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Gastric Sleeve Surgery

Millions of people in the United States struggle with their weight. In fact, severe obesity is the second-leading cause of preventable death in this country. Also known as weight loss surgery, bariatric surgery is a life-altering and potentially life-saving solution for many severely obese people.

One increasingly popular type of bariatric surgery is gastric sleeve surgery. AnMed Health’s gastric sleeve surgeons in Anderson can help you achieve your weight loss goals with gastric sleeve surgery. The AnMed Health team provides the best in patient care for patients undergoing gastric sleeve surgery.

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What is gastric sleeve surgery?

Gastric sleeve surgery is a restrictive stapling procedure in which a large portion of the stomach is removed. The remaining portion of the stomach is then reshaped into a narrow and tubular pouch. Ultimately, gastric sleeve surgery supports weight loss in three distinct ways:

  1. It reduces the volume the stomach can hold thereby leading patients to feel fuller sooner
  2. It causes hormonal changes that reduce feelings of hunger
  3. It allows food to pass more quickly through the stomach and intestine

This bariatric technique is linked with many benefits, including excess weight loss of between 60 and 70 percent in the year after the procedure; improvement of health conditions related to obesity, such as diabetes, sleep apnea, hypertension, joint pain, hyperlipidemia and liver disease; reduced hunger sensation and desire to eat; and overall improved quality of life.

While gastric sleeve surgery is the newest of approved bariatric surgeries, it is often preferred over other options for several reasons. It is generally a faster procedure than others like gastric bypass surgery. It also avoids other issues associated with other bariatric surgeries, such as dumping syndrome with gastric bypass and the need for band adjustments with Lap Band surgery.

For these and other reasons, gastric sleeve surgery is the most common type of bariatric procedure both in the US and throughout the world. It accounts for more than half of all bariatric surgeries performed in this country with the number of gastric sleeve surgeries increasing annually. 

Not everyone is a candidate for gastric sleeve surgery

Gastric sleeve surgery is usually indicated for adults between the ages of 18 and 65 who are morbidly obese. This means they have a body mass index (BMI) of 40 or higher.

Typically, bariatric surgery may be recommended for patients who meet the following criterion:

  • A BMI of 40 or greater or who are at least 100 pounds overweight 
  • A BMI of 35 or greater with one or more obesity-related health conditions, such as type II diabetes, hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease
  • The inability to have successfully achieved  and sustained healthy weight loss through other weight loss efforts

Additionally, your doctor must determine that you’re prepared to handle the physical stress of surgery. Some people have health complications that increase the riskiness of surgery; these may include complications stemming directly from obesity. If this is the case, you may be asked to lose an initial amount of weight to improve your health enough to undergo surgery.

Lastly, a patient’s psychological readiness is also a factor. In order for patients to be successful, they must be ready to make significant lifestyle changes that require a positive attitude about food, exercise, and overall health. Because of this, a psychological consultation is often required as part of the pre-operative process.

If you think you are a candidate for gastric sleeve surgery and you’re ready to make the changes necessary to support your success, a conversation with your healthcare team and insurance providers can help you more thoroughly understand your options.

Success rate of sleeve gastrectomy

Bariatric surgery has been proven to be more effective than non-surgical approaches in helping morbidly obese people achieve and maintain their weight loss goals. In general, the amount of weight lost depends on a variety of factors, including the patient’s pre-surgical health and weight, the type of bariatric procedure performed, and adherence to doctor-recommended diet and exercise plans.

Studies indicate an average weight loss between the 60 percent seen in Roux-en-Y gastric bypass and the 50 percent seen with the lap-band procedure. This amounts to an average weight loss of between 80 and 140 pounds occurring over a period of several years.

It’s important to keep in mind, however, that some patients lose more or less than national averages. In general, patients who weigh more prior to surgery are likelier to lose more. Weight maintenance is also subjective, varying from patient to patient dependent on factors including post-surgical diet and level of exercise.

Ongoing counseling may be recommended for several years after the surgery postoperative counseling serves several purposes. In addition to supporting patients in adjusting their dietary and activity habits, it also guides them through the physical, emotional, and social adjustments that usually accompany dramatic weight loss.

The success of gastric sleeve surgery can be measured by other factors beyond weight loss, as well. It is linked with improving and/or resolving a breadth and depth of health conditions related to overweightness and obesity, including heart disease, high blood pressure, high cholesterol, obstructive sleep apnea, type 2 diabetes, stroke, and infertility. Again, the degree to which these conditions improve vary depending on patient specifics.

