One of the biggest problems that many people face today is weight gain. There is almost nothing they can do to lose weight. They go to the gym, control their diet, and do various exercises. But for some, no matter what they do, it is very difficult to get the desired results. Obesity, or as we call it, ``obesity`` is not just a beauty issue, it is also a cause of many serious diseases such as diabetes, high blood pressure, and cholesterol. So, today we are going to talk about a very successful method in medicine to help those suffering from this type of obesity. That is gastric sleeve surgery.
Simply put, what is gastric sleeve surgery?
Gastric sleeve surgery, or as doctors call it, ``sleeve gastrectomy,'' is a weight loss surgery. It's also called ``bariatric surgery.'' What happens here is very simple. A large part of your stomach, about 80%, is surgically removed.
Think of your stomach as a small pouch. After this surgery, a large piece of the pouch is removed, leaving only a small, banana-shaped, tube-like part (sleeve). That's why it's called gastric sleeve surgery. The main point of this surgery is to make the stomach very small in this way.
Okay, how do you lose weight by shrinking your stomach?
Now you may be wondering, "How can I lose weight by shrinking my stomach?" There are two main reasons for that.
1. Limiting the amount of food you eat: Since your stomach is so small, the amount of food you can eat at one time is greatly reduced. Even if you used to eat a plateful, after the surgery you will feel full with just a small amount of food. Simply put, you will feel full faster. This naturally controls the amount of calories your body takes in.
2. Decrease in hunger hormones: This is the most important point. Our stomach produces the hormone `(ghrelin),` which is the main hormone that causes hunger. Since about 80% of the stomach is removed during gastric sleeve surgery, the amount of this hormone produced is also greatly reduced. This means that your hunger and cravings for food are greatly reduced. The main reason for gaining weight again after losing weight is the uncontrollable desire to eat. This surgery also provides a good solution for that.
The most important thing is that this is not cosmetic surgery. It is done to control serious health problems caused by obesity.
Who is eligible to have this surgery?
This is not a surgery that everyone can do. A doctor will examine you carefully and refer you for this surgery only if you meet certain qualifications. Let's see what those qualifications are.
| Eligibility | Simple explanation |
|---|---|
| Severe Obesity | Your body mass index, or BMI, should be 40 or higher. BMI is a measure of whether you are at a healthy weight for your height. Sometimes, if your BMI is around 35 and you have other obesity-related conditions, such as diabetes and high blood pressure, you may still be eligible for this surgery. |
| Other methods fail | Before surgery, you should have tried to lose weight through other methods, such as diet and exercise. Some insurance companies may require you to participate in a medically supervised weight loss program for 3-6 months before approving the surgery. |
| Physical and mental preparation | This is a major surgery and a life-long change. So you need to be well prepared, both physically and mentally. Before deciding whether you are eligible for the surgery, you will need to meet with a team of dietitians, psychologists, and other specialists. |
What other diseases can be cured with this surgery?
Although the main goal of gastric sleeve surgery is weight loss, it can also control, and sometimes completely cure, many other diseases caused by obesity.
- Insulin resistance and type 2 diabetes
- Hypertension and related heart diseases
- High blood cholesterol levels (Hyperlipidemia) and arteriosclerosis
- Nonalcoholic fatty liver disease (NAFLD)
- Obstructive sleep apnea
- Joint pain and osteoarthritis
This surgery helps to provide relief from many such diseases.
How does the surgery process take place?
Let's now see what happens before, during, and after the surgery.
What should you do before surgery?
Once your doctors have determined that you are a good candidate for surgery, you will be placed on a special liquid diet for about two weeks prior to surgery. This is intended to help reduce some of the unwanted fat in your abdomen and liver, making the surgery safer.
Additionally, you will not be allowed to eat or drink anything for 12 hours before the surgery, as your stomach must be completely empty during the surgery.
How is the surgery done?
