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Sleeve Gastrectomy
Sleeve gastrectomy or vertical sleeve gastrectomy is a minimally-invasive surgical procedure performed for weight loss. Sleeve gastrectomy procedure is generally performed laparoscopically, which includes the insertion of small instruments through small incisions in the upper abdomen (stomach) area.
Approximately 80% of the stomach is removed during the procedure, leaving behind a tube-shaped stomach which is the size and shape of a banana.
This procedure will limit the size of your stomach, therefore, restricting the amount of food that you can consume. Also, this procedure brings about hormonal changes that help in the loss of weight. These hormonal changes help in relieving the conditions that can make you overweight, like heart disease or high blood pressure.
Advantages:
Sleeve gastrectomy is mainly done to help you in losing excess weight and reduce the chances of developing life-threatening weight-related health problems like:
- High blood pressure
- Heart diseases
- Diabetes
- High cholesterol
- Cancer
- Stroke (a condition that occurs when the blood supply to the brain stops)
- Cancer
- Infertility
- Obstructive sleep apnea (a sleep-related breathing disorder)
Candidates for Sleeve Gastrectomy procedure:
It is a procedure done only if you have attempted to lose weight by modifying your diet and exercising, and have failed.
The procedure is done in the following individuals:
- If the body mass index (BMI) of a person is 40 or more than 40 (severe obesity).
- If the BMI of an individual is 35 to 39.9 (obesity), and you have a serious weight-related health disorder like high blood pressure, diabetes, or severe sleep apnea.
- If your BMI is between 30 and 34 and you have serious weight-related health disorders.
- The patient must be willing to make permanent healthy lifestyle changes and participate in long-term follow-up plans, which may include monitoring of nutrition, lifestyle, and medical conditions.
Obesity is fairly self diagnostic and can be determined with a simple physical exam by a doctor. However, the doctor may perform certain tests to determine the level of obesity and the presence of other obesity related disorders. The following diagnostic procedures may be followed.
- Physical exam - during the physical exam, the first thing that the doctor would measure would be the person’s body mass index (BMI). Body mass index is determined by diving a person’s weight by the square of the person’s height. People with a BMI higher than 25 upto 29.5 are considered overweight whereas those with a BMI of over 30 are considered obese. A BMI higher than 40 poses a need for surgery.
- Medical history – the doctor may take a full medical history to decide the course of the treatment. The doctor would potentially check for the presence of any other medical conditions and whether the patient’s weight has responded to diets or exercise in the past to confirm the need for surgery.
- Tests – the doctor may require other tests for co-morbid conditions like hypertension, diabetes, heart disease etc. Other illnesses such as Prader-Willi syndrome, Cohen syndrome, Cushing’s syndrome and hypothyroidism can also cause obesity. Obesity can automatically be handled if these conditions are confirmed and treated.
The sleeve gastrectomy procedure is performed laparoscopically in most cases. This is done by making several small incisions in the abdomen. The surgical instruments are inserted through these incisions. The stomach is then reduced in size to almost 15% of its original size to form a small narrow tube almost like the shape of a banana. The open edges are then stapled and the excess stomach tissue is removed and discarded. Reducing the size of the stomach automatically reduces the amount of food one can consume thus aiding in weight loss. It also reduces the production of the hunger producing hormone ghrelin, which would make the patient feel satiated with smaller quantities of food. It does not involve re-arranging the intestines like in gastric bypass, and is therefore less invasive.
- The possibility of a leak in the stomach along the staple line that can cause its contents to overflow in the bloodstream. This can be life threatening and would require a second surgery
- Infection at the site of incision
- Excessive bleeding
- Requirement for a second surgery
- Formation of blood clots in the veins (deep vein thrombosis) or pulmonary embolism (clots in the lungs)
- Damage to other nearby internal organs
- You will be staying in the hospital for three to four days after the procedure.
- The first follow-up appointment is scheduled on the seventh to tenth day from the surgery when the clips and dressings are removed.
