Bariatric or weight loss surgery is one of the options for patients who struggle with obesity or morbid obesity, but it is usually only recommended in cases when other non-surgical methods have been tried and found to be ineffective. In the United States, there are four common surgical procedures for weight loss, which are gastric bypass, adjustable gastric banding, sleeve gastrectomy and biliopancreatic diversion with duodenal switch. While it may seem a good option, prior to a bariatric surgery patients need to consider numerous factors, including risks, potential outcomes and preparations to be done.
Sleeve gastrectomy involves the removal of part of the stomach and stapling of the remaining part, leaving a long vertical tube or banana-shaped stomach. It is usually conducted laparoscopically, which means that the surgeon makes two to five small in the abdomen, to insert the surgical instruments and a small camera called laparoscope. The sleeve gastrectomy takes about 60 to 90 minutes and it does not implicate cutting or changing the sphincter muscles that allow food to enter or leave the stomach.
What to Consider Prior to Deciding for a Sleeve Gastrectomy
Before deciding on a life-changing option like undergoing bariatric surgery, both physicians and patients need to decide if it is the best decision. An accredited medical care team evaluates patients’ overall health, need for a bariatric surgery and eligibility criteria. Patients are also informed about the implications of the surgery, including the risks, possible results, commitment needed before and after the sleeve gastrectomy, and eventually other non-surgical medically supervised weight loss programs.
Before being approved for sleeve gastrectomy, all patients need to present copies of their medical record with the results of the evaluation, medical clearance from the primary care physician, as well as psychological clearance. Psychological evaluation is determinant in the process to assess if obesity is not associated with other problems like stress or binge eating, which can be treated with other methods. In addition, patients need to be aware and committed to numerous lifestyle alterations, which reduce the risk of side effects and improve the probability of achieving the goals.
Lifestyle Alterations Prior to Sleeve Gastrectomy Surgery
Patients are reminded that the treatment does not start or end with the surgery, which is why it is important for patients to start making alterations in their lives even before the sleeve gastrectomy. The medical care team will provide specific guidelines on behavioral alterations during the preparation for the surgery, which can take months or even more than a year. During the time of preparation, patients are followed by a bariatric physician, psychologists, dietitian and other specialists.
The medical team will define a plan and diet taking into consideration patients’ characteristics, age, weight, and the existence of any co-morbidity. Adopting healthier life habits increases the possibilities of losing more excessive weight after sleeve gastrectomy and helps patients during the transition after the surgery. In addition, patients need to stop smoking sooner or later to improve overall health and decrease the risk of chest infections such as pneumonia, that can slow down the healing process.
Overall Preparation After Scheduling Sleeve Gastrectomy
When patients are fully aware of the implications of undergoing a sleeve gastrectomy, have been cleared by the medical team and completed the preparation plan defined by the physicians, they may schedule the surgery. It is normal to be stressed about the day, since it is supposed to be a life-changing moment. Physicians may help by providing patients instructions and answering any remaining questions. In addition, patients will be asked additional lab tests and exams before the sleeve gastrectomy, while physicians will control the medication taken by the patients.
The night before the sleeve gastrectomy procedure, patients are not permitted to eat so that the stomach is empty in order to minimize surgical risks. Other preparations should be done by the time the patient arrives the hospital. After a sleeve gastrectomy, patients will stay in the hospital for least a day and four to six weeks at home, which means that home and work arrangements need to be made in advance. In addition, having a friend or family member at the hospital may help with the impact of the surgery after the patient wakes up and during the first days of adaptation.
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