Laparoscopic Sleeve gastrectomy
||Stay In Tunisia
||Back To Work
||All Inclusive Price
| Gastric sleeve surgery
Weight loss surgery has been gaining momentum around the world for more than a decade. When the stage of morbid obesity is reached surgery remains a useful and beneficial solution. The stomach is a bulky «J-shaped" organ located in the upper part of the belly mostly under the ribs. It follows the esophagus that leads food from the mouth and extends through the duodenum which is the first part of the small intestine.
What is a gastric sleeve
Sleeve Gastrectomy, also known as longitudinal gastrectomy or vertical gastrectomy is calibrated with gastric resection. Indeed, it is one of the techniques of bariatric surgery, alongside with the gastric band, the bypass and the bilio-pancreatic diversion. It is an operation that removes all or part of the stomach. The distal section always bears on the duodenum beyond the pylorus while the proximal section at a variable level leaves a larger or smaller gastric stump in place. The choice of the extent of the partial or total resection depends on the disease to be treated and its location. This surgery helps to achieve a high weight loss by reducing the risks associated with obesity and improving the quality of the patient’s life. However, it requires medical and nutritional monitoring for life.
Sleeve gastrectomy technique is recommended for adult suffering from a significant weight gain, with at least one pathology that can be improved after surgery such as high blood pressure, apnea syndrome obstructive sleep hypopneas and other severe respiratory disorders, disabling osteoarticular diseases, nonalcoholic steatohepatitis. The ideal candidate for a bariatric sleeve procedure, however, must follow a specific path before they can benefit from sleeve gastrectomy. They must have previously followed, without success, a medical, nutritional, dietary and psychotherapeutic treatment well conducted for 6-12 months.
You might also be interested to know about thegastric balloon surgery.
Sleeve gastrectomy price
The price of a Sleeve gastrectomy in Tunisia coupled with a week of recovery or vacation in a 5 stars hotel is at least % cheaper than the sole procedure in Europe and for the same medical quality.
How is Sleeve Gastrectomy performed ?
The operation is performed under general anesthesia and lasts about 2 hours. The procedure is carried out by laparoscopy, very rarely by laparotomy. The surgeon makes incisions 3 to 5 usually in the abdomen and trocars are put in place. Then, a tube, called a candle, is introduced through the mouth into the stomach. Indeed, it serves as a calibration for the new stomach. And then with automatic forceps, the stomach is cut and sutured at the same time with a triple row of staples. The part of the removed stomach is then extracted from the abdomen.
The scars are sutured with absorbable thread, more rarely with non-absorbable thread or staples.
Post operative effects and recovery after Sleeve Gastrectomy
After the procedure, the patient stays for 3 to 6 hours in the recovery room to make sure that everything is going well both surgically and anesthetically. Upon awakening, the patient has placed tubes such as bladder catheter, gastric tube, drain, infusion are gradually removed. Pain medications are administered intravenously. Moreover, injections of anticoagulants are made to prevent the risk of phlebitis. Hospitalization lasts about 2 days according to the patient state. The patient is recommended to stop working from 2 to 3 weeks depending on the general condition of the patient and his professional activity. The resumption of the diet must be progressive. Furthermore, the recovery program depends on the establishment, but the diet is usually completely liquid the first 2-3 days, then consists of soup, mashed potatoes, and yogurt, then mixed and finally normal. However, it is essential to eat and drink in small quantities and chew well.
Result and outcome after Gastric Sleeve surgery
Sleeve gastrectomy promotes weight loss through three mechanisms. Indeed, it limits food intake by reducing the volume of the stomach. Because the stomach is smaller, the person cannot swallow too much food. In addition, it reduces the feeling of hunger because the secretion of ghrelin is limited. It also changes the bacterial flora of the stomach, which leads to a change in the perception of tastes and palatability for certain foods. However, this technique does not disturb the digestion of food.
For a person of average height (1.70 m) with a BMI of 40 kg / m2, the expected weight loss is of 45 to 65% of the excess weight. This weight loss helps to improve the potential disorders associated with obesity, such as type 2 diabetes or high blood pressure, and of course the quality of life of the patient.
Advices before and after Sleeve Gastrectomy surgery
Before gastric sleeve, there is a preoperative assessment which includes in particular; a review and management of comorbidities such as cardiovascular, metabolic, respiratory, etc. An assessment of eating behavior and the management of a possible eating disorder (TCA). It is important to make a nutritional and vitamin balance i.e albumin, hemoglobin, ferritin and ferric saturation measurements of transferrin, calcemia, vitamin D, vitamin B1, B9, B12 as well as a correction of possible deficits, an evaluation of chewing abilities. oesogastroduodenal endoscopy and the search for Helicobacter pylori. The establishment of a therapeutic education program in dietary plans and physical activity is recommended as early as the preoperative period.
Follow-up care is indispensable after sleeve gastric procedure. In fact, it has different purposes; to evaluate the weight loss, to monitor the general state of health and to take care of the possible complications or nutritional deficiencies, to evaluate the psychological state of the patients, to make sure that they follow well their new habits food and physical activity, etc. The personal commitment is indeed very important in the success of the intervention.
The sleeve gastrectomy method is not reversible, but the tube will expand gradually and will no longer be effective after 5 to 7 years.