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Surgery usually takes one to two hours. After surgery, you awaken in a recovery room, where medical staff monitors you for any complications. After the procedure Avoid all fizzy drinks as these can cause discomfort, bloating and stretch your small stomach pouch You will now have completed 6 weeks of texture progression and your stomach should have healed enough for you to gradually introduce regular texture foods and begin to increase the variety of foods in your diet. Once you have completed the puree stage you can move onto soft foods. It is important to follow this stage as your stomach is still healing and recovering from surgery. What is soft food? Coblijn UK, Karres J, de Raaff CAL, et al. Predicting postoperative complications after bariatric surgery: the bariatric surgery index for complications, BASIC. Surg Endosc. 2017;31(11):4438-4445. doi:10.1007/s00464-017-5494-0
Choose foods that are high in protein to help you to meet your protein requirements (at least 70g protein each day). Aiming for at least 500ml (1 pint) of protein rich fluids daily will help you achieve this. How much and when? Another method for hemostasis involves the use of buttressing materials. Several buttressing products made from different materials have been introduced into the market, including bovine pericardium (Peri-Strips Dry with Veritas, Synovis, Deerfield, IL, USA), absorbable synthetic polymer membranes (SEAMGUARD ®, Gore ®, W. L. Gore & Associates, Inc., Newark, DE, USA, or Tri-Staple™ 2.0 Reinforced Reload, Medtronic, Minneapolis, MN, USA). Many previous studies have been conducted to elucidate the efficacy of these buttressing products in preventing bleeding from staple lines and leakage from staple line disruption. Although the results from these studies were not entirely consistent, using the buttressing product along the staple line during SG appeared to reduce the incidence of staple line bleeding; its efficacy on leakage has not been clearly demonstrated [ 4, 11, 15, 16]. However, these buttressing products are not commercially available in Korea yet. Halliday TA, Sundqvist J, Hultin M, Walldén J. Post-operative nausea and vomiting in bariatric surgery patients: an observational study. Acta Anaesthesiol Scand. 2017;61(5):471-479. doi:10.1111/aas.12884Sioka E, Zacharoulis D, Zachari E, et al. Complicated gallstones after laparoscopic sleeve gastrectomy. J Obes. 2014;468203. doi:10.1155/2014/468203 In stable patients, less-invasive non-surgical management should be attempted. This includes a wide range of endoscopic interventions, from endoscopic stenting and direct fistula closure, to internal drainage and radiologic interventions. Adequate drainage has been the most important treatment for early leaks, and abscesses can be drained percutaneously or endoscopically. The gastric wall defect needs to be repaired either by diverting the fistula or by direct closure. Endoscopic intervention depends on the size and characteristics of the defect [ 22]. Abdominal CT after contrast swallow in a patient with a sleeve leak. Disruption of the staple lines (a), extralumination of the contrast medium to the left subphrenic area (b, c), reactive pleural effusion (d). As with any major surgery, sleeve gastrectomy poses potential health risks, both in the short term and long term. During the first 6-9 months after your surgery, you will experience rapid weight loss and hair loss can occur. By following a healthy balanced diet with enough protein and taking your vitamin and mineral supplements, should result in your hair returning to normal. Constipation
Remember to space your vitamins and minerals across the day, as taking them all together will affect how well you absorb them. You will need to take your calcium supplement separately from your multivitamins and minerals and iron. In a sleeve gastrectomy, part of the stomach is separated and removed from the body. The remaining section of the stomach is formed into a tubelike structure. This smaller stomach cannot hold as much food. It also produces less of the appetite-regulating hormone ghrelin, which may lessen your desire to eat. However, sleeve gastrectomy does not affect the absorption of calories and nutrients in the intestines. Results You may experience changes as your body reacts to the rapid weight loss in the first three to six months after sleeve gastrectomy, including:Lim RB. Bariatric procedures for the management of severe obesity: Descriptions. https://www.uptodate.com/contents/search. Accessed June 8, 2020. Kraljević M, Cordasco V, Schneider R, et al. Long-term effects of laparoscopic sleeve gastrectomy: What are the results beyond 10 years? Obes Surg. 2021;31(8):3427-3433. doi:10.1007/s11695-021-05437-3 Levy JL, Levine MS, Rubesin SE, Williams NN, Dumon KR. Stenosis of gastric sleeve after laparoscopic sleeve gastrectomy: clinical, radiographic and endoscopic findings. Br J Radiol. 2018;91(1089):20170702. doi:10.1259/bjr.20170702 Tissue sealants have also been used to close the fistulas. Fibrin glue functions in two ways: mechanical occlusion of the defect and promotion of fibroblast proliferation. The glue can be delivered endoscopically or radiologically, and multiple sessions with intervals of several days are usually required to occlude the fistula completely. Assalia et al. [ 38] reported that percutaneous application of fibrin glue with fluoroscopic guidance under endoscopic visualization achieved successful fistula closure in 23 of 24 patients with sleeve leak patients with 2.2 sessions on average (range, 1–6). This suggests that plugging leaky sleeves with tissue sealant is a simple, tolerable, and effective method to treat sleeve leaks with fewer complications. Do not drink with meals. Drink 20 minutes before meals and then wait at least 20 minutes after a meal before you drink some fluids
Praveenraj P, Gomes RM, Kumar S, et al. Management of gastric leaks after laparoscopic sleeve gastrectomy for morbid obesity: A tertiary care experience and design of a management algorithm. J Minim Access Surg. 2016;12(4):342-9. doi:10.4103/0972-9941.181285 Ma IT, Madura JA. Gastrointestinal complications after bariatric surgery. Gastroenterol Hepatol (N Y). 2015;11(8):526-35. The incidence of cholelithiasis after sleeve gastrectomy and its association with weight loss: A two-centre retrospective cohort study. Int J Surg. 2016;30:13-18. doi:10.1016/j.ijsu.2016.03.060 Do not eat until you are ‘full’. Overeating will stretch your stomach pouch, cause discomfort and may cause vomiting Sleeve gastrectomy surgery can also improve your ability to perform routine daily activities, and can help improve your quality of life. When weight-loss surgery doesn't work
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Eat slowly: put a small amount of food in your mouth at a time (size of a thumbnail) and chew this very well (at least 20 times). Take 20-30 minutes to complete your meal Bariatric surgery. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/weight-management/bariatric-surgery. Accessed June 2, 2020.
If you experience constipation make sure you are drinking enough fluids. You should aim for 1.5-2 litres of fluids each day. During the early post-operative stages it can be difficult to get enough fibre as your focus is on protein. When you are in the puree stage, include some puree cereals and fruit and vegetables in your diet to help your bowels work more efficiently. If constipation persists then speak to your GP about a suitable laxative. Reactive Hypoglycaemia Soft foods are foods that have a soft consistency, are well cooked and can be easily mashed with a fork. You do not need to use a blender during the soft stage. Foods to avoid:Sleeve gastrectomy is done to help you lose excess weight and reduce your risk of potentially life-threatening weight-related health problems, including:
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