- After the procedure, you will be required to have a sugar-free, non-carbonated liquid diet for the first seven days.
- You can start with pureed foods after one week. This diet can continue for another three weeks.
- Regular food can be started approximately four weeks after the surgery.
- The patient needs to eat small quantities of food at a time and chew it slowly.
- The doctor will prescribe multivitamins that need to be taken twice a day.
- A calcium supplement will be prescribed to be taken once a day.
- A vitamin B-12 injection will be given once a month, for the rest of life.
- Follow-ups and frequent medical checkups will be required for the first several weeks following the procedure.
- The regular check-ups may include blood tests and other examinations.
- The patient is expected to lose about 70% of his excess body weight, approximately 6 to 8 kgs on an average every month.
There are several changes in the body that may occur due to the rapid loss of weight in the first three to six months following the surgery:
- Body aches
- Exhaustion
- Flu-like symptoms
- Dry skin
- Feeling cold
- Thinning or loss of hair
- Changes in mood
Sleeve Gastrectomy Cost from trusted Hospitals in Chennai
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Sleeve Gastrectomy
Sleeve gastrectomy or vertical sleeve gastrectomy is a minimally-invasive surgical procedure performed for weight loss. Sleeve gastrectomy procedure is generally performed laparoscopically, which includes the insertion of small instruments through small incisions in the upper abdomen (stomach) area.
Approximately 80% of the stomach is removed during the procedure, leaving behind a tube-shaped stomach which is the size and shape of a banana.
This procedure will limit the size of your stomach, therefore, restricting the amount of food that you can consume. Also, this procedure brings about hormonal changes that help in the loss of weight. These hormonal changes help in relieving the conditions that can make you overweight, like heart disease or high blood pressure.
Advantages:
The various advantages of sleeve gastrectomy include:
- Long-term weight loss
- Improvement in quality of life
- Improved ability to perform normal daily activities
- Loss of weight helps in improving or treating the following conditions that are related to obesity or being overweight:
- High blood pressure
- High cholesterol
- Heart diseases
- Diabetes
- Obstructive sleep apnea
- Stroke
- Infertility
Risks:
The following risks are associated with sleeve gastrectomy procedure:
- Infection
- Bleeding
- Blood clot formation
- Adverse reactions to anesthesia
- Breathing problems
- Leaks from the stomach
- Hernias (a bulging of the tissue or organ through an opening in the abdomen)
- Gastrointestinal obstruction (a condition in which there is a prevention of the digested material from normally passing through the bowel)
- Hypoglycemia (low blood sugar)
- Vomiting
- Malnutrition
Symptoms
Sleeve gastrectomy is mainly done to help you in losing excess weight and reduce the chances of developing life-threatening weight-related health problems like:
- High blood pressure
- Heart diseases
- Diabetes
- High cholesterol
- Cancer
- Stroke (a condition that occurs when the blood supply to the brain stops)
- Cancer
- Infertility
- Obstructive sleep apnea (a sleep-related breathing disorder)
Candidates for Sleeve Gastrectomy procedure:
It is a procedure done only if you have attempted to lose weight by modifying your diet and exercising, and have failed.
The procedure is done in the following individuals:
- If the body mass index (BMI) of a person is 40 or more than 40 (severe obesity).
- If the BMI of an individual is 35 to 39.9 (obesity), and you have a serious weight-related health disorder like high blood pressure, diabetes, or severe sleep apnea.
- If your BMI is between 30 and 34 and you have serious weight-related health disorders.
- The patient must be willing to make permanent healthy lifestyle changes and participate in long-term follow-up plans, which may include monitoring of nutrition, lifestyle, and medical conditions.
Diagnosis
Obesity is fairly self diagnostic and can be determined with a simple physical exam by a doctor. However, the doctor may perform certain tests to determine the level of obesity and the presence of other obesity related disorders. The following diagnostic procedures may be followed.
