Sleeve Gastrectomy is one of the bariatric surgeries restricting food intake. It is the process of removing most of the stomach with a laparoscopic operation, preserving a tube-shaped part of the stomach that will ensure its continuity with the esophagus and intestine.

There is an increase in the prevalence of obesity in the world and in our country. In the operation, which is also referred to as obesity surgery, stomach reduction or tube stomach, it is aimed to satiate people with less food. In the first year after the surgery, people lose weight quickly. By the end of the first year, the rate of weight loss is at its peak. Depending on the patient's change in eating habits, 70-80% of the excess weight can be lost in the first 1-1.5 years.

Like other bariatric surgeries, the standards of the International Society of Obesity and Metabolic Surgery are valid here.

Current indications in bariatric surgery:

• Body mass index (BMI) is 40 kg. / m² or more.
• BMI more than 35kg / m² and at least one obesity-related comorbid condition. These accompanying conditions can be diseases such as Type 2 diabetes, hypertension, sleep apnea, fatty liver, joint diseases, high cholesterol.
• New clinical practice guidelines published by the American Society of Clinical Endocrinologists, the Society of Obesity, and the American Society of Metabolic and Bariatric Surgery suggest that surgery can reduce the risk of cardiovascular disease and for those with uncontrolled diabetes, it may also be suitable for patients with a body mass index that is larger than 30 kg / m².

Patients who meet these criteria and wish to undergo bariatric surgery are usually evaluated by a team of dietitians, a psychologist, internists and surgical physicians to determine whether the patient is a suitable candidate for surgery.

Exclusion criteria for bariatric surgery are used to protect patients from risks that may outweigh the potential benefits. These criteria include treatable diseases that can cause obesity, ongoing drug or alcohol abuse, untreated eating disorders, poorly controlled or severe psychiatric diseases, portal hypertension, advanced cancer, current pregnancy, or the patient's post-operative dietary guidelines. Includes cognitive impairments that prevent them from complying.

Each procedure also has its own contraindications. For example, the adjustable gastric band is contraindicated for patients who use steroids for a long time or have chronic inflammatory diseases (e.g. Crohn's disease, chronic pancreatitis). Sleeve Gastrectomy is contraindicated for patients with Barrett's esophagus and severe gastroesophageal reflux disease. Roux Y Gastric bypass and Duodenal Switch are relatively contraindicated for patients with inflammatory bowel disease. It should be known that as the field of bariatric surgery develops, absolute contraindications may become indistinguishable from standard patients. Age is an example of this. While bariatric surgery was contraindicated for patients older than 60 years and younger than 18 years old, today many health centers consider the functional age of the patient rather than just the chronological age. The results of the study showed that the quality of life was improved with bariatric surgery in those older than 65 years and younger than 18 years of age.

Those who are planning a pregnancy within 1 year in the near future,

Cancer patients,

Patients with lung disease,

Those with serious and untreated psychiatric illness,
Those with substance or alcohol addiction,

Those with heart disease,
Patients with hormonal and endocrine disorders,
Patients who cannot make the necessary changes in diet and lifestyle after surgery,
Those who have a disease that will prevent anesthesia,

• Since it is performed laparoscopically (closed), wound healing is faster, pain rates are reduced, and hospital stay is shortened.
• Since the stomach functions are not changed, the natural nutrient flow direction is not disturbed.
• The secretion of the hormone Ghrelin, which gives a feeling of hunger, decreases and thus the appetite decreases significantly from the first day.
• Intestinal bypass carries a high risk in those with chronic bowel disease such as Crohn's disease. Sleeve Gastrectomy can be easily performed in these patients.
• Since it is applied laparoscopically, it provides less wounds, lung problems, less pain and faster recovery.
• Obesity-related co-morbidities such as hypertension, sleep apnea and diabetes improve by 70-80% after surgery.
• Intestinal structure and anatomy do not deteriorate.
• As there is no malabsorption of minerals and vitamins, as in procedures that bypass the small intestine, external vitamin-mineral supplementation is not required.
• Dumping syndrome does not occur and sugar and sugary foods can be tolerated better. It can be followed endoscopically.
• It can be followed endoscopically.

The common risks involved in every surgical procedure are also valid in Gastric Sleeve surgeries.

Possible complications specific to this operation are respiratory problems that may occur due to the movement of clots formed in the veins of the leg due to the weight of the patient, especially leaks at the seams and related abscesses, and are seen at a rate of 1%. The reason for the decrease in this rate is the increasing prevalence of this operation, the increase in the number of experienced centers and surgeons, and the advancement of the technology used.

