Listed below is the step by step procedure of sleeve gastrectomy:
Sleeve gastrectomy, gastric sleeve surgery or laprascopic sleeve gastrectomy (LSG) is a procedure in which the stomach is reduced to about 2/3rd of its original size. As a result, what we get is a tube or sleeve like structure. It is a kind of restrictive surgery, where the structure of the stomach is altered to restrict food intake.
It is done in those patients who are obese and need surgical aid to reduce their weight. Reduced size of stomach causes less intake of food, resulting in subsequent weight loss. It is a gradual procedure and, instant.
If the indications give a green signal to surgery, your doctor will ask you to undergo some tests to ensure an uneventful and successful procedure.
An important thing to keep in mind is that the tests should be performed within 30 days of the sleeve gastrectomy procedure. Tests advised will include the routine blood workup & imaging tests plus those which are particular to your present health condition.
The diagnostic tests are as follows :
Have a nice bath on this day. On reaching the hospital, the staff will record your details for the admission procedure. Again your blood and urine tests will be conducted. A nurse will inject a medicine that will prevent your blood from clotting (heparin) and ask you wear compression stockings to prevent the risk of deep vein thrombosis.
After settling down, your surgeon and anesthetist will visit you and you can clarify all doubts with them. Then a consent form will be given to you which explains all the details of the surgery, underlining the risks and complications as well. If you are satisfied with the details and wish to continue further, you will have to sign the form. Then you are taken to the operation theater.
All the equipment is sterilized and the operation theater is disinfected. You will be draped in a clean patient drape and made to lie down on the operation table.
The aim of sleeve gastrectomy is to reduce the stomach size. An advantage of this technique is that the important anatomic structures and connections are preserved. Most of the procedure inside the abdominal cavity is carried out using a laparascope, which makes this surgery minimally invasive.
You will be assessed for the possibility of difficult intubation. General anesthesia is used in most of the cases. It is given either intravenously or by inhalation of gas.
While giving anesthesia, a few pillows are kept under your head to elevate your upper body well above the chest level. This is to improve visualisation during laryngoscopy.
The patient is positioned so that he/she lies flat on the back. Abdominal skin is shaved and cleaned with an antiseptic solution. Suitable incisions are made over the abdominal skin, to gain access to stomach. After the muscles have been dissected, the surgeon proceeds to operate upon the stomach. The stomach is a J shaped pouch which is to be reduced in volume. The J shaped side of the stomach is folded and stitched together to leave behind what looks like a cylindrical tube. If the surgeon feels, the extra flap of stomach is surgically removed.
The abdominal muscles are then placed in their former position and abdominal skin is sutured. The patient is then transferred to a recovery room, till effects of anesthesia wear off.
Following sleeve gastrectomy, these guidelines may be of some help -
In the initial few hours after surgery, you may not feel anything. This is the effect of anesthesia and pain medications given during the procedure.
Once the anesthesia starts wearing off, you will start to feel pain for sometime. This will be felt in places where the doctor has given sutures (stitches) and most importantly the part from where the large portion of stomach was removed. Just let the nursing staff know, they will give the pain medications as and when required.
A generalised soreness in the body may be felt.
Recovery in the following days- The next day the radiologist will conduct a gastrograffin swallow test to make sure there are no leaks in the GIT (gastro intestinal tract) and then give a green signal. You can finally consume fluids!
Your quality of life will improve drastically, but the results should be maintained with a strict healthy diet and regular exercise
What to expect after sleeve gastrectomy?
In the long run, you will feel more energetic and the problems related to obesity will gradually disappear. You should be able to perform routine activities without much difficulty. Patients have experienced improvements in the conditions of morbidity (type II diabetes mellitus, high blood pressure, obstructive sleep apnea). Since the weight loss is quick, the overlying skin may sag a little. Do discuss this with your cosmetic surgeon for other treatment options.Follow up-
Regualr visits to the doctor ensure that the healing is going well and monitoring of the diet and exercise regimen becomes easy.However, if you find any of the following happening, contact your doctor as soon as possible -
Though a rare occurrence, some problems may arise – Bowel obstruction
Any kind of bariatric surgery is a life-changing experience. It completely changes the way how we look after and care for our bodies. Indeed, it is a very quick way to lose weight, but it is possible to maintain its results only with a disciplined way of living, with lots of healthy food and exercise. As it is said, "the journey of a thousand miles begins with a single step.”
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