Gastric Sleeve Surgery

What is Gastric Sleeve Surgery?

Gastric sleeve surgery is a surgical procedure that aims to reduce the food intake of obese patients and remove the fundus part of the stomach, known as the hunger center. Today, gastric sleeve surgery is the most commonly used surgical method in obesity worldwide. It has been used for a long time and complication numbers decreased at the present.  It is suitable for offering patients as a first choice. 

In this surgery form of the stomach is converted from  a rugby ball to a banana, by this way the amount of food that the patient can consume in one meal is reduced. They feel less hunger as a result of the decrease in the hunger hormone. In addition, as a result of intervention in hormone balances, comorbid diseases can be healed.

Gastric sleeve surgery in a glance

How is gastric sleeve surgery performed?

Gastric sleeve surgery starts after the patient is taken under general anesthesia. After the patient is placed in the necessary position, the surgeon takes his place and begins to create the holes. After the first hole is completed, the inside of the abdomen is filled with CO2 gas and inflated. The stomach is separated from its attachment in its long arch with long and thin tools. Since the stomach is an organ with a large amount of blood supply, bleeding can be seen at this stage. These bleedings are usually easily detected and stopped during surgery. A very important point is the section where the stomach joins the esophagus and what we call the “His angle”. 

The His angle is the area that should be protected especially so that gastric fluid does not escape into the esophagus. In almost all patients, this part is covered by a fat pad. Proper removal of this fat layer is important for identification of the His angle.

gastric sleeve performing sleeve and stitch

Improper dissection of this area may cause the surgeon to leave the upper part of the stomach wide. In a more undesirable situation, if the cut is made in a way that distorts this angle,  stenosis or reflux complaints can occur . After this area is dissected properly, the stage of cutting the stomach in the form of a tube begins.

The cutting and stitching phase!!

At this stage, surgeons get help from a bougie. A bougie is sent from the mouth to the stomach of the patient. The surgeon starts the cutting process by taking this tube as a guide in this stage. In the stomach cutting stage, stapling and cutting tools called staplers are used. 

These materials differ in quality and size and are used according to the surgeon’s choice. We use the highest quality staplers in our operations. After the stomach cutting is completed, the stomach remains as a banana-shaped tube and as a result, a volume of about 20% of the stomach is left in the patient. The rest of the stomach is taken out of the abdomen through the widest hole. The approach after this stage also varies among surgeons. Some surgeons only apply clips. 

We apply staple line suturing in all our operations, since it minimizes the possibility of both leakage and bleeding. As a result, we do not use drains and catheters. After the final check, the holes are controled for bleeding. Holes larger than 10mm are closed. And the operation is finished by removing the gas in the abdomen and skin stitches.

Frequently asked questions

This issue is still controversial, preoperative endoscopy may reveal reflux disease which can alter the operation time. Therefore we recommend performing endoscopy before surgery.

We want patients to drink fluids alone for 1 week. At this stage, patients usually have an expectaiton that they will feel hunger. Since the stomach volume remains very small, patients reach the feeling of satiety with small amounts of flui. Even in later stages, we strongly recommend that patients do not take fluid with meals because they may not get the nutrients they need by reaching a feeling of satiety with only fluid. After one week, we allow patients to switch to mashed foods, then soft foods, and then gradually to normal foods.

Since absorbable stitches are applied, your stitches will be absorbed over time.

Our patients start taking a bath the day after surgery.

In the earlier period gastric sleeve surgeries performed in open method due to insufficient technology and experience. In the last 15 years, with the transition to closed method, changes such as a serious decrease in complications, increased patient comfort, and reduced hospital stay have increased significantly.