Sleeve Gastrectomy

Sleeve gastrectomy is the most preferred surgical method in the treatment of obesity; it is a stomach reduction procedure. According to the World Health Organization (WHO), obesity is one of the conditions in the highest-risk disease group. It is a complex but preventable disease. Sleeve gastrectomy, one of the surgical treatments, is a restrictive operation that limits food intake without causing malabsorption.

About 80% of the stomach is removed, with the aim of reducing food consumption and thereby achieving weight loss. In sleeve gastrectomy, the stomach is reduced in size and shaped into a long, thin tube (sleeve), which is why the procedure is called a tube or sleeve operation. Whether patients are suitable for sleeve gastrectomy is determined by taking into account factors such as their body mass index and health status. It is an option for those who want to get rid of excess weight and start a new life.

Who Is a Suitable Candidate for Sleeve Gastrectomy?

People with a body mass index above 40 kg/m² (severely obese), or people with a body mass index between 35 and 40 who have an obesity-related chronic disease, are suitable candidates for sleeve gastrectomy. People who meet these criteria and have been unable to lose weight with methods such as diet and exercise can undergo sleeve gastrectomy.

How Is Sleeve Gastrectomy Performed?

Preoperative Evaluation

Detailed tests are performed before surgery to find out whether there is any health problem that would prevent the operation. The operation cannot be performed in people who have a condition that rules out anesthesia. Before surgery, the patient's weight and height are measured and their body mass index is recorded. These values are important for determining suitability for surgery and for monitoring the postoperative period.

If the patient believes they will be able to eat as much as before, or even more, after surgery and does not want to make any lifestyle changes, surgery should not be chosen; it is also helpful to set realistic expectations. For this reason, the patient's expectations from this treatment should be carefully evaluated during the preoperative consultation with the physician.

Sleeve gastrectomy is a surgical procedure performed under general anesthesia. Although the duration of surgery varies depending on many factors, it can take approximately 30 minutes to an hour and a half. The stomach is reached using a closed (laparoscopic) method through a few small openings around it. The stomach is cut and about 80% of it is removed. During this procedure, the entrance and exit of the stomach are preserved, so that the digestive system continues to function in the same way.

After Sleeve Gastrectomy

Recovery Period

• A hospital stay of about 3–4 days may be required after sleeve gastrectomy. Depending on the patient's condition, this period may be shorter.
• Because the operation is performed using a closed method, the incision sites and stitches are very small. Therefore, recovery is completed within one or two weeks.
• Until the stitches heal, you should avoid lifting heavy objects, bending over or reaching upward.
• Light walking can be started 10 days after surgery. At the end of the first month, weight training can gradually be started.

Nutrition Period

• For the first 2 weeks, no solid food should be eaten; only liquid foods should be consumed.
• In weeks 3 and 4, you move to a soft, moist diet. Soft foods and puréed foods can be eaten.
• After week 5, you can return to normal eating. However, it is recommended that you take care to eat healthy foods and avoid carbonated drinks.

Weight-Loss Period

• First Month

12–15 kilograms are lost. Depending on diet and exercise, more weight loss is possible. In the first month, the reduced size of the stomach also decreases appetite, which can help with following the nutrition program given by the dietitian. Still, giving up old eating habits can be challenging for many patients. This varies from person to person.

• First 3 Months

The total weight lost in the first 3 months is about 30% of the excess weight. During the first 3 months, it is important to stick to the healthy eating program prepared by the dietitian. If healthy eating and regular exercise habits are established in the first months, it will be easy to maintain these habits in the months that follow.

• First 6 Months

50% of the excess weight is lost. Patients who complete 6 months become able to do many things in their daily lives that they could not do before. The improvement in patients' quality of life increases their motivation and becomes a driving force to continue healthy eating and exercise.

• After 12 Months

Sleeve gastrectomy patients who complete the 12-month period can lose 60% of their excess weight. Of course, the patient's determination can make a difference in the weight-loss process.

• After 18 Months

By the end of the 18th month after sleeve gastrectomy, the rate of excess weight lost can reach around 80%. Depending on factors such as the patient's lifestyle and eating habits, weight loss may continue.