- Physical exam - during the physical exam, the first thing that the doctor would measure would be the person’s body mass index (BMI). Body mass index is determined by diving a person’s weight by the square of the person’s height. People with a BMI higher than 25 upto 29.5 are considered overweight whereas those with a BMI of over 30 are considered obese. A BMI higher than 40 poses a need for surgery.
- Medical history – the doctor may take a full medical history to decide the course of the treatment. The doctor would potentially check for the presence of any other medical conditions and whether the patient’s weight has responded to diets or exercise in the past to confirm the need for surgery.
- Tests – the doctor may require other tests for co-morbid conditions like hypertension, diabetes, heart disease etc. Other illnesses such as Prader-Willi syndrome, Cohen syndrome, Cushing’s syndrome and hypothyroidism can also cause obesity. Obesity can automatically be handled if these conditions are confirmed and treated.
Treatment
The sleeve gastrectomy procedure is performed laparoscopically in most cases. This is done by making several small incisions in the abdomen. The surgical instruments are inserted through these incisions. The stomach is then reduced in size to almost 15% of its original size to form a small narrow tube almost like the shape of a banana. The open edges are then stapled and the excess stomach tissue is removed and discarded. Reducing the size of the stomach automatically reduces the amount of food one can consume thus aiding in weight loss. It also reduces the production of the hunger producing hormone ghrelin, which would make the patient feel satiated with smaller quantities of food. It does not involve re-arranging the intestines like in gastric bypass, and is therefore less invasive.
Risks
- The possibility of a leak in the stomach along the staple line that can cause its contents to overflow in the bloodstream. This can be life threatening and would require a second surgery
- Infection at the site of incision
- Excessive bleeding
- Requirement for a second surgery
- Formation of blood clots in the veins (deep vein thrombosis) or pulmonary embolism (clots in the lungs)
- Damage to other nearby internal organs
After Procedure
- You will be staying in the hospital for three to four days after the procedure.
- The first follow-up appointment is scheduled on the seventh to tenth day from the surgery when the clips and dressings are removed.
- After the procedure, you will be required to have a sugar-free, non-carbonated liquid diet for the first seven days.
- You can start with pureed foods after one week. This diet can continue for another three weeks.
- Regular food can be started approximately four weeks after the surgery.
- The patient needs to eat small quantities of food at a time and chew it slowly.
- The doctor will prescribe multivitamins that need to be taken twice a day.
- A calcium supplement will be prescribed to be taken once a day.
- A vitamin B-12 injection will be given once a month, for the rest of life.
- Follow-ups and frequent medical checkups will be required for the first several weeks following the procedure.
- The regular check-ups may include blood tests and other examinations.
- The patient is expected to lose about 70% of his excess body weight, approximately 6 to 8 kgs on an average every month.
There are several changes in the body that may occur due to the rapid loss of weight in the first three to six months following the surgery:
- Body aches
- Exhaustion
- Flu-like symptoms
- Dry skin
- Feeling cold
- Thinning or loss of hair
- Changes in mood
FAQ Section
Sleeve Gastrectomy or Vertical Sleeve Gastrectomy (VSG) is a surgical procedure which aids in weight loss. It involves removal of the curvature portion of the stomach (about 70% of your stomach) laparoscopically to decrease the person’s appetite through a reduction in the size of the stomach and reducing the release of ghrelin, the hunger hormone. This reduction in the capacity to eat and appetite helps the person to lose weight. The reduced stomach looks like a sleeve or a tube giving the surgery its name.
It is sometimes done as a pre-procedure for a Gastric Bypass.
You would qualify for Sleeve Gastrectomy if
- You have a BMI (Body Mass Index) of over 40 indicating extreme obesity.
- You have a BMI (Body Mass Index) of over 30 in combination with a weight-related health problem like Type-II Diabetes, high cholesterol, high blood pressure, Obstructive Sleep Apnea, infertility, some heart disease, etc.
It is recommended to consult with a doctor to gauge whether your health problem is weight related and whether weight loss would help in treating your condition.
The short term risk factors of VSG include –
- Leaking from the sleeve (remaining portion of the stomach).
