Obesity is a chronic disease that in the case where it is massive or severe, it can be the cause of inconvenience in everyday life.
Obesity is a breeding ground for many diseases (diabetes, hypertension, hypercholesterolemia, etc.) which can further complicate the health status of the patient.
After trying several methods, whether they be dietary or medical, the patient may have to resort to surgical methods, then we speak of gastroplasty.
These techniques for weight loss is sustainable, there are the sleeve of the stomach.
The sleeve gastric surgery at the level of the stomach that allows us to ask staples.
The presence of staples will decrease the capacity of the stomach, which may not contain more than a litre.
The sleeve gastrectomy is indicated for :
- A person suffering from obesity massive having a body mass index BMI ≥40 kg/m2
- A person suffering from severe obesity having a BMI ≥35 kg/m2 is associated with a complication which can be relieved by surgery (diabetes, high blood pressure, sleep apnea…..)
- A person whose attempts at weight loss through diets, and medications have failed
The sleeve gastrectomy or sleeve gastrectomy longitudinal allows a significant weight loss and quick but also the regression of complications due to obesity, as well as the reduction of the sensation of hunger.
Before the procedure of installation of sleeve gastrectomy