Sleeve Gastrectomy

Sleeve gastrectomy for weight loss for morbid obesity was first demonstrated by Marceau in the year 1993 as a constituent of biliopancreatic diversion. After weight reduction surgery, more problems were observed in case of super-morbidly obese patients with higher rates of failure. Therefore, a two-step proposition comprised of laparoscopic sleeve gastrectomy (LSG) precedes laparoscopic roux-en-y gastric bypass (LRYGB) was first tabled by Regan et al. in 2003 to solve the complications faced by the super-morbid patients. Over time more investigations were made to modify the surgical method to improve the postoperative quality of life of heavily morbid patients. Sleeve gastrectomy is often now practiced in isolation because it describes effectiveness as regards to excess weight loss (EWL) and determination co-morbid obesity condition.

What is sleeve gastrectomy surgery?

Sleeve gastrectomy is a weight loss surgery that eliminates part of stomach making a sleeve-shaped pouch about the size of a banana. After surgery stomach can possess 1 ½ to 5 ounces food. As a result, patients cannot eat much food. The body also absorbs much fewer calories. Hormonal communication between stomach and brain are rescheduled. Patient himself/herself observe weight loss, metabolic syndrome, and overall healthy development.

What is pre-operative diet?

Since you are obese, so is your liver. Therefore, you have to follow a strict diet chart as prescribed by your doctor 2 weeks prior to sleeve gastrectomy surgery to reduce the surgical risk. Following are the recommended diet chart:

  • Increase consumption of protein like lean meats.
  • Lower consumption of carbohydrates and avoid rice, bread, cereals, pasta etc.
  • Eliminate any sorts of sugar component from the diet.
  • Take the high quality of protein shake and make sure that there is no sugar in it.
  • Take vegetables, nuts, berries etc.
  • Keep yourself sufficiently hydrated.
  • Take carbonated beverages and caffeine just two days before the surgery.

What is post-operative diet?

You should remember that you are sailing your life-boat into a healthier zone after sleeve gastrectomy surgery. So in any case, after the operation, you should not cheat yourself. During few weeks of the post-operative stage, you will feel frequent irritation which is not impractical to think your decision of surgery. However, it is utterly important to follow the instructions of your surgeon meticulously.

As ghrelin is responsible for the desire to eat and it is almost removed from the stomach during surgery so, a patient has no desire to eat anything. This is the toughest post-operative situation. Still, you have to take sugarless clear liquids during the first week of surgery.

In the second week, you will start to realize some hunger pains. Stick yourself strictly to the recommended diet chart of your surgeon. Your diet chart may include the following items from the beginning of the second week:

  • Take a mixture of protein powder and sugarless non-carbonated clear liquid.
  • You may take sugar-free pudding, non-fat yogurt, and soup with soft noodles according to your test.
  • Sugar-free carnation instant breakfast and very thin creamed soups are allowed for you.
  • Sugarless sorbet or watery hot oatmeal can be taken.
  • After completion of two weeks, you still require following the diet chart as provided by your surgeon.

What are the complications of sleeve gastrectomy?

The occurrence of complications in sleeve gastrectomy surgery is reported at 0-24%. Rates of stricture after surgery are reported at less than 1%.


Authored By Dr G Parthasarathy - Surgical Gastroenterologist, Hyderabad