What Are the Risks and Complications of Sleeve Gastrectomy?

 What is a Sleeve Gastrectomy?

Sleeve gastrectomy, also known as vertical sleeve gastrectomy (VSG), is a surgical weight-loss procedure that involves the removal of a large portion of the stomach. The remaining stomach is reshaped into a slender, banana-like sleeve. This procedure may be done laparoscopically, which means the surgeon creates several smaller cuts instead of one large one and uses a camera to direct the operation.

How Does Sleeve Gastrectomy Work?

The primary mechanisms through which sleeve gastrectomy promotes weight loss include:

• Restriction: By reducing the stomach's size by approximately 75-80%, the volume of food it can hold is significantly decreased. This means patients feel full after consuming much smaller amounts of food.
• Hormonal Changes: The surgery also involves removing the part of the stomach that produces the hormone ghrelin, which stimulates appetite. This reduction in ghrelin levels helps decrease hunger and food intake.

The Surgical Procedure

• Preparation: Before the surgery, patients undergo a thorough medical evaluation, including blood tests, imaging studies, and consultations with various specialists such as dietitians and psychologists.
• Anesthesia: The procedure is performed under general anesthesia.
• Laparoscopic Surgery: The surgeon makes several small incisions in the abdomen and inserts a laparoscope (a small camera) and surgical instruments.
• Resection: Approximately 75-80% of the stomach is removed along its greater curvature, leaving a tube-like stomach.
• Closure: The remaining portion of the stomach is stapled closed and checked for leaks to ensure it is sealed properly.
• Recovery: The incisions are closed, and the patient is monitored in the recovery room before being transferred to a hospital room.

Benefits of Sleeve Gastrectomy

• Significant Weight Loss: Patients typically lose 50-70% of their excess body weight within the first two years post-surgery.
• Improvement in Obesity-Related Conditions: Many patients experience significant improvements in conditions such as type 2 diabetes, hypertension, obstructive sleep apnea, and hyperlipidemia.
• No Foreign Objects: Unlike gastric banding, sleeve gastrectomy does not involve placing any foreign objects inside the body.
• Simpler Than Other Surgeries: Compared to gastric bypass, sleeve gastrectomy is technically simpler and has a lower risk of complications related to malabsorption.

Risks and Complications

As with any major surgery, sleeve gastrectomy carries potential risks and complications:

• Surgical Risks: These include infection, bleeding, adverse reactions to anesthesia, and blood clots.
• Postoperative Complications: Potential issues include leakage from the stapled stomach, stricture (narrowing) of the stomach, and gastroesophageal reflux disease (GERD).
• Nutrient Deficiencies: Reduced stomach size can lead to insufficient intake of essential nutrients, necessitating lifelong vitamin and mineral supplements.
• Weight Regain: Some patients may experience weight regain if they do not adhere to recommended lifestyle and dietary changes.

Post-Surgery Lifestyle and Dietary Changes

• Dietary Phases:
• Liquid Phase: For the first few days post-surgery, patients consume only clear liquids.
• Pureed Foods: Gradually, patients transition to pureed foods.
• Soft Foods: After a few weeks, soft foods are introduced.
• Regular Diet: Eventually, patients can eat regular foods, with an emphasis on small, nutrient-dense meals.
• Long-term Dietary Changes: Patients need to eat high-protein, low-fat, low-sugar foods and avoid high-calorie, low-nutrient foods.
• Hydration: Drinking plenty of water is crucial, but patients should avoid drinking fluids with meals to prevent overfilling the small stomach.
• Exercise: Regular physical activity is essential to maintain weight loss and overall health.

Eligibility and Evaluation

Sleeve gastrectomy is typically recommended for individuals who:

• Have a body mass index (BMI) of 40 or higher.
• Have a BMI of 35 or higher with obesity-related health conditions such as type 2 diabetes, hypertension, or sleep apnea.
• Have been unable to achieve sustainable weight loss through diet, exercise, and medical therapy.

Sleeve gastrectomy in Bangalore is a highly effective weight-loss surgery that offers significant benefits for patients struggling with severe obesity and related health conditions. However, it requires a lifelong commitment to healthy eating, regular physical activity, and ongoing medical follow-up to ensure long-term success and monitor for potential complications. By understanding the procedure, its benefits, and the necessary lifestyle changes, patients can make informed decisions about their weight-loss journey and improve their overall health and quality of life.