Cairo Plastic Clinic 

Bariatric surgery (Sleeve gastrectomy)

Bariatric surgery, or weight loss surgery, is a type of procedure performed on people who have morbid obesity, for the purpose of losing weight.

This weight loss is usually achieved by through removal of a portion of the stomach (sleeve gastrectomy )

Dr Wilson recommends Bariatric surgery  for obese people with a body mass index (BMI) of at least 40, or with BMI 35 and serious coexisting medical conditions such as diabetes mellitus, high blood pressure, high blood lipids, and sleeping disorders. Furthermore, in patients with a BMI of 40 or greater, there is a 5-fold risk of depression.

Long-term studies show the procedures cause significant long-term loss of weight, recovery from diabetes, improvement in cardiovascular risk factors, and a reduction in mortality of 40% to 23%.

How is Sleeve Gastrectomy Performed?

 

In sleeve gastrectomy the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach, following the major curve. The open edges are then attached together to form a sleeve or tube with a banana shape. The procedure permanently reduces the size of the stomach. The procedure is performed laparoscopically and is not reversible. The ideal approximate remaining size of the stomach after the procedure is about 150 mL.

After the surgery,a dye is injected into the stomach and an X-Ray is taken to confirm the size of the gastric remnant, and that there is adequate emptying of the stomach wthout any leaks.

Advantages of Sleeve Gastrectomy

Sleeve gastrectomy reduces the stomach volume,  but the remaining part tends to function normally so most food items can be consumed in small amounts.  More important is that it removes the portion of the stomach that produces the hormones that stimulates hunger so the patient loses the craving for food. In addition, it is a procedure with far less risks than the intestinal bypass and is very effective in making patients lose weight. Most patients can expect to lose 30 to 50% of their excess body weight over a 6 - 12 month period. Then they will be candidates for body lifting.

Diet After the Surgery

Immediately after surgery, the patient is restricted to a clear liquid diet,
 Then the patient is put on a blended or pureed sugar-free diet for at least two weeks. Afterwards, the patient is unable to overeat because exceeding the capacity of the stomach causes nausea and vomiting.
A daily multivitamin pill for life is recommended to compensate for reduced absorption of essential nutrients, as well as a diet that is relatively high in protein and low in fats.

Complications

Sleeve gastrectomy may cause complications; such as sleeve leaking, aversion to food and nausea, delay in moving food from the stomach to the small intestine, vomiting, and esophageal spasm / pain. Most of these complications are manageable, but some are permanent.

Sleeve Gastrectomy and abdominoplasty in a 59-year old patient. Note restored abdominal contour.

Sleeve Gastrectomy and abdominoplasty in a 64 -year old female. Note restored abdominal contour.