Gastric sleeve gastrectomy is a type of restrictive surgical procedure included in the group of weight loss or bariatric surgeries performed in the United States, alongside gastric bypass, adjustable gastric banding and biliopancreatic diversion with duodenal switch. Surgery is usually the last resort for obese or morbidly obese patients who tried but failed to lose weight with other medically supervised weight loss programs like behavioral changes, pre-packed substitution meals, or pharmachotherapy.
During the procedure, surgeons cut and remove more than half of the stomach, creating a thin vertical sleeve shaped like a banana or a sleeve. Sleeve gastrectomy can be performed either in an open surgery, which involves a large incision, or laparoscopically, which means that small incisions are made in the abdomen to insert a small camera and the surgical instruments. The smaller stomach can result in weight loss since the organ can hold less amounts of food and the patients will feel full faster. However, the treatment also includes changes in diet and exercise to ensure the success of the surgery.
Recovery From Sleeve Gastrectomy Surgery
The surgery is performed with the patient asleep under general anesthesia and as the patient wakes up, he or she is not likely to feel any pain right away due to pain medication. Patients are usually discharged from the hospital during the first or second day after the procedure and may start experiencing some pain. Right after the surgery, patients won’t eat anything and will gradually transition from liquids to solid food during the following months and according to the doctor’s recommendations. Regarding activity, patients are asked to start moving shortly after waking up, but need to reduce their activities and are advised not to lift anything heavy during preliminary recovery.
This entire process aims to let the stomach heal and patients usually return to work and their normal routine four to six weeks after the surgery. It is normal to notice alterations in the digestive process and bowel movements. Patients may also experience mental and emotional instability, which can be addressed with the help of individual counseling and bariatric support groups sessions. Due to advancements in medicine and technology, the sleeve gastrectomy is usually conducted in a laparoscopic procedure, reason why the recovery time is shortened.
Sleeve Gastrectomy Recovery Compared to Other Procedures
The American Society for Metabolic and Bariatric Surgery (ASMBS) highlights the advantages and disadvantages of the sleeve gastrectomy procedure and compare it with the other types of bariatric surgery available. While the surgery results in the restriction of the amount of food the stomach can hold, it also provokes rapid and significant weight loss, higher than 50% five years after the surgery, which is similar to the gastric bypass, superior to gastric band, but inferior to biliopancreatic division with duodenal switch. In addition, it requires no foreign objects, on contrary to the gastric band, and no bypass or re-routing of the food stream, unlike the two other procedures.
Regarding recovery, the society emphasizes the “relatively short hospital stay of approximately 2 days,” as well as the importance of the sleeve gastrectomy in positively altering “gut hormones that suppress hunger, reduce appetite and improve satiety.” However, similarly to the gastric bypass and the biliopancreatic division, it is a non-reversible procedure, and potential for long-term vitamin deficiencies. The risk of early complications is only higher than adjustable gastric banding, but lower than the other two.
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