What’s it like: To get a sleeve gastrectomy

Dec. 08--Why get the surgery?

A sleeve gastrectomy is one option that people take when looking for a type of weight-loss surgery.

Generally, the surgery is performed for people who have a body mass index higher than 40, which translates to a person who is about 100 pounds overweight, or for people who have a BMI of 35 or higher and a medical condition associated with obesity, such as diabetes, hypertension, heart disease or sleep apnea.

These guidelines are similar to the criteria that Medicare and some insurance companies have in place to determine whether they will cover a person's surgery.

A surgeon might also perform a sleeve gastrectomy on someone who suffers from gastroparesis, a disorder also referred to as "delayed gastric emptying" that slows or stops food moving from a person's stomach to the small intestine.

What happens?

During a sleeve gastrectomy, your doctor will remove about 80 percent of your stomach, leaving your stomach similar to the size and shape of a banana.

About two weeks before surgery, your doctor will sometimes place you on a low-calorie diet. This can help decrease the size of your liver and decrease the amount of belly fat you have, which would make the operation easier.

The day of surgery, you will be placed under general anesthesia, meaning you'll be asleep.

Most surgeons perform the surgery using a small camera called a laparoscope. Your surgeon will make a few small cuts on your stomach and place the camera and other operating tools inside of you.

Your surgeon might use a medical stapling tool to staple off the section of your stomach that's being removed and the section of your stomach that's staying.

After your stomach is stapled off, the medical team might test it for leaks. To do this, they might put your stomach in saline and then pump gas into your stomach through your mouth. If everything looks OK, they will then remove about 80 percent of your stomach.

Does it hurt?

When you wake up, you might be nauseous. You might start a liquid diet that day.

You will likely be sore where the cuts are on your abdomen, especially near the cut where the stomach was removed.

Also, your shoulder might hurt because of the gas used to inflate your abdomen. It's referred pain -- the gas irritates your diaphragm, which has nerves in the spinal cord near the shoulder nerves. This sometimes causes your shoulder to hurt because of the pressure of the gas. It should clear up in 24 hours to 48 hours.

And following the surgery, you won't need to eat as much as you did before your stomach was reduced. If you eat too much, you might get sick and vomit.

What are the risk factors?

As with most surgeries, there's a risk of bleeding, infection, blood clots or a heart attack or stroke during surgery.

Specifically with a sleeve gastrectomy, there's a risk of your stomach leaking, which happens in an estimated 1 to 3 percent of patients. Also, your stomach could become inflamed or develop ulcers.

The risks associated with sleeve gastrectomy increase in people the older they are and the more obese they are. It's important to talk with your doctor about any questions or concerns you might have.

What's the recovery time?

You will likely be on a liquid or puree diet for about two weeks. After that, you might be on a soft diet, eating foods such as lunch meats, cooked vegetables and soft fruits.

You will be off work about two weeks. If you do light desk work, you might be able to return sooner.

What's the follow-up?

The weeks after surgery, you could lose weight quickly. However, the amount of success you see with the surgery depends on your personal actions.

There are three main components that better ensure this surgery will yield successful results: exercise, the amount you eat and the types of food you eat. You will not need to eat as much food as before the surgery and likely will relearn what it means to be full.

After surgery, you will have periodic visits with your doctor. These can be important because you will likely be coming off different types of medications you've been taking. For example, sometimes people with sleeve gastrectomy have drops in blood pressure and no longer need to take blood pressure medicine. People who have diabetes also might be able to take fewer medications than before surgery.

It's important to listen to your health care provider and ask any question you have. You are your own health advocate.

Sources: Dr. Andrew Wheeler, a general surgeon at Norman Regional Health System; National Institutes of Health; Society of American Gastrointestinal and Endoscopic Surgeons; the Mayo Clinic.

___

(c)2013 The Oklahoman

Visit The Oklahoman at www.newsok.com

Distributed by MCT Information Services