laparoscopic techniques in the field of obesity surgery has revolutionized not only the effectiveness of weight loss surgeries but also the reduction of associated risks for patients. Data from over 60,000 patients indicate that the risk of mortality associated with sleeve gastrectomy is just 0.1%, which is lower than that of gallbladder removal surgery or hip replacement surgery. Additionally, studies show that there is an 89% reduction in the mortality rate among individuals who have undergone gastric sleeve surgery due to the alleviation of various obesity-related medical issues.
It is worth noting that significant complications from gastric sleeve surgery are rare, occurring in less than 1% of cases. Fatal complications from the procedure are extremely uncommon. The risks associated with gastric sleeve surgery are slightly higher than those related to laparoscopic adjustable band surgery, yet lower in comparison to gastric bypass surgery. As with any surgical intervention, various short-term and long-term risks can arise, including:
- Short-term complications: These may include severe bleeding during surgery, surgical site infections, adverse reactions to anesthesia, blood clots, respiratory issues, leaks from the resected portion of the stomach, injury to surrounding organs during the procedure, and the necessity to convert to an open surgery instead of a laparoscopic approach.
- Long-term complications: Potential long-term issues can include gastric outlet obstruction, hernias, gastroesophageal reflux disease (GERD), low blood sugar levels, nutritional deficiencies, and vomiting.
Expected Weight Loss
Patients can expect to lose approximately 60% of their excess weight within 12-18 months post-surgery. For example, an individual 100 kg overweight may lose around 60 kg. While some individuals might experience greater weight loss, others might lose less, the combination of regular exercise and healthy eating habits post-surgery significantly enhances weight loss effectiveness following the gastric sleeve procedure.
Post-Operative Diet After Gastric Sleeve Surgery
The diet following gastric sleeve surgery typically progresses through four distinct stages, outlined as follows:
- Stage One: This initial stage generally lasts for about one week post-surgery, during which patients are restricted to clear liquids only. Caffeinated beverages, sugary drinks, and carbonated beverages should be avoided, with an emphasis on consuming sugar-free liquids. It is essential to drink at least eight cups of water daily. Acceptable options during this stage may include clear broth, decaffeinated tea or coffee, and gelatin.
- Stage Two: The second stage lasts from the end of the first week up to ten days post-surgery. During this time, many patients may begin to experience feelings of hunger. The focus shifts to a high-protein liquid diet while avoiding sugary and low-nutrient foods. Examples of foods to avoid include full-fat dairy products. Patients should continue to consume plenty of water and include protein-rich elements in their diets, possibly through sugar-free protein powders mixed with clear liquids. Acceptable foods may include thin soups, sugar-free puddings or ice creams, diluted juice, soft foods, and low-fat yogurts.
- Stage Three: In this stage, patients should avoid sugary foods, bread, skins, and seeds from fruits and vegetables, as well as fatty foods, including oils and butter, white pasta, and rice. High-protein foods are encouraged as they are nutrient-dense and help maintain the feeling of satiety. Safe options include lean meats, tender fish, low-fat cheese, and well-cooked vegetables.
- Stage Four: The final stage begins about four weeks after the surgery and introduces solid foods back into the diet. During this stage, patients can incorporate the same safe foods from Stage Three while continuing to avoid white bread, sugary snacks, canned foods (like potato chips), cooking oils, fried foods, carbonated beverages, sweets, and high-calorie foods.