Now, most of the time, this surgery is done using a method called ``laparoscopic surgery.'' That is, instead of making a large incision and opening the abdomen, the surgery is performed by inserting a camera and special instruments through several very small incisions. This is also called "keyhole surgery." This method is less painful and the recovery time is much shorter.
1. First, you will be put under general anesthesia. This means that you will not feel anything during the surgery, you will be asleep.
2. Then the surgeon makes a very small incision (about half an inch) in your abdomen and inserts a small tube through it.
3. A little carbon dioxide gas is passed through the tube into the abdomen to inflate the abdominal cavity. This allows the organs inside to be clearly seen.
4. Next, a small camera (laparoscope) is inserted through the tube. The doctor performs the surgery by viewing the images from the camera on a monitor.
5. One or more small incisions are made, through which the long, thin instruments needed for the surgery are inserted.
6. Using these instruments, the "sleeve" portion of the stomach that needs to be left is measured, and the unnecessary large portion is separated and cut away with a special type of stapler (surgical stapler).
7. Finally, the removed part of the stomach is taken out and the small incisions are sewn closed.
This entire surgery usually takes about an hour and a half.
What happens after the surgery?
You will need to stay in the hospital for a day or two after surgery. During that time, the medical staff will help you control your pain and manage temporary side effects, such as nausea.
After you leave the hospital, you will need to see your doctor at regular intervals. He or she will monitor your weight loss, whether other medical conditions are under control, and whether there are any side effects after the surgery.
Do I need to make any major changes to my eating and drinking habits after surgery?
Yes, absolutely. This is the most challenging and important part of this journey. After the surgery, you need to be very careful about what you eat and drink for the rest of your life.
- The first few weeks: During this time, you can only eat liquids. Things like soup, milk, and fruit juice.
- Next: You can gradually switch to a soft diet, such as mashed rice, mashed vegetables, and yogurt.
- After a few months: You can gradually start eating regular solid foods.
But remember, you can never eat as much food as you used to. The food you eat should be very nutritious , because you need to get all the nutrients your body needs in small amounts.
Also, after surgery, you will need to take vitamin and mineral supplements for the rest of your life. This is because it is difficult to get all the nutrients your body needs from food alone due to the reduced amount of food you eat.
What are the benefits and risks of this surgery?
Like any surgery, this one has benefits as well as some risks.
Advantages
- Compared to other types of bariatric surgery, this is a relatively simple, quick, and safe surgery.
- Since the surgery does not make any changes to the intestines, the risk of long-term nutritional deficiencies is low.
- You can lose weight very successfully and thereby control diseases like diabetes and high blood pressure.
Risks and Complications
The risk of complications from this surgery is very low (less than 1%). However, it is important to be aware.
| Risk type | Description |
|---|---|
| Short-term risks associated with surgery |
|
| Long-term complications |
|
How much weight can I lose? Will I gain it back?
Typically, you can lose between 25% and 30% of your total body weight within the first year or two after surgery. For example, someone who weighs 120 kg can lose about 30-36 kg. This amount depends on the lifestyle you follow after surgery.
Some people may gain some weight back over time, either because they go back to their old eating habits or because their stomach stretches over time. If that happens, you may need to consider revision surgery. This can involve either a revision of the original surgery or a conversion to another weight loss surgery, such as gastric bypass.
Take-Home Message
- Gastric sleeve surgery is a very effective way to control severe obesity and its associated diseases. It is not a cosmetic procedure.
- This is a major, irreversible, lifelong change. So be well informed before making a decision.
- The success of the surgery is 100% up to you. You must commit to a lifelong diet, exercise, and healthy lifestyle after the surgery.
- This surgery not only helps with weight loss, but it also helps to cure a number of diseases such as diabetes, high blood pressure, and cholesterol.
- If you are considering this surgery, talk openly with a specialist surgeon or your family doctor about it to fully understand whether it is right for you and what the pros and cons are.
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