In layman’s language, Sleeve gastrectomy is a surgical procedure that induces weight loss. But clinically, it would be defined as a transformative, irreversible standalone procedure that reduces the size of the stomach by almost 80%, limiting the food-holding capacity and thus facilitating weight loss.
This blog discusses the essentials of the sleeve gastrectomy procedure, which will help patients determine if they are ideal candidates for Sleeve gastrectomy.
If you are contemplating bariatric surgery, such as Sleeve gastrectomy surgery in Delhi, consider consulting Dr. Atul Peters. Renowned for his expertise in bariatric and laparoscopic procedures, Dr. Peters utilizes state-of-the-art surgical techniques to ensure optimal patient outcomes.
“Gastrectomy” refers to the surgical procedure to remove a portion of the stomach. It helps individuals with severe obesity who are unable to lose weight by conventional weight loss like exercising and dietary modifications.
Components of Sleeve gastrectomy procedure involves:
Laparoscopic technique/Robotic: Sleeve gastrectomy procedure is performed laparoscopically as well as robotically. Both yield quick recovery, reduced risks of wound infection, and minimal postoperative discomfort.
Gastric resection: A portion of the stomach is surgically stapled and removed. The stomach then resembles the shape of the banana/sleeve.
Hormonal modulation: Removal of stomach portion leads to decreased Ghrelin levels, resulting in reduced hunger signals and thus diminishing cravings.
- Other stomach and intestinal hormones such as Peptide YY, Glucagon-like peptide (GLP-1), Insulin, Leptin, Adinopectin and Amylin are also affected which thus promotes metabolic health, satiety and glucose regulation leading to weight loss and improvement of obesity-related conditions.
Below are some general criteria and considerations for candidates who can consider Sleeve gastrectomy procedure:
Body Mass Index (BMI) ≥ 40: Individuals without coexisting medical problems, and for whom bariatric procedures would not be associated with excessive risk are eligible.
BMI of 35–39.9 with Comorbidities: Individuals with obesity-related health issues—such as obstructive sleep apnea, fatty liver disease, or osteoarthritis.
BMI >30-34.9: Individuals with inadequate glycemic control despite optimal lifestyle and medical therapy can be considered for a bariatric procedure.
Failure of conventional weight-loss methods: Sleeve gastrectomy is indicated when traditional methods such as diet modification and routine exercise programs don’t yield sustainable weight reduction.
Comprehensive medical history, psychosocial history, physical examination, appropriate laboratory testing followed by consultation with a Cardiologist, Endocrinologist, Pulmonologist, Intensivist, and Internist are to be performed pre-operatively to assess surgical risks.
Sleeve gastrectomy is contra-indicated in uncontrolled psychological disease and pregnancy.
Alcohol and smoking will have to be stopped when planning for the sleeve gastrectomy surgery. Adequate hydration should be maintained.
Some prior medications that the patient might have been prescribed for other health conditions may need to be paused after the surgeon reviews them.
Most surgeons advise stopping solid foods by late afternoon the day before the procedure, then switching to a liquid diet until midnight, with no intake thereafter.
Anaesthesia and incisions: Surgery is typically performed under general anesthesia. Surgical instruments and a camera are introduced in the abdomen through small incisions. In rare cases, open surgery with a single large incision might be necessary.
Stomach resection: The surgeon first ensures the blood supply to the removed stomach portion is managed to minimize bleeding. If a hiatal hernia is present, it is corrected before proceeding.
Forming the “Sleeve”: A thin cylindrical tube is introduced through the mouth into the stomach to guide the resection. The surgeon removes the excess portion of the stomach and staples the remaining tissue to create a narrow, tube-like structure.
End of surgery: Once stapling is done, the cylindrical tube is withdrawn from the mouth, and the resected stomach tissue is extracted through one of the small incisions in the abdomen.
Diet progression: Clear liquids are typically consumed for about two weeks. Soft and solid foods are gradually reintroduced, following nutritionist’s guidance.
Lifestyle recommendations: Exercise and dietary restrictions must be maintained after recovery from Sleeve gastrectomy procedure to ensure healthy weight and adequate nutrition.
Highly effective: Sleeve gastrectomy delivers prompt and sustained weight loss.
Fast results: Most patients shed 60–70% of their excess body weight within one to one and half years.
