Sleeve gastrectomy is a surgical procedure in which the stomach is reshaped into a narrow tube-like structure. This operation is not only performed to reduce stomach volume, but also to help influence the hunger hormone produced in the stomach. As a result, the desire to eat may decrease and a hormonal effect that supports weight loss may be achieved.

Sleeve gastrectomy is primarily known as a surgical treatment option for morbid obesity. It may also provide successful results in patients with type 2 diabetes associated with obesity. In patients with severe obesity, sleeve gastrectomy can sometimes be considered as a staged surgical approach. The medical name of this procedure is Sleeve Gastrectomy.

In this operation, the stomach volume is reduced, helping the patient consume smaller portions. Approximately 70% to 80% of the stomach is surgically removed, leaving the stomach in a narrower form. After the procedure, calorie intake decreases as the stomach capacity becomes smaller. Patients usually feel full more quickly, which may support faster weight loss. Since the part of the stomach responsible for producing the hunger hormone is also removed during the operation, the feeling of appetite may decrease significantly.

Who Is Suitable For Sleeve Gastrectomy?

To determine whether a patient is suitable for sleeve gastrectomy, the body mass index, also known as BMI, is evaluated. BMI is calculated by dividing a person’s weight by the square of their height. It is also used to determine the degree of obesity.

The general BMI classification is as follows:

• BMI 30 – 34.9: Class 1 obesity
• BMI 35 – 39.9: Class 2 obesity
• BMI 40 and above: Morbid obesity

Patients diagnosed with morbid obesity may be suitable candidates for sleeve gastrectomy. For other BMI values, a doctor’s evaluation and approval are required.

In patients with a BMI between 35 and 40, some obesity-related diseases may also be present. If these conditions exist, sleeve gastrectomy may be considered. These diseases include:

• High cholesterol
• Hypertension
• Type 2 diabetes
• Sleep apnea
• Knee and joint problems
• Cardiovascular diseases
• Fatty liver disease

This operation may also be performed on individuals who cannot lose weight through diet and exercise. Patients who have tried long-term medication, exercise programs, and medically supervised weight loss methods but have not achieved successful results may be considered for surgical treatment.

Who Is Not Suitable For Sleeve Gastrectomy?

Sleeve gastrectomy is an effective surgical method, but it is not suitable for every patient. This process requires not only physical readiness but also psychological compliance. Patients with severe depression, uncontrolled anxiety disorder, eating disorders, or untreated psychological conditions may not be suitable candidates for this operation.

It may also be risky for individuals with alcohol or substance addiction. This is because the recovery process after surgery may be negatively affected, and adapting to the required nutrition plan may become difficult. In addition, the risk of liver damage may increase. Therefore, sleeve gastrectomy is generally not considered appropriate before addiction treatment is completed.

Some advanced health conditions may also significantly increase surgical risk. Sleeve gastrectomy is generally not performed in patients with advanced heart disease, severe organ failure, or uncontrolled respiratory disease. It may also be highly risky for patients with COPD or advanced heart failure.

Sleeve gastrectomy is not recommended during pregnancy, as the health of both the mother and baby must be prioritized. Surgical procedures may carry serious risks for expectant mothers and can be planned after childbirth if appropriate.

This operation is also not suitable for patients who are unlikely to follow post-operative rules. Sleeve gastrectomy is not only a surgical procedure; it also requires major lifestyle changes. Inability to follow healthy eating rules, unwillingness to exercise, or failure to attend regular doctor check-ups may prevent a patient from being considered suitable for surgery.

What Should Be Known Before Sleeve Gastrectomy?

Before sleeve gastrectomy, patients undergo a detailed medical evaluation. The required tests may include:

• Abdominal ultrasound
• Hormone tests
• Chest X-ray
• ECG
• Cardiology examination
• Blood tests

In addition to these tests, endoscopy may be performed for a detailed evaluation of the stomach. Endoscopy helps determine whether conditions such as gastritis, ulcers, or other stomach diseases are present.

Before the operation, patients may also be advised to follow a short-term diet. The aim is to reduce the size of the liver to some extent. In patients with obesity, the liver may be enlarged and fatty. Short-term dietary preparation is important to make the surgery safer and easier for the surgeon.

Smoking and alcohol consumption should be completely stopped before the procedure. These habits may cause lung complications, slow wound healing, and increase the risk of infection. Smoking should especially be stopped at least 2 to 4 weeks before surgery.

