What is Sleeve Gastrectomy

A sleeve gastrectomy is a surgery in which a large portion of the stomach is removed. After the surgery, the stomach is a narrow tube about the size of a banana.

The reduced size of the stomach restricts the amount of food that you can eat, which helps you to lose weight.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant, if this applies.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures or organs.
• Blood clots.
• Leakage of fluid from the stomach into the abdominal cavity. (This is rare.)

What happens before the procedure?

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• You may have tests, including:
  • Blood tests.
  • Urine tests.
  • Stool tests.
  • X-rays.
  • Ultrasound.
  • Esophageal manometry. This checks the tube that carries food and liquids from your mouth to your stomach (esophagus).
• Follow instructions from your health care provider about eating or drinking restrictions.
• Plan to have someone take you home after the procedure.
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be given antibiotic medicine to help prevent infection.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given a medicine to make you fall asleep (general anesthetic). You may also be given a medicine to help you relax (sedative).
• Several small incisions will be made in your abdomen.
• A thin, lighted tube with a tiny camera on the end (laparoscope) will be inserted into one of the incisions. The camera sends a picture to a TV screen in the operating room. This gives the surgeon a good view of the stomach.
• Small surgical instruments will be put through the other incisions.
• Part of your stomach will be cut and removed through one of the incisions.
• The remaining part of your stomach will be closed using stitches (sutures).
• A small tube (drain) may be placed through one of the incisions to allow extra fluid to flow from the area.
• Your incisions may be closed with sutures, staples, or skin glue.
• Your incisions may be covered with a bandage (dressing).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• You will continue to receive fluids and medicines through an IV tube.
• You may have some pain and nausea. Medicines will be available to help you.
• You may have fluid leaking from a drain in one of your incisions.
• You may have to wear compression stockings. These stockings help to prevent blood clots and reduce swelling in your legs.
• You will be encouraged to walk around several times a day. This helps to prevent blood clots.
• You will be started on a liquid diet the first day after your procedure. You may have some tests to check if you are ready to start the liquid diet.
• You will be encouraged to cough and to perform deep-breathing exercises. This helps to prevent a lung infection.
• Do not drive for 24 hours if you received a sedative.

Sleeve Gastrectomy, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain in your abdomen.
• Decreased appetite.
• Clear fluid leaking through the small tube (drain) that comes from your incision site.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not drive for 24 hours if you received a sedative.
• Do not drive or operate heavy machinery while taking prescription pain medicine.

Incision and drain care

• Follow instructions from your health care provider about how to take care of your incisions. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to be in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Keep the area around your incisions and your drain clean and dry.
• Check your incision areas every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• Empty your drain every day. Follow instructions from your health care provider about recording the amount of fluid that comes from your drain. Make note of any changes in the amount or appearance of the fluid.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do not lift anything that is heavier than 10 lb (4.5 kg).
• Avoid intense physical activity for as long as told by your health care provider.
• Move around at least once per day, every day. As you start to feel better, you may start to exercise more.

Eating and drinking

• Follow instructions from your health care provider about eating or drinking restrictions. You will be given instructions about the type, the size, and the timing of your meals.
  • Keep track of any foods that cause discomfort, such as bloating or cramping.
  • Eat healthy foods. Avoid foods that are high in fat or sugar.
• Stop eating when you feel full.
• Take supplements only as told by your health care provider.
• Drink enough fluid to keep your urine clear or pale yellow.

General instructions

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths for bathing.
• Do not use tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. If you need help quitting, ask your health care provider.
• Wear compression stockings as told by your health care provider. These stockings help to prevent blood clots and reduce swelling in your legs.
• Do breathing exercises as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have pain that gets worse or does not get better with medicine.
• You have more redness, swelling, or pain around your incisions.
• You have more fluid or blood coming from your incisions.
• Your incisions feel warm to the touch.
• You have pus or a bad smell coming from your incisions.
• You have a fever or chills.
• You have problems with your drain.
• You have green or bad-smelling fluid leaking from your drain.

Get help right away if:

• You have difficulty breathing.
• You have severe pain, especially in your legs.