Resolved obesity: related conditions: Many patients experience significant relief in obesity-related conditions such as type 2 diabetes, hypertension, and sleep apnea.
Hormonal regulation: The hormonal changes after sleeve gastrectomy work together to reduce hunger, enhance satiety, improve insulin sensitivity, and regulate glucose metabolism.
Simpler process: Unlike gastric bypass, sleeve gastrectomy doesn't include intestine rerouting which makes it a simpler procedure.
Improved quality of life: Many patients report improved focus, productivity, and self-esteem. The sense of control over health fosters optimism and resilience, hence improving overall quality of life.
Before the surgery, the patient should discuss the risks and complications related to the sleeve gastrectomy with their surgeon. These risks include:
Nausea, vomiting, and difficulty eating because of the narrow stomach blockage.
Due to reduced stomach capacity, patients might struggle to meet their nutritional requirements. A bariatric specific micronutrient supplementation should be taken to full fill the nutritional requirements.
Worsening or onset of Gastroesophageal Reflux Disease (GERD) post-surgery.
Rapid weight loss can promote gallstone formation, potentially leading to cholecystectomy.
Minor complications such as post-operative leaks along the staple line, infections, or complications related to anaesthesia can occur during or after a sleeve gastrectomy, and their likelihood often depends on the surgeon's expertise and the patient's overall health.
These risks, however, are reduced to a minimum when in the hands of experienced surgeons in Delhi.
Recovery from sleeve gastrectomy is typically straightforward. Patients can expect:
Quick recovery and hospital discharge: The procedure itself often takes between 15 to 45 minutes. Most patients remain in the hospital for one to two nights postoperatively.
Minimal pain: Postoperative pain is usually mild and effectively controlled with prescribed medications.
Faster return to normal activities: Patients are allowed to engage in their daily activities immediately after discharge. Most of the patients resume all activities within a week after surgery.
Gradual transition of diet:
- Phase I Clear Liquid Diet (Only clear liquids allowed) – for 24 hours post-surgery,
- Phase II Clear Liquid Diet (Only clear liquids allowed)- begins on discharge from the hospital,
- Phase III Puree Diet (progression towards soft and pureed food items), and
- Phase IV Slow progression Diet (From soft to normal diet).
Expertise and precision are particular in bariatric surgeries such as sleeve gastrectomy. Dr. Atul N.C. Peters stands out as the premier choice for bariatric and sleeve gastrectomy surgery in Delhi, offering unparalleled expertise, advanced medical infrastructure, and comprehensive patient care.
As a trusted authority at Max Hospital and Smart Cliniqs, Delhi, Dr. Peters brings extensive experience in minimally invasive techniques, ensuring safer, more efficient procedures with outstanding results. His dedication to patient success extends beyond the operating room, with robust postoperative support, including dietetic counseling which are essential for long-term weight management.
With his prestigious certifications, numerous accolades, and commitment to delivering transformative health outcomes, Dr. Atul Peters is the ideal choice for those seeking a smooth, successful pathway to significant weight loss and improved health.
- Individuals with BMI ≥ 40 without coexisting medical problems,
- BMI of 35–39.9 with comorbidities such as obstructive sleep apnea, fatty liver disease, or osteoarthritis, and
- BMI >30-34.9 with inadequate glycemic control despite optimal lifestyle and medical therapy should be considered for a Sleeve gastrectomy procedure.
Most patients stay in the hospital for one to two nights, with the surgery itself taking 15-45 minutes. Recovery tends to be rapid, allowing a return to daily activities within a week. Some activities can be resumed immediately after discharge.
Sleeve gastrectomy helps patients shed 60–70% of their excess body weight within one and one and a half years. Benefits of Gastric sleeve surgery include improvement in obesity-related issues (type 2 diabetes, hypertension, and sleep apnoea), hormonal regulation, no gastric banding, mental health benefits, and no intestinal rearrangement.
Gastric sleeve surgery is a relatively easy and quick procedure. Since this surgery does not alter the form of the intestines, the chances of facing long-term nutritional complications are also much lesser.
Gradual transition is made from a mechanically altered soft diet to a normal low-fat, high-protein diet, ensuring easy digestion and minimal chewing. Sugar, Spirits, Straw, Soda, and Smoking should be avoided to prevent bloating, abdominal discomfort, and respiratory issues.
