LAPAROSCOPIC SLEEVE GASTRECTOMY (LSG)
Sleeve gastrectomy is a restrictive procedure. It greatly reduces the size of your stomach and limits the amount of food that can be eaten at one time. It does not cause decreased absorption of nutrients or bypass your intestines. After eating a small amount of food, you will feel full very quickly and continue to feel full for several hours.
Weight-loss surgery is suitable for people who are severely overweight and who have not been able to lose weight with diet, exercise, or medicine.
Patients must undergo a preoperative diet to reduce body fat in the liver (size of the liver). There is direct correlation between obesity and the condition called fatty liver. This fatty liver enlarges it and makes it heavier; diet helps shrink your liver prior to surgery by depleting stored glycogen.
In the first 1 year after LSG, most people will lose between 40% and 70% of their excess body weight.
LSG surgery is done under general anesthesia. The Surgeon will make about 4-5 small cuts (0.5-1cm) in your belly. He will do the surgery using a thin, long, telescope with a tiny camera at the end. Instruments will be introduced through the incisions will be used to remove about 75% of your stomach. The procedure will be done using images on a TV screen in the operating room. This surgery takes out the part of your stomach that curves outward, called the fundus. After the fundus is taken out, the Surgeon will close the rest of your stomach into a tube shape (using a standard caliber) that looks like a banana or the sleeve of your shirt, hence the name “sleeve gastrectomy.” Because you will have a much smaller stomach, you will fill up quickly at mealtimes and eat less. The fundus contains most of the area of your stomach that secretes a hormone called ghrelin. Because ghrelin may be partly responsible for making you feel hungry, taking out this part of your stomach may also help you lose weight afterward by decreasing your hunger.
LSG surgery takes about 1 hour. Most people stay in the hospital for about 1-2 days after surgery.
Immediately after the surgery, once your surgeon has advised that you may start orally, you will first be given sips of water. Once you tolerate it well, you will progress to clear liquids. For about the first month after surgery, your stomach can only handle small amounts of soft foods and liquids while you are healing. It is important to try to sip water throughout the day to avoid becoming dehydrated. You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements (if needed ask for medication).
Bit by bit, you will be able to add solid foods back into your diet. You must be careful to chew food well and to stop eating when you feel full. This can take some getting used to, because you will feel full after eating much less food than you are used to eating. If you do not chew your food well or do not stop eating soon enough, you may feel discomfort or nausea and may sometimes vomit. If you drink a lot of high-calorie liquid such as soda or fruit juice, you may not lose weight. If you continually overeat, the stomach may stretch. If your stomach stretches, you will not benefit from your surgery.
The doctor will probably recommend that you work with a dietitian to plan healthy meals that give you enough protein, vitamins, and minerals while you are losing weight. Even with a healthy diet, you will need to take vitamin and mineral supplements for the rest of your life.
After the surgery you will need to follow a special diet for about 4-6 weeks before you return to a normal textured diet.
Stages of Post-Operative Gastric Sleeve Diet:
- Phase 1 (first week) – Clear Liquid Diet
- Phase 2 (second week) – Full Liquids Diet
- Phase 3 (third week) – Soft Foods Diet
- Phase 4 (fourth week onwards) – Regular Foods Diet
Things to do After Surgery:
- Daily Vitamins and Protein
- Exercise
- Regular follow ups