The Sleeve gastrectomy or also called calibrated vertical gastroplasty with gastric resection is a surgical operation that consists of removing a large part of the stomach to form a tube.
The stomach will only measure about 30% of its previous size, forcing patients to eat smaller portions and change their diet.
The Sleeve is an irreversible intervention. However, the tube will gradually expand and will no longer be effective after 5 to 7 years.
The volume and size of the stomach is reduced, the passage of food is very slow, but there is no change in the digestion of food.
The Sleeve causes a decrease in ghrelin levels, which is the hunger hormone, resulting in a lack of interest in food.
• Patients with a BMI > 40 kg/m2
• Patients with a BMI > 35 kg/m2 associated with at least one comorbidity that could be improved after surgery (diabetes, osteoarthritis, cardiovascular disease)
• Age < 60 years old
• Well-informed patients who have been evaluated beforehand.
Duration of hospital stay
2 to 3 days.
Monitoring required after the intervention.
Average length of stay
The surgeon will have to agree that the patient can fly again.
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The patient will have to undergo various tests and examinations before going to surgery as well as follow a diet. The surgeon will recommend that the patient stops all medication and stops smoking. The patient should be fasting from midnight the day before the operation.
**The preoperative check-up **:
• Biological assessment
• Abdominal-pelvic ultrasound
The operation is performed under general anaesthesia by laparoscopic surgery, using 5 scars of 5 to 15 mm in the upper part of the abdomen, allowing the introduction of a camera, various instruments, and the stapling pliers. A small scar of less than 10 cm will be made at the end of the procedure to remove the cut stomach segment (2/3 of the stomach).
The operation lasts from 1 hour 30 to 2 hours in general. It consists of cutting the stomach vertically, leaving a gastric tube in place. The other piece of stomach will be permanently removed.
After the procedure, you will spend a few hours in the recovery room, then be taken back to your room.
Pain medication will be administered to you through the vein.
A chest tube is placed after the operation.
The day after the operation:
• Resumption of a progressive diet respecting a specific nutritional program;
• The diet should include 2 snacks and 3 meals to avoid vomiting;
• Put in a sitting position by a physiotherapist;
• Initiation of oral pain treatment; withdrawal of infusion
• Scar monitoring.
Nutritional monitoring must be regular (weekly and monthly)
Weight loss is about 4 kg per month for the first 6 months and then 2 to 4 kg / month.
Weight loss is in the order of 65% to 10 years of excess weight, but a weight recovery is not excluded because the gastric tube can expand.
Biological follow-up is important at 1 month, 3 months and 6 months to eliminate or correct any vitamin deficiencies.
• immediate complications: perforations, bleeding
• scar infections
• stomach ulcer
• stenosis (narrowing) revealed by vomiting
• vitamin deficiencies
MEDICAIM takes care of the follow-up on a case-by-case basis. www.medicaim.com
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