- Infection at the site of surgery
- Allergic reactions to anesthesia and medications used during the operation.
- Blood clots
- Strictures (Narrowing of the blood vessels)
- Bleeding at the site of surgery
- Stomach ache which can get very severe
The long term risk factors of VSG include-
- Gastroesophageal Reflux Disease (GERD)
- Gastrointestinal Obstruction
- Hypoglycemia (Low blood sugar)
- Hernias
- Vomiting
- Nausea
- Gastroparesis (condition in which food remains in the stomach for an abnormally long time)
- Vagus nerve damage causing constant nausea
- Oesophageal pain
Cases of these complications being fatal are very rare. These risk factors can be avoided if the surgery is done properly by a qualified surgeon using proper equipment and taking care to stick to the diet plan provided for at least four weeks. If you see any symptoms, contact your doctor immediately. Hernias can be avoided by not putting a strain on the operated area.
Sleeve Gastrectomy is only the first step towards getting rid of your weight-related problems. Several eating and lifestyle changes are required to see the full results.
VSG will definitely aid in weight loss since the capacity to eat, and the appetite of a person is greatly reduced. It has been found in various studies that VSG is very effective in durable weight loss.
The cost of Sleeve Gastrectomy in India varies across different hospitals and cities.
| CITY | COST |
| Cost of Sleeve Gastrectomy in Mumbai | INR 250000- INR 325000 |
| Cost of Sleeve Gastrectomy in Banglore | INR 230000- INR 310000 |
| Cost of Sleeve Gastrectomy in Delhi | INR 230000- INR 310000 |
| Cost of Sleeve Gastrectomy in Chennai | INR 210000- INR 300000 |
For the first week after the surgery, you can only consume liquid foods with prescribed mineral and vitamin supplements.
For the next three weeks, only pureed foods can be consumed, and the mineral and vitamin supplements will continue.
Only after four weeks of surgery can you revert to normal food. Since the quantity of food consumed will be less, people are recommended to take supplements for the rest of their lives to make sure the body gets all the essential nutrients.
Mild stomach ache right after surgery is pretty common but prolonged or severe stomach ache after the surgery needs to be checked by a doctor.
After the surgery, due to rapid weight loss, you might experience stomach ache along with several other body aches. These will be mild and generally stop after a few months. If they persist, medical attention should be sought.
Sleeve Gastrectomy should be chosen only if diet and exercise plans have all failed you in achieving the desired weight loss.
It is a very good option for dealing with weight and weight-related health problems. It reduces the capacity to eat by restricting the size of the stomach and also affects the appetite by reducing the amount of ghrelin produced (which is also known as the ‘hunger hormone’ and is responsible for a person’s appetite). These two effects are instrumental in helping individuals achieve the desired weight loss and thereby, in some cases, treating the weight-related disorders they have or even reduce the possibility or life-threatening events like a cardiac arrest.
Sleeve Gastrectomy is a very safe procedure if done under the proper conditions by a well-trained surgeon. Any fatal cases, which are extremely rare, can only be attributed to improper conditions, faulty equipment or the surgeons’ mistake. Thus, to minimize any dangers associated with the surgery, a well-established hospital with proper facilities, standard equipment, and good surgeons should be chosen for the surgery.
The surgery itself is a two-hour procedure. You will be at the hospital for around three days which includes the pre-surgery and post-surgery days. After a complete check-up, you will be released from the hospital but will have to adhere to the dieting plan provided by the doctor. Liquid food like juices etc. in the first week and pureed food for the next three weeks is generally recommended. You are also advised not to put a strain on the operated area for this period of four weeks to avoid any possibility of a hernia.
Sleeve Gastrectomy is a permanent and irreversible procedure since it involves removal of about 2/3rd of your stomach.
The effect in weight loss would slowly decline with 60-70% excess weight loss in the beginning to very less after about the third year.
VSG is a minimally invasive procedure which is very safe if done in a proper environment by a well-trained surgeon. Cases of any short-term or long-term effects of the procedure being life-threatening are extremely rare.