Together, all of these benefits can add up to overall enhanced quality of life for patients resulting from the improved ability to perform daily activities.

Gastric sleeve surgery risks

All surgeries are accompanied by some degree of risk, and gastric sleeve surgery is not immune. Understanding both the short- and long-term risks can help you make the most informed decision about whether this bariatric surgery is right for you.

Of course, being overweight or obese is in and of itself associated with many health risks.  Known as comorbidities, these include increased risk of heart disease, diabetes, cancer, high blood pressure, high cholesterol, sleep apnea, and many other issues. Your healthcare team can help you determine whether the benefits of gastric sleeve surgery outweigh the risks.

Several potential complications can happen during gastric sleeve surgery. The good news is that not only are these “intraoperative” complication rates low, but they’re also easily managed during surgery. They may include the following:

  • Excessive bleeding
  • Wound infection
  • Adverse anesthesia reactions to anesthesia
  • Blood clotting
  • Breathing and lung problems
  • Staple line leaks

Other complications may emerge in the days, weeks and months following gastric sleeve surgery. These longer-term risks and complications may include the following:

  • Obstruction
  • Hernia
  • Gastroesophageal reflux
  • Hypoglycemia (low blood sugar)
  • Nutritional deficiencies and malnutrition 
  • Vomiting

How much does gastric sleeve surgery cost?

Sleeve gastrectomy costs depend on many factors and may vary widely. These include the following:

  • Type of procedure 
  • Hospital stay duration
  • Hospital performing the surgery
  • Location where the surgery is being performed
  • Additional medical complications

Many health insurance companies do cover the cost of bariatric surgery if it is deemed medically necessary. However, stringent qualifications may apply. Because of this, it’s important to talk to your health insurance provider before moving forward with the decision to undergo gastric sleeve surgery.

Some specific questions to ask may include whether the specific bariatric procedure you’re considering is covered, if you need a primary-care physician referral, if the performing hospital is covered, and what percentage of the total bill you’ll ultimately be responsible for.

If you determine that your insurance provider will not cover your sleeve gastrectomy cost, you may still have financing options.

Opting for an alternate non-surgical, medically supervised weight loss program is also a possibility. However, as bariatric surgery is often presented as a “last resort,” you may have already exercised these options. Bariatric surgery does typically support the best outcomes making the gastric sleeve cost a worthwhile investment for many people.

According to figures provided by the National Institutes of Health, the average price tag for bariatric surgery ranges between $12,000 to $35,000 and more. While gastric sleeve surgery may be on the higher side of this range, it’s largely considered to be a worthwhile investment because of its safety and effectiveness.

The benefit of working with an experienced medical team at AnMed Health is that we will review the cost of surgery with each patient. We’ll explain the different factors that can influence the price and review all your payment options, including insurance and any out-of-pocket costs you may incur.

How does gastric sleeve surgery work?

During gastric sleeve surgery, the surgeon makes a series of small incisions in the abdominal wall. A tube is then inserted as a sizer, after which a stapler is used to section the stomach into two parts. After the stomach is completely divided, the resulting banana-shaped pouch will allow for just 20 to 25 percent of the original stomach volume. The incision will then be closed with staples and checked carefully to confirm that there’s no leakage. Lastly, the surgeon will remove the instruments and close the incision sites.

Gastric sleeve surgery is often conducted via laparoscopy, a minimally invasive type of surgery during which the surgeon uses a small thin tube attached to a camera to perform the procedure without causing major trauma to the patient. Laparoscopic surgery has many benefits, including less pain, shorter hospital stays, quicker recovery, and reduced scarring.

In less common cases, the surgery will be performed “open,” which means a larger incision is made to give the surgeon direct access to the stomach. This may also involve a longer and more painful recovery with more scarring.

Preparing for gastric sleeve surgery

Preparing for gastric sleeve surgery is a process aimed at ensuring best outcomes for patients. Once your insurance coverage is settled and your surgery is scheduled, you will receive specific instructions from your healthcare team regarding how to prepare. Adherence to these instructions is the best way to set yourself up for success.

In the weeks leading up to your surgery, you will be asked to make necessary lifestyle changes, including stopping tobacco use, limiting caffeine, and avoiding certain medications like aspirin, blood thinners and NSAIDS. You may also be required to start an exercise regimen, and to participate in a series of bariatric pre-surgical lifestyle classes.

