SLEEVE GASTRECTOMY is the most practiced intervention in France in recent years.
Intermediate technical difficulty between gastric band and bypass, we can say that the sleeve has only one disadvantage: the risk of fistula at the level of the stomach operated. The intervention consists in removing 3/4 of the stomach, a tube through the mouth during the intervention in the stomach is used to calibrate the size of the new stomach. We cut it along the probe and at the same time the automatic clip sutures the section of the stomach. It thus poses a triple row of staples, but despite there is still a small risk of bad, or lack of healing on the instalment of the section. There may thus appear a fistula with leakage of gastric contents in the ‘belly’, dreaded complication resulting re-intervention, drainage, put in place of prosthesis (see: Sleeve – Fistula – Complications).
- No complications after leaving the clinic, monitoring will be less systematic.
- Very important improval of diabetes, hypertension, sleep apnea.
- No vitamins deficiency.
- The decrease in volume of the stomach will reduce the secretion of a hormone called ghrelin materializing the feeling of hunger.
INDICATION: BMI ≥ 40 or BMI ≥ 35 associated at comorbid conditions likely to be improved after surgery (including cardiovascular disease, sleep apnea, severe respiratory disorders, severe metabolic disorders, especially type 2 diabetes, osteo-articular diseases).
- In second intention after failure of medical treatment, nutritional, dietary and psycho-therapeutic, well conducted during 6 to 12 months.
- In absence of sufficient weight loss or in absence of weight loss maintenance, diets supervised by a specialist (nutritionist, dietician, endocrinologist…), with written proof (prescriptions etc…) very important for your medical insurance company !
- Patient well informed in advance.
- Assessment and multidisciplinary preoperative support for several months.
- Procedure and need understood and accepted by the patient for life during medical and surgical follow-up.
- Acceptable operative risk.
Let’s emphasize once again that, whatever the chosen intervention, a life long change of eating habits and lifestyle is essential. Bariatric surgery is not a cosmetic surgery. Long term follow-up is necessary.
See : Preoperative Checkup
It is mandatory to have regular follow-up after surgery: a consultation with a nutritionist every three months, and at least every six months. Then, consultations can be done with annual frequency.
This site is exclusively devoted to obesity surgery. Dr. Jean-Pierre Anfroy is the author, he receives no support for its financing and refuses any form of advertising. Last update: 23/04/17