Risk Ratios of Gastric Sleeve Surgery Published in International Literature;

The risk of leakage complications is 1-2% (1-2 percent) in a good center
Bleeding risk 2-3% (2-3 percent)
The risk of death is reported as 0.1% - 0.2% (1-2 per thousand) in the literature.

These risks are much higher in surgeries that cause malabsorption and are more complicated, such as Gastric Bypass surgery, Ileal Interposition, Transit Bipartition, SADI-S.

It usually takes 1-1.5 hours, excluding preparation.

Those who have a desk job can return to work within 7-10 days after the operation. In those with heavy work, the restriction lasts until the 3rd week after the surgery. Those who return to work after the 7th day should also avoid movements that will force the abdominal wall.

After obesity surgery, the most important thing for people to pay attention to is to maintain their weight over the years. The success rate of stomach reduction surgeries is very high. People can easily lose weight because they are full quickly. They do not need any additional effort for this. However, some people may gain weight again as a result of 'malnutrition' over the years.

Nutrition after bariatric surgery should take place under the guidance of a dietitian. In particular, a protein-based nutrition program should be established; Alcohol, processed nuts, sugary foods, fatty foods or fried foods should be consumed very, very rarely.

It is inevitable to gain weight because unhealthy diet and consumption of processed products make people feel hungry again quickly. People who have had sleeve gastrectomy surgery should choose their food consciously.

Another issue that should not be neglected after bariatric surgery is exercise. Any exercise program that is suitable for the person must be done on a daily basis. There are some sports branches that are good for people who lose weight quickly, especially after sleeve gastrectomy surgery, to prevent sagging. These; swimming, pilates, fitness.

In addition to healthy nutrition and sports, 'water consumption' is also very important for healthy weight loss / weight control. If enough water is not drunk, people may experience problems such as exhaustion, fatigue, nausea, and feeling unwell. A person who has undergone gastric sleeve surgery should never dehydrate their body. Drinking plenty of water is an important step in losing weight in a healthy way.

It is normal to experience vitamin / mineral deficiency due to weakening after surgery. People should have the necessary tests and use the supplements recommended by the doctor. Obesity surgery is not a 'periodic nutrition program'. They should live with healthy eating habits for life and adopt a new lifestyle.

Nausea is one of the most common problems experienced after bariatric surgery. One of the most worrying issues after the operation is the possibility of nausea. Although there is nausea in the first day after the operation, with the effect of anesthesia, on other days in the hospital, nausea can be prevented by the effect of drugs. People who leave the hospital can sometimes develop sensitivity to odors. Nausea may be felt with sensitivity to odors. In fact, this is part of the operation. Because of the part that is removed from the stomach, the secretion of granule is reduced and this results in loss of appetite. These occur in the first days after surgery.

In the following days, the reason for the development of nausea; is to fill the stomach, which has reduced in volume, with too much food. After the surgery, people should stop eating more as soon as they are full.

Another factor that causes nausea after sleeve gastrectomy is swallowing food in large pieces without chewing too much. After the surgery, people should change not only their nutrition program, but also their chewing and eating habits.

After the operation, as the body gets used to its new pace, the feeling of nausea will begin to improve. Of course, if people make nutritional mistakes and continue their eating habits without chewing quickly and completely, nausea may continue. After the operation, the dietitian transfers the diet and other details to the patient. Stability in the nutrition program is important after bariatric surgery.

Eating should be interrupted when nausea is felt. In fact, depending on the situation, it may be necessary to continue the continuation of that day with only liquid meals. E.g.; water, unsweetened compote, natural apple juice, etc. It is beneficial not to consume the food that causes nausea for a while. Nausea that develops after sleeve gastrectomy may also cause weakness, tiredness, loss of fluid, insomnia and pain and cramps due to retching.

People who have nausea problems after the operation, if there is a decrease in their quality of life due to nausea, should definitely talk to the doctor who performed the surgery. Nausea should be followed, it is not right to pass; however, when necessary precautions are taken, there is no nausea problem, and people can enjoy their new lives in a healthy and peaceful way.

Since Sleeve Gastrectomy is performed with the laparoscopic method, only small incision scars remain in the abdomen. Over time it becomes invisible.

Gastric sleeve surgery varies according to the hospital segment and length of stay. You can contact us for detailed information about pricing. iletişime geçebilirsiniz.