(vertical sleeve gastrectomy, sleeve gastrectomy in Poland, bariatric treatment abroad)

1. General Treatment Information

a) Expected results, benefits

What are the advantages of sleeve gastrectomy?

Sleeve gastrectomy is a safe procedure that causes spectacular effects – significant body weight reduction, which in combination with proper diet and physical exercises helps in quick and efficient weight loss. Clinical research had proven that this procedure has a great positive impact in control of other diseases such as diabetes, high blood pressure, cholesterol or sleep apnea syndrome. It minimises the risk of occurrence of gastric ulcers. During the surgery, a specific part of stomach producing ghrelin (appetite stimulating hormone) is removed, which makes the surgery outcome even more successful.

b) About the procedure

Sleeve gastrectomy is the easiest and in most cases effective modern surgical technique of obesity treatment. By removing about 80% of your stomach, it makes it smaller and helps to lose weight. You will feel full much quicker than before, which means permanent changes in your eating habits, eating smaller portions and different foods. The surgery is carried out under general anaesthesia. It can be done as an open procedure, by making a large incision in the abdomen, or by the laparoscopic approach, where small cuts are done for entering camera and tools. A thin vertical sleeve in banana shape and size is left after the procedure. By surgical staples your new stomach is closed. This procedure is not reversible.

c) Treatment Schedule

The procedure of sleeve gastrectomy is provided under adhibiting general anaesthetization and lasts for about 90 minutes. The surgeon makes an incision in the abdomen and resects a greater part of your stomach. After the surgery, Patient is given painkillers medicines. For the correct recovery, Patient should start to sit during the same day. In the first 24 hours an X-Ray image of the upper gastrointestinal tract is performed to assess the treatment effect. After the surgery, your eating habits need to be diametrically changed. During first two weeks, you should use a liquid diet.

d) Potential side effects

What are the risks of sleeve gastrectomy?

The sleeve gastrectomy surgery is considered as safe and effective, but as with all types of surgical intervention, it carries the risk of complications and possible side effects. Sometimes the reduced stomach got extended, which requires a second operation. The procedure is irreversible, does not limit absorption, which can slow down the weight loss and requires a more rigorous diet than gastric bypass. Following complications may also rarely occur: infections of surgical wounds, bleeding from the stomach part, leaking from the stomach, damage to the spleen, pneumonia, renal disease, deficiency in vitamins and nutrients, postoperative depression.

e) Full Recovery Time

In the first term after surgery, you may need pain medicine – you will feel discomfort in your stomach, and incisions probably will be sore and tender. Because of the dumping syndrome – food emptying into the small intestine too quickly – you may have diarrhoea and feel nauseated. You will need to be careful with physical exercises during your recovery time. Usually, the surgery is done as the laparoscopic procedure, which makes a recovery faster, but after open surgery, it is important to avoid heavy lifting or exercises. Some people are ready to get back to work after the first week, but in most cases, you will be able to get back to your daily routines in 4-6 weeks. Your doctor will probably approve solid foods after 2 months. After 6 months you can add strenuous exercises and heavy lifting to your daily practice.

2. Patient’s preparation
The most important step in your lose weight surgery preparation is changing your habits, about how to eat, exercise and about youth lifestyle. Patients who started to lose weight before the surgery are more likely to lose more after, and to experience fewer complications during the procedure. After making a decision about undergoing the sleeve gastrectomy, you should try to begin eating for your health, and not for pleasure. You should get used to smaller portions, and prepare your body for less food – that is why you should plan them carefully, to supply your body with necessary minerals and vitamins. Make sure your daily diet contains lots of proteins. Eat slower, watch the portion sizes, and chew bites carefully. Reduce the amount of coffee, stop smoking and drinking alcohol. Remember how physical activity is important, try to exercise more. Two weeks before surgery you should eat like you have already had the procedure done. The day before, you will be probably asked not to drink or eat anything.
3. Diagnostics

To diagnose if the Patient can be qualified to a sleeve gastrectomy following tests should be done:

  • Blood group and RH factor
  • Complete blood count
  • Biochemical tests (sodium, potassium, glucose, creatinine, coagulation APTT, INR, total cholesterol, HDL, LDL, triglycerides, calcium, iron, AST, ALT, total bilirubin, TSH, fT4, HBsAg, HCV)
  • Urinalysis
  • Measurement of height and weight – BMI rating (you should have BMI index above 40, but if you are diagnosed with another serious health condition like high blood pressure or diabetes BMI 35 will be enough). Adults with diabetes type 2 can be considered with bariatric surgery with BMI over 30.
  • EKG, Spirometry, Panendoscopy, UKG, abdominal ultrasound.

Also, consultations with specialists should be done:

  • Internal medicine doctor
  • Psychologist (psychiatrist)
  • Laryngologist
  • Endocrinologist
  • Dentist
4. Qualification for the procedure

If the patient is unlikely to lose weight despite a long time of implementation other methods like diet, exercises, pharmacological treatment, and still with BMI index strongly exceeded (35-50), he/she may be a good candidate for the bariatric surgery. Before giving consent to this procedure, Patient should be well informed about how life may change after the operation – limited food choices, side effects, lifelong healthy lifestyle and physical activity, intake of vitamins, minerals. Before the operation, the Doctors consilium consults the surgery Patient, to make a final decision about sleeve gastrectomy procedure qualification. Diabetes type 2 may be a disqualifying feature from the surgery.