Since sleeve gastrectomy requires a serious lifestyle transformation, psychological preparation is also important. After the operation, eating habits change and portion sizes become smaller. Some foods may also not be well tolerated by the stomach. Therefore, after psychological evaluation, the patient’s ability to adapt to the process is assessed.

Patients should be fully prepared for the post-operative period. It should be remembered that regular exercise habits must be developed and nutritional rules must be followed. In addition, supplements such as iron, vitamin D, calcium, and vitamin B12 may be required after surgery to prevent mineral and vitamin deficiencies. These supplements should only be taken in the dosage recommended by the doctor.

After sleeve gastrectomy, maintaining a healthy and balanced diet, exercising regularly, drinking enough water, and avoiding sugary foods are essential.

How Is Sleeve Gastrectomy Performed?

Sleeve gastrectomy is performed under general anesthesia in a hospital setting. During the operation, the patient is fully asleep and does not feel pain.

Small incisions of up to approximately 1 cm are made in the abdominal area. Through these incisions, a laparoscope and surgical instruments are inserted into the abdomen. With the help of these instruments, the specialist surgeon views the abdominal area and begins the operation.

During the procedure, the surgeon removes a large part of the stomach. A surgical stapling device is used during this process. With this device, the part of the stomach where the hunger hormone is produced is also removed.

After the area associated with ghrelin production is removed, the patient’s feeling of hunger may decrease significantly. The remaining part of the stomach is left as a long and narrow tube. The removed part of the stomach is taken out through the abdomen. After this, the stomach line is checked carefully.

Special methods are used to test the stomach line and determine whether there is any leakage. At the end of the procedure, the surgical instruments are removed from the abdomen and the incisions are closed properly.

Recovery Process After Sleeve Gastrectomy

After the operation, the patient is awakened and kept under observation for a while. A few hours later, the patient’s pulse and blood pressure are checked. Pain control is performed, and the surgical team checks whether there is any bleeding.

Short walks are usually recommended the day after surgery. This helps reduce the risk of blood clot formation. During the first week, recovery usually progresses quickly, although mild abdominal pain may be felt. Fatigue and sensitivity around the incision areas may also occur.

How Should Nutrition Be After Sleeve Gastrectomy?

Nutrition is one of the most important parts of the post-operative process. The main points to consider are:

• Carbonated drinks are completely prohibited
• A liquid diet is essential during the first 14 days after surgery
• Solid and liquid foods should not be consumed at the same time
• Nuts, fruits, vegetables, and salads should be included regularly in the nutrition plan according to the dietitian’s guidance
• Professional support from a specialist dietitian should be received during this process

How Long Does Sleeve Gastrectomy Take?

Sleeve gastrectomy is usually performed under general anesthesia. The duration of the operation may vary depending on the patient’s condition and the details of the surgical process. In most patients, the surgery can be completed within approximately 1 to 2 hours.

However, this duration refers only to the surgical procedure itself. Pre-operative preparation, anesthesia, and post-operative observation are also part of the overall hospital process. Therefore, the patient’s surgery day and follow-up period should be planned by a specialist medical team.

Frequently Asked Questions

Is Sleeve Gastrectomy Permanent?

In sleeve gastrectomy, a large part of the stomach is surgically removed. Therefore, the procedure is anatomically permanent. However, the long-term success of weight loss depends on the patient’s eating habits and lifestyle.

Is Sleeve Gastrectomy Painful?

Since the operation is performed under general anesthesia, the patient does not feel pain during the procedure. Mild pain and sensitivity may occur after surgery. This process is managed with pain control recommended by the doctor.

When Can Patients Return To Normal Life After Sleeve Gastrectomy?

Although this may vary depending on the patient’s general health condition, many patients can return to daily life within a short period. However, medical approval should be obtained before starting heavy exercise or intense physical activities.

Does Sleeve Gastrectomy Leave Scars?

The operation is usually performed laparoscopically through small incisions. Therefore, the scars may be smaller compared to open surgery. Their visibility may decrease over time.

Is Sleeve Gastrectomy Suitable For Every Patient With Obesity?

No. Sleeve gastrectomy is not suitable for every patient. Body mass index, obesity-related diseases, psychological condition, eating habits, and the patient’s ability to adapt to the post-operative process should all be evaluated.