Sleeve gastrectomy is an operation to narrow your stomach from its normal kidney shape to the shape of a shirt sleeve.

How does it work?

Changing the shape of the stomach has the effect of dramatically decreasing the amount of food you can eat in a meal.  It works in more ways than just this.  For example it will decrease the time food will spend in contact with your stomach (called increased gastric transit).  It can alter the hormones associated with the feeling of being full after a meal, and can change the type of food you crave.  It can affect the way your body processes sugars and the hormones that are involved in fat storage.  It is a highly effective operation at both decreasing your weight and also treating complications of your weight you may be suffering from (e.g. diabetes, sleep apnoea, high blood pressure, arthritis etc).

A sleeve gastrectomy is performed as a laparoscopic (key-hole) operation through 4 small incisions.  The ‘greater curve’ or left hand side of your stomach is disconnected and removed so that your stomach becomes the shape of a shirt sleeve.  

Why can’t I lose weight by myself

A lot of people think that they can’t lose weight because they aren’t trying hard enough.  This is simply incorrect.  When you are overweight, your body gets used to being heavy, and will fight your efforts to lose weight.  Your body is designed to keep weight on, and to stay or return to the heaviest weight you have been.  This is known as the ‘body set point’.  If you try very hard and do manage to lose weight, the most common thing is for your body to fight against you.  Up to 98% of people find that they put their weight on again.  Having a weight loss operation can help you reset your body set point to a lower level.  

Putting on weight again after dieting can be very disheartening, but is a normal experience.  If you are getting frustrating with continually trying hard but putting weight back on again, it may be worth considering a weight loss operation.

Health benefits

There are many health benefits from undergoing weight loss surgery.  Some of the medical conditions known to get better after weight loss surgery include type 2 diabetes, high blood pressure, high cholesterol, obstructive sleep apnoea, fatty liver, some arthritis pains, polycystic ovary syndrome and urinary stress incontinence (wetting yourself when you cough, common after childbirth).  Even if you don’t suffer from any of these medical conditions, most people will find that they have a lot more energy and have a longer life expectancy as a result of the surgery.  

What to expect

Before your operation

You will need to make an appointment to see Dr Hamer to discuss potential surgery.  Please make sure you let the rooms know you are interested in discussing weight loss surgery, and they will allow a longer appointment time to make sure you have enough time to discuss everything properly and have all your questions answered.

If you decide to proceed with surgery you will need to go on an ‘optifast’ diet.  This is a meal replacement/shake diet which is designed to shrink your liver before surgery.  Shrinking your liver is important as it makes the operation safer for you, and decreases the risk of bleeding during surgery

You will be see our dietician before your operation and receive specific instructions on how to best take the optifast.

You will be given contact details for our psychologist. The most valuable time to see a psychologist is in the year following surgery when you are starting to put in place good habits to hopefully last a lifetime.   Our psychologist can help you with ways to achieve this.  

Making your operation safer

There are 2 main things to do to make your operation safer.  Firstly keeping strictly to your optifast diet is important.  Secondly, if you are a smoker it is important to stop smoking for at least 4 weeks before your operation.  Smoking even 1 cigarette in the four weeks before your surgery can increase your risk of serious complications.  

Your operation and hospital stay

You will get a phone call from the hospital the day before your admission advising you what time to arrive.  On the day of surgery you will arrive and the hospital and the nursing staff will weigh you again and take your blood pressure and pulse.  You will be brought through to the operating room where you will see Dr Hamer and your anaesthetist before being administered the anaesthetic.  Afterwards you will wake up in the recovery before being transferred to the ward.  The nursing staff on the ward are very experienced and will guide you through your recovery.  Most people will be able to stand up and walk around the ward the day of the operation, and feel well enough to be discharged by 4pm the day following their procedure.  Occassionally if you haven’t woken up well from your anaesthetic, you may need to stay two nights.  

At home after your operation

Most people take around 2 weeks off work to recover.  Even though you will be able to walk around and will have minimal discomfort after the operation, your energy levels can be very low as your body adjusts to a decreased calorie intake.  It is important during this period to avoid becoming dehydrated, and to follow your dietary advice carefully.  If at any stage you have concerns around what you can eat, your information booklet will have most answers, and if not you can contact your dietician.  If you become unwell, have increasing pain or develop sweats or fevers you should contact Dr Hamer’s rooms.  

Adjusting to life with a sleeve gastrectomy

There are some important issues to think through before going ahead with any weight loss operation.  A weight loss operation is a powerful tool that will help you get weight off and to keep it off.  It is important though to recognise that you will need to change some aspects of your lifestyle, such as eating different foods, and starting regular exercise regimes if you want to keep the weight off longer term.  

After a sleeve gastrectomy, you will not be able to eat as much as you can before your operation.  Although this may sound self evident, it is important to have thought through how this can affect you socially.  If eating out or eating big meals with your family is a regular thing in your life, it may be wise to spend some time thinking about how you will adjust to this after your operation.  

As you lose weight quickly, over the first few months you can experience some hair loss.  This is not permanent.  

Follow up

Dr Hamer and his team will follow you up regularly after your operation.  You will see both him and your dietician to help ensure you are on track with your weight loss, dietary and lifestyle changes.  If you have any problems post operatively you should contact the rooms for an extra appointment.  

Side effects to be aware of

All operations have side effects or potential complications you need to be aware of.  Risks of any operation include the risk of the anaesthetic, small risks of bleeding, infection, developing hernias where the key hole instruments are inserted, blood clots and pneumonia.  In sleeve gastrectomy there is a risk of leakage from the staple line which occurs in approximately 1/100 people.  This can be a serious complication, and in some cases require a prolonged stay in hospital, and further operations.  There is a risk of bleeding from the staple line, often this will settle down with no intervention, sometimes it will require a second key-hole operation to stop it.  Longer term some people will develop reflux as a result of their sleeve gastrectomy.  If you have concerns about your reflux please discuss this with Dr Hamer as there are other options availabe to you.

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