Sleeve Gastrectomy

The process

2 weeks prior to your surgery you will need to be on a low calorie diet to shrink the size of your liver. This makes the surgery safer. Come in on day of surgery – the hospital will tell you the time and when to fast from a few days before the operation.

You will usually see the anesthetist on the day of surgery.

Surgery takes 1-2 hours then recovery ward for usually less than an hour before return to ward. Oral clear fluids as tolerated when awake.

Sounds easy?

Unfortunately, for the sleeve gastrectomy to work as a weight loss operation, the sleeve needs to be made tight and immediately after the surgery normal healing causes swelling that makes the sleeve temporarily tighter again. This is at its worst in the first few days and then improves over the next few weeks and months.

In the first few days water will only just go down slowly. Pain and nausea need to be managed. Regretting having the operation in the first day or two is common but passes as the pain and nausea usually settle quickly and your swallowing slowly and steadily improves and then comes the weight loss.

The first week or so is a liquid diet. Low calorie electrolyte drinks and protein supplements are useful. Water with low calorie flavoring is your friend.

Home in 2-4 days usually.

Post op visit with surgeon  ideally 10 to 14 days after surgery. Around 3-4 visits after this over next 3 months, then 6 and 12 months. Will be more frequent if required and phone consultations are available as well.

Soft high protein diet after 10 days, then solid foods approaching a month. Volume at this time will be low- ¼ cup over 20-30min. An acid lowering medication will be required for at least the first 6 weeks. Multivitamin daily for life. Periodic blood tests for iron, B12 and other micronutrients.

Surgical technique

All surgeons should believe that their technique is the best!

We have a fully trained, bariatric experienced surgeon as an assistant.

Lack of conclusive proof that a variation of the operation has no benefit doesn’t mean that one does in fact exist.

Surgery is performed with key hole surgery. 5 cuts from 5 to 15mm in size. Bladeless 15 mm trochar to minimize risk of hernia formation.

The operation in total takes around 1-2 hours.

A 36 french Gastrisail bougie is inserted (available Australia since 2016) to enable precise calibration of your sleeve. After mobilisation of your stomach the opening in your diaphragm to allow your oesophagus through may be tightened to minimize the risk of reflux. Covidien tristaples with buttressing are used to seal off the sleeve from the 90% or so of residual stomach that is removed. Buttressing of the staple line probably reduces the risk of bleeding and may reduce the risk of leak.

All of staple line imbricated with V-Lock suture to increase burst strength of staple line and probably lower leak rate.

Sleeve not too narrow at incisura of stomach, upper sleeve sewn to retroperitoneum to minimize risk of kink or stricture of sleeve.

Sleeve made tight for greater weight loss in short and probably long term.