Dr. Luis Zavala - BeMyBariatric

GASTRIC SLEEVE

Sleeve gastrectomy, also called gastric sleeve, is a surgical procedure for weight loss. Currently, this procedure is performed laparoscopically, which involves the insertion of small instruments through small incisions in the upper abdomen. During the surgery, approximately 80 percent of the stomach is removed, leaving a tubular-shaped stomach.

This will result in a restriction on the amount of food you are able to consume. In addition, the part of the stomach where a hormone called Ghrelin is produced—which is partly responsible for appetite—is removed. By decreasing its production, the feeling of hunger the patient experiences is reduced. There are also other hormonal changes that aid in satiety and better blood glucose control.

Studies show that the gastric sleeve is as effective as the gastric bypass in weight loss and in the control or remission of diabetes.

Procedure We perform the surgery using a minimally invasive technique. General anesthesia is provided, which will keep you asleep and pain-free during the surgery.

We make 5 incisions in the abdomen: two of 1 cm and three of 5 mm. We introduce a harmless gas into the abdomen to expand it.
Subsequently, a camera and a lens are inserted, which are connected to a monitor; this allows me to see inside your abdomen and perform the surgery.
Then, approximately 80% of the stomach is removed using a special stapler.
This procedure does not make any changes to the intestines.
Once finished, the instruments are removed, and the wounds are closed.
The surgery lasts between 40 and 60 minutes.

Who is a Candidate

Patients with a body mass index (BMI) greater than 35, or greater than 30 who suffer from a metabolic disease (diabetes, hypertension, hypothyroidism, etc.).
Patients who have had several failed attempts to lose weight.
Patients who are willing to make a change in their lives.

Advantages

Restricts the amount of food the stomach can hold.
Induces rapid and significant weight loss.
Does not require the placement of external objects inside the abdomen and does not change the pathway through which food passes.
Requires a short hospital stay of approximately 48 hours.
Losing weight will also help improve your mobility and make everyday tasks easier.
Losing enough weight after surgery can improve many medical conditions you might also have. Conditions that can improve include asthma, type 2 diabetes, arthritis, high blood pressure, obstructive sleep apnea, high cholesterol, and snoring, among others.
Obesity is strongly linked to 13 types of cancer, so losing weight will help decrease the chances of suffering from any of them.

Risks

Allergic reactions
Respiratory problems
Bleeding (<4%)
Thrombus formation (1-3%)
Infections (3%)
Marginal ulcers
Leaks (0-3%)
Malnutrition

It is important to highlight that currently, this is a very safe procedure. There are measures we take to prevent each and every one of the aforementioned risks, which will be explained in detail during your first assessment appointment.

BEFORE SURGERY

You will need to consult with different specialists and undergo various tests before surgery.

The first step toward change is attending the assessment appointment. In the office, I will explain the details of the surgery, the risks, and the benefits, and I will show you illustrations that will help you understand. In addition, a body composition exam is performed using a highly sophisticated scale that allows me to determine your body fat, muscle, and water percentage.

If you decide to undergo surgery, the next step is to carry out blood and imaging tests, as well as an electrocardiogram. Afterward, you will be evaluated by nutrition, internal medicine, psychology, and anesthesiology specialists. All these evaluations and tests allow us to detect any abnormality you might have. If any are detected, we will normalize or stabilize them before going into the operating room.

If you smoke, you must quit 8 weeks before surgery since tobacco interferes with proper lung function and impairs healing. Approximately 10 days before surgery, you will be asked to follow a special diet, which will help reduce the size of your liver and visceral fat, making the surgery simpler and safer.

AFTER SURGERY

You will be in the hospital for approximately 48 hours. On the second day, we will perform an oral contrast study to rule out the presence of leaks. On the third day, you will be able to drink clear liquids, and you will be given a diet to follow, divided and explained in stages.

Upon discharge, I will give you a prescription for the medications you will be taking for a few days. It will be necessary for you to take nutritional supplements to compensate for the accelerated weight loss and ensure you do not lose muscle mass or fall into malnutrition.

It is very important that you maintain close contact with the team and attend all your follow-up appointments so you can reach your goals without adding other health problems. The first follow-up appointment is one week after your surgery; if you are out of town, we can talk via videoconference. The next visit will be in one month, then at 3 months, then 6 months, and in 1 year. For the 6-month appointment, I will again request laboratory tests and blood vitamin levels to detect any deficiency in time. If you are diabetic, I will request tests starting the 1st month to check your glucose control.

Bariatric surgery has transformed the lives of many people. You can change yours too. I hope this article has cleared up some of your doubts and helps you make your decision.