Gastric sleeve - What is a gastric sleeve?

What is a gastric sleeve?

With a gastric sleeve, the surgeon removes a large portion of your stomach. He will do this lengthwise, from top to bottom. The stomach is reduced in size by removing the outward bend of the stomach. As a result, you are left with a smaller tube-shaped (banana-shaped) stomach. 65 to 80 per cent of the stomach is removed.

The entrance and the exit of the stomach will stay the same. Your digestive tract will also stay the same. But your stomach is a lot smaller. The part that will no longer be used is removed from your body. Because your stomach has become a lot smaller, it is no longer possible to eat large quantities of food. Also, you may experience some changes in certain hormones. You will produce less of the appetite hormone making you feel ‘full’ faster. This will ultimately make you lose weight.

Care Clinic acts as a mediator for the gastric sleeve. You can sign up with us in Barendrecht and make a follow-up appointment. You will be treated in and be under the responsibility of a bariatric centre (Centre for weight loss) in Belgium.

How is a gastric sleeve operation done?

An intravenous drip is inserted into your arm in the preparation room. The anaesthesiologist will administer medication through this drip. The operation will be done under a full general anaesthetic. This means that you will be asleep during the whole procedure and will not feel anything.
Once you have arrived in the operating theatre, you will be attached to the monitoring equipment, to measure your blood pressure, and adhesive patches will be used to register your heart rate. You will receive oxygen via an oxygen mask, and the anaesthetic will be administered via an intravenous drip. Only when you are fully asleep will the operation begin.

After the abdomen has been expanded (inflated) with carbon dioxide, a total of four incisions will be made. Everything will be documented on camera. Next, the surgical instruments are inserted. A gastric tube is inserted into the stomach, and the stomach is checked. The stomach is closed using staples. The section of the stomach to be removed is extracted via one of the remaining incisions, causing this area to be slightly painful after the operation.

You will be woken up once the gastric sleeve is completed and you will have no recollection of the operation. You will remain in the clinic for one night after the surgery, after which you may go home.

When am I a suitable candidate for a gastric sleeve?

A gastric sleeve is a good alternative to a gastric bypass. Loss of weight is comparable. Eating habits or the patient’s own preferences can be reasons for choosing the gastric sleeve, but also when a gastric bypass would not be a safe option, because of, for example, the length of the intestine or previous stomach operations. You are a good candidate for a gastric sleeve at Care Clinic when you have a BMI of 29.

CONSULTATION

‘Bariatrics’ is the collective term for all procedures used to treat obesity. Such as the gastric balloon, gastric band, gastric sleeve and the gastric bypass.
We fully understand that it is a huge step to make an appointment for a bariatric procedure. Therefore, you can expect our full support in this – if you would like, of course. We advise you to bring your partner or a good friend with you to the first consultation.

During the first consultation, we will discuss everything to do with the procedure. First of all, we will discuss with you what disturbs you the most about your body and what you would like to have changed. Also, we will discuss the methods and surgical techniques used and will inform you which are the most suitable for you. But also, what results you may expect, what the possible risks are and the aftercare. You will always receive an honest opinion and will be informed clearly about the procedure and period afterwards.

During the consultation, the consultant will look to see if you are a suitable candidate for the bariatric surgery you have chosen. The surgeon will ask you some questions regarding your health, medical background and any medicines you may be using. Should you use blood thinners, then you should stop taking these at least one week before the procedure.

You will be able to make the right choice after this first consultation. We understand it’s a lot of information to absorb. Therefore, do not hesitate should you wish to contact us again after this consultation with more questions.

What are the advantages and disadvantages of a gastric sleeve?

You may only have fluid foods in the first week after the operation. If this goes well, then you may switch over to solid foods. One advantage of the gastric sleeve compared to the gastric bypass is that you will not experience any ‘dumping’ symptoms with this procedure.

Advantages

No diet – you will never eat too much.
You are no longer hungry.
This operation has a positive effect on diabetes mellitus type 2.
A gastric bypass is keyhole surgery.
The scars are small; therefore, the recovery is quick.

Disadvantages and possible complications

Vomiting/nausea
You will need to take extra vitamins
Seam leakage/peritonitis
You may suffer from heartburn.

A gastric sleeve will have a huge impact on your life. You will have to be more aware of what you eat because your body can absorb and process less food. After your gastric reduction, you must take extra vitamins daily. After the operation, you may only eat fluid or ground food, for three weeks, so that the sutures in the stomach can heal properly.

It is also important to adjust your lifestyle. Only by doing so will you continue to benefit from your weight loss. You will experience fewer health problems – some of which can disappear entirely. Also, your quality of life will greatly improve.

You may start walking directly after the surgery, and you may go home after about two days. The day after you have returned home you will receive a call from us to make an appointment for your first check-up. Furthermore, your dietary instructions must be clear. Should this not be the case, then we will be happy to help you. We can be reached by phone daily.

Check-ups

Two weeks after the surgery, you will have a check-up with the bariatric nurse at the practice of Diana Gabriels. You will have further check-ups with our bariatric nurse after three, six and nine months, and after one year.

Each time adjustments will be made when and where necessary. Should there be any specific issues, you can make an extra appointment. We advise you to hand in a blood sample to your local GP after six months. This to check the nutritional and vitamin levels in your blood. You should continue to repeat this at least once a year. Should your levels be low, we will then start with supplementary medication. There will be a bi-yearly check-up as from the first year after the operation, over five years.

Physical exercise

You should take it easy for the first two weeks so that the wounds will heal well. After the first two weeks, and only if the wounds have healed well, can you start to do everything again.

It is essential that you then immediately start to get enough physical exercise. This will have a positive effect on the end result. By burning more calories, you will lose more weight, and you will stimulate the muscles. Look to see which activities suit you and do what you enjoy. Exercising together with someone often acts as a motivator.

Make sure in any case that you get at least half an hour of physical exercise a day. Start swimming, for example, or walking, jogging or fitness. Small changes make a big difference. Take the stairs instead of the lift for a change. (If possible) Walk to appointments or the shops. Park the car just that little bit further away.

Doing sports and exercise will need to become a permanent and logical part of your new lifestyle. This is healthier, and it will help you to maintain your new weight. Doing this will be much easier to achieve when you have support – think of an exercise therapist or doing sports in a group.

Regardless of whether you are being treated for a gastric band, sleeve or bypass, or whether your BMI is less than 40, it is still possible to lose up to 100 per cent of your excess weight. The target weight is then a BMI of 23-25.
Is your BMI the same or higher than 40, then you will statistically lose 70 per cent of your excess weight.