One or two weeks prior to your surgery, you may be asked to switch to a liquid-only diet. The specifics will depend on factors like your surgeon’s preference and your pre-surgical BMI.

The night before your surgery, you may be asked to shower using a certain type of antibacterial soap. You may also be asked to refrain from eating or drinking after midnight on the night before your surgery.

You may also be asked to pack certain belongings for your hospital stay, as well as to plan ahead for after the surgery by arranging for a ride home and/or help at home, if you will need it.

What to expect during gastric sleeve surgery

Gastric sleeve surgery is performed in the hospital. Depending on whether your surgery is laparoscopic or open, as well as how you recover, you can expect a hospital stay of one or two nights.

When you arrive at the hospital, you’ll be directed to a pre-operative room, where you’ll change into a hospital gown and have an IV catheter inserted. You will then be transported to the operating room, where you’ll be given a general anesthetic which will put you to sleep and keep you comfortable throughout the surgery.

The surgery usually takes between one or two hours, after which you’ll be taken to a recovery room where you’ll be monitored for complications.

Recovering from gastric sleeve surgery

After you wake up in the recovery room, you can expect to feel some grogginess. Many patients also feel some nausea, vomiting and pain. You may be given medication to ease these symptoms. You’ll spend a few hours in recovery before being moved to a hospital room.

Throughout your time in the hospital, you will be monitored closely for bleeding, infection and other potential complications. Most hospitals require patients to start walking as soon as possible to help prevent blood clots from forming.

Your immediate post-operative diet will consist of clear liquids, usually beginning the morning following the surgery. You will be discharged with further instructions when you demonstrate that you can tolerate these without complications.

Life after gastric sleeve surgery

Gastric sleeve surgery is the end of one journey and the beginning of another. Upon your return home, you will likely be advised to stay hydrated, take all medication as directed, and to keep your incision sites dry and clean. You can expect to return to work within one or two weeks of your surgery, although you’ll be advised to avoid strenuous activity for three to six weeks.

Recovery from bariatric surgery involves a phased return to eating. You will meet regularly with a nutritionist who will guide you through the subsequent weeks as you progress through the stages of liquids, pureed, and soft foods until you’re ready for a return to solids approximately four weeks after your surgery date. In addition to tracking how much you eat after gastric sleeve surgery, you must also be mindful about choosing nutrient-dense foods. Your nutritionist will work with you to construct a healthy eating plan.

Because malnutrition can be an issue for some patients, you will likely be required to take supplements, including multivitamins, calcium and vitamin B-12. You will also have routine checkups, including exams, bloodwork and other laboratory testing, in the first few months following your surgery to monitor your health and progression.

Following gastric sleeve surgery, the majority of weight loss occurs within the first year. As such, your body will need some time to adjust to the changes associated with such rapid weight loss. Body aches, tiredness, feeling cold, dry skin, hair loss and mood swings may occur.

And remember: gastric sleeve surgery is a lifelong commitment. Because your new stomach pouch can stretch over time, you may gradually regain the weight if you’re not rigorous about sticking to mindful eating and exercise. Specific causes of weight gain following gastric sleeve surgery may include binge and emotional eating, impulse eating, stress, depression, inactivity, overconsumption of sugary and alcoholic beverages, genetics, lack of sleep and medications.

Lasting weight loss and weight maintenance depends on a continual commitment to healthy lifestyle behaviors. However, if you are adhering to the recommended post-gastric sleeve surgery guidelines and you aren’t losing weight, talk to your doctor.

Obesity impacts your health, how you look and feel about yourself, and your overall quality of life. For many people who meet the qualifications for bariatric surgery and who are in the right mindset to commit to making meaningful change in their lives, gastric sleeve surgery can be a powerful aid in the effort to lose weight and keep it off.

Sleeve gastrectomy at AnMed Health

At AnMed Health, patients will find dedicated sleeve gastrectomy surgeons in Anderson that have years of experience performing bariatric surgery. AnMed Health meets all of the national accreditation criteria for bariatric surgery and our team of sleeve gastrectomy surgeons in Anderson are committed to delivering the highest quality of patient care. The doctors, nurses and medical professionals at AnMed Health are here to help patients achieve their weight-loss goals and to emotionally and physically prepare for life after weight-loss surgery.

If you think gastric sleeve surgery may be an option for you, set up a consultation today.