Table of Contents

What is a Gastric Tube?

It is a method of creating a new tube-shaped stomach that looks like a banana by removing 80% of the original stomach. Although the stomach size varies slightly from person to person, it is actually more or less the same in both genders. This surgery does not cause the displacement of any of the organs. After the surgery, the capacity of the stomach is reduced to 100-150 ml from its maximum capacity of 1-1.5 liters.

Tube stomach surgery was performed laparoscopically for the first time in 2001 as the first phase of duodenal switch surgery performed by M. Gagner on patients with excess weight. The aim was to slim these people down with the first stage of the operation and reduce the risk of the actual surgery that is to be performed later. Since tube stomach surgery itself enabled effective weight loss in some patients, the second phase of the surgery was not required. Since then, the popularity of tube stomach surgery increased rapidly both in the world and in our country. Today, tube stomach surgery is the most common bariatric surgery method worldwide (60% of all cases, on average)

How is Gastric Sleeve Surgery Performed?

Please click here to review the rest of the success stories.

Songül Can

Songul lost 35 kilos in a year after laparoscopic sleeve gastrectomy. She used to suffer from severe type2 diabetes and hypertension diseases before surgery. She quit all her medications, including the use of insulin after gastric sleeve surgery.

Deniz Lama Metin

It has been 4 years since Deniz underwent gastric sleeve surgery. In the first year after her operation, she lost 80 kilos and she weighs 74 kilos since then. She eats proper food regularly, she never misses her exercises and avoids unnecessary calories.

Mert Levent

Mert Levent is one of Turkey’s internationally acclaimed DJ’s.

It has been 3 years since he had gastric sleeve surgery. He lost a total of 80 kilos.

How is Gastric Sleeve Surgery Performed?

In a gastric sleeve operation, first the stomach is completely cleaned from the surrounding fatty tissues by various methods. Then an instrument (“bougie”) used for exploring the details of body parts is placed inside the stomach. The stomach is divided into two and 80% of the stomach is cut out by a device called “stapler” that lays 3 rows of titanium staples starting from the “pylorus”, exit region of the stomach. Consequently, a tube-shaped stomach with a volume of 100-150 ml is created. The cut part of the stomach is taken out of the body. This type of surgery is called gastric sleeve surgery regardless of the size of the stomach cut out.

Performing the bariatric surgery operation correctly according to certain rules is one of the most important factors affecting the postoperative process. These rules are listed below:

1.The stomach should not be left wide.

2.Particular attention should be paid to the region located in the middle of the stomach, also known as “incisura”, and this region should not be left narrow.

3.The dome-shaped part located on the upper side of the stomach, also known as “fundus”, must be completely removed. If this region is not completely removed, patients may experience inadequate weight loss and some patients may have severe reflux after surgery.

4.A bariatric surgeon should take the necessary precautions to avoid any errors that may occur along the line cut by staples in the stomach. This line is stitched back and forth in bariatric operations performed in our clinic. This method is called “double stitching”.

5.Necessary precautions should be taken to prevent the newly formed stomach from twisting, bending and breaking.

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  • Fluid intake should be stopped 8 hours before surgery and solid food consumption should be stopped 12 hours before surgery. These two issues are extremely important since general anesthesia is needed for gastric sleeve surgery.
  • Before the operation, the patient should undergo some tests such as blood test, urine test, electrocardiography and respiratory system controls, and if there are no problems encountered in these tests, then the patient becomes eligible for bariatric surgery.
  • If you have eaten anything before the operation, you should convey this information to your surgeon because this information is crucial and it may even cause the surgery to be delayed.
  • Do not use aspirin before surgery. If you have used it, please inform your doctor.
  • We recommend to take easy-to-change and comfortable clothes with you. Choosing the right pieces of clothes is important as you will receive serum support during your stay in hospital.

Recovery Process After Gastric Sleeve Surgery

When you regain consciousness, you will be observed for a while in the postoperative observation area of the hospital. Here, your visitors will be able to see you for a short time. After the control of your anesthesiologist and surgeons, you will be transferred to your room. You will recover completely from general anesthesia in three hours time after the surgery. You will even be able to stand up and walk. We will specifically ask you to do so because early mobilization after surgery is a crucial point we emphasize.

Under normal circumstances, the pain felt by the patient is supposed to be minimal after bariatric operations. However, some patients may feel some pain as each patient’s threshold for pain will differ from one another. This much pain does not pose a very serious problem and is easily eliminated with painkillers.

The next day after the operation, one of the surgeons who performed the surgery will take an x-ray while you are drinking a specifically designed liquid. On this x-ray, you can see your newly created stomach for the first time. Some clinics do not take this x-ray, but we think it is necessary. This x-ray enables us to control whether the liquid is able to pass through the stomach and make assessments regarding the newly developed stomach. It helps us predict whether the patient will experience any problems in the postoperative period. If the outcome of the x-ray is positive, then you can start drinking water and clear liquids.

You will be hospitalized for a total of three days, including the day of surgery. You will be given continuous intravenous serum during your stay in the hospital. We discharge our patients only after they can have enough liquid orally since you will not be able to get intravenous serum at home. Studies have shown that the most frequent reason for returning to the hospital is dehydration. Keeping this in mind, we hospitalize our patients for three days as a standard practice.

On the day of discharge, you will be informed about what to do in the upcoming period following the discharge. In addition, you will be given an info booklet on matters to be considered, medication to be used and your nutrition program. After discharge, you will come to a check when your surgeons deem it appropriate.

Frankly, you will become a member of our ever-growing family on the very day you decide to undergo bariatric surgery. You will be able to contact us at any time during the postoperative follow-up period. We will continue to keep in touch with you for many years and we will always be by your side on your success-oriented journey to regain your health.

Are you ready? Time has come. You might be excited just a little, maybe a bit anxious. Let’s briefly mention the concerns you might have in your mind on the day of surgery.

It is worth mentioning the following two issues: Gastric sleeve surgery is a laparoscopic operation, that is, a closed surgery. Therefore, postoperative pain is minimal. The probability of serious complications in experienced hands during or after this surgery is extremely low.

You need to relax so please do not be bothered with such things. Your surgeons will likely schedule the operation early in the morning not to keep you waiting for so long.

You have successfully followed the liver reducing diet given to you before the operation. Try to relax and enjoy the moment. If you relax and feel calm, the rest will be easily handled by the surgical team.

Before coming to the hospital on the day of surgery, pack your things and clothes into a small bag. We recommend that you bring comfortable and easy-to-change clothes such as short-sleeved t-shirts and shorts. Please keep in mind that you will receive serum support during your stay in hospital so choose your clothes accordingly. You should stop eating and drinking at midnight just before the day of the operation. This is extremely important as general anesthesia is needed for the bariatric surgery. If you eat or drink something in the morning of the surgery, please inform your doctor. This can cause your surgery to be delayed.

It is very important for smokers to reduce smoking as much as possible before surgery. We are not sure whether the smokers will find it easy to keep this advice but please do your best.

Do not use aspirin in the preoperative period. If you have used it, please inform your doctor.

Please tell your possible visitors that you do not want to be flooded by many visitors in the post-operative period. The doctors try to avoid too many visitors and they have a very good reason for this: to avoid contagious infections like flu.

On the day of the operation, a team consisting of experienced nurses will take care of you and make sure that you are ready for the surgery once you get to the hospital. Your surgeons will see you and your loved ones in the morning before going into surgery. When the time of operation comes, you will be given a tranquilizer to make you feel calm and ease the stress of having an operation just before entering the operating room. A team will welcome you at the entrance of the operating room and you will be taken to the room where your surgery will take place. After you see your surgeons, your anesthesiologist will ask you to breathe through a mask and you will sleep in a minute.

  • After the surgery, you are kept under observation for a while in the observation area.
  • After the controls and approvals of your surgeon and your anesthesiologist, you will be transferred to your room.
  • You will regain consciousness within 3 hours after the operation.
  • You can even take a few steps if you want to.
  • The day after the operation, your real –time x-ray will be taken while you are drinking a liquid specifically designed for this test in order to check whether fluids can pass through your stomach. You can start drinking water according to the results of this test.
  • You will be discharged after you are able to drink enough liquid.
  • Before you are discharged, you will be informed about the upcoming period following the discharge. This information includes your nutrition program, medications you are supposed to use and topics you should be aware of.

Reviews of Patients Who Had Gastric Sleeve Surgery

5,0 ★ ★ ★ ★ ★ (27)

Frequently Asked Questions about Gastric Sleeve Surgery

You can find detailed information about our patients who had undergone gastric sleeve surgery here

Gastric sleeve surgery is a closed surgical operation, hence the pain felt after the surgery is so very little. This pain is easily relieved with painkillers.

You can watch the video below to find out the answer to the question.

You will stay in hospital for a total of three days.

As with any surgery, it is crucial to undergo gastric sleeve operation in a full-fledged hospital in order to be able to immediately and completely respond to postoperative complications. There should be an intensive care unit in the hospital.

The patient can have only one person to stay with him/her after the operation.

It is forbidden to lift weights for at least 20 days following the operation.

Yes, you can take a shower after the operation.

There is no problem in having sexual intercourse 15-20 days after the operation.

Compression stockings should be used while driving. You should not travel by plane without your doctor's approval after the operation.

Walking: It is recommended to take short walks after the operation.
Swimming: It is not recommended to swim for at least two months after the operation.
Fitness: You can exercise as long as you do not stretch the abdominal muscles. However, fitness is not recommended for at least two months after the operation.
Football, Volleyball etc.: It is recommended to wait for at least three months before playing football, volleyball, etc.

It is recommended that you sleep on your back during the first month after the operation. You can sleep on your stomach after one month following the operation.

You can watch the opinions of people who have undergone gastric sleeve operation with comparisons of how they feel before and after the operation on our YouTube channel and on our web site.

Body Mass Index is a simple calculation using a person's height and weight. The formula is BMI = kg/m2 where kg is a person's weight in kilograms and m2 is their height in metres squared. If your BMI is between 20 and 25, you are considered healthy.

Other BMI Categories:

Overweight: 25-30
Obese: 30 -35
Severely obese: 35-40
Morbidly obese: 40 and more

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What are the advantages of gastric sleeve surgery?

1.Most of your stomach is removed from your body resulting in smaller portion sizes and decreased hunger. Weight loss gets much easier.

2.Ghrelin is the primary hormone that stimulates hunger and is produced by the upper portion (called “fundus”) of the stomach. Since fundus is eliminated by the gastric sleeve operation, your appetite often lessens.

3.Compared to other surgical operations such as gastric bypass, gastric sleeve is an easier operation and its duration is shorter.

4.The positions of the intestines are not changed.

5. Dumping syndrome is a condition that occurs when food, especially sugar, moves from your stomach into your small bowel too quickly causing light-headedness, sweating, nausea, abdominal cramping and it is not a desired condition for patients. Symptoms of dumping syndrome are not very common since the gastric exit door (pylorus) remains intact after the gastric sleeve operation hence the food does not leave the stomach immediately.

6.No tube is placed in the stomach in this surgery. The stomach is reconstructed in the form of a thin tube.

7.Weight loss after the operation continues for approximately 1-1.5 years.

8.Patients who regain weight in the long run have always a chance to undergo another surgical operation. In other surgeries such as gastric bypass, revision (having another weight loss operation) is quite difficult for patients who regain weight after the operation.

 

Why do surgeons recommend gastric sleeve surgery?
As of 2018, gastric sleeve operations account for 60% of all obesity surgery operations in the United States. In Turkey, the mentioned rate is over 80% and the rate of gastric bypass operations falls gradually. There are several reasons for this:

The primary reason is that your organs are not displaced in gastric sleeve surgery. What is solely done is to reduce the capacity of your stomach. Gastric sleeve surgery is technically easier to perform and less complex in the short and long terms. Vitamin and mineral deficiency in patients is less common in gastric sleeve surgery. Gastric sleeve and gastric bypass surgeries have a similar effect on patients in terms of getting rid of comorbid diseases such as blood pressure, diabetes, sleep apnea caused by obesity and weight loss performance in the five-year period following the surgery.

 

Although, in the long term, the risk of regaining weight after gastric sleeve surgery is slightly higher than gastric bypass method, it is not possible to know precisely which specific type of operation will yield better results for a patient in advance. By combining their motivations provided by effective weight loss after surgery with adopting the relevant changes in their lifestyles, some patients may be successful far beyond expectations.

After gastric bypass surgery, internal herniation may be life-threatening and lead to bowel obstruction. Also, ulcers causing bleeding or perforation and dumping syndrome can be seen in the area of junction where stomach meets intestines. Studies involving the 10-year follow-up period after surgery have shown that percentage of regaining weight after gastric bypass surgery reaches considerable figures (more than 20%). In some patients, diabetes may also reappear due to postoperative weight gain and other factors. This is an extremely difficult situation for bariatric surgeons who encounter patients that need revision surgery in the long term. Options for revision (having a second surgical operation) after gastric bypass surgery are limited and really difficult. However, patients who need revision in the long term after gastric sleeve surgery can undergo any type of surgical operation, including second gastric sleeve operation. This is itself a very important advantage compared to gastric bypass. Those who oppose to gastric sleeve surgery claim that rates of reversal and elimination of diabetes as a result of gastric sleeve surgery are not as high and risk of regaining weight after the surgery is quite high in the long term. Inıtially, gastric sleeve surgery was the first stage of duodenal switch surgery. Those who oppose to gastric sleeve surgery ignore the fact that other surgical methods can easily be performed in case of regaining weight or getting diabetes again in the future. Hence with certain exceptions, laparoscopic sleeve gastrectomy is the best choice for most patients and advanced results will yield with the ever-growing experience of surgeons in sleeve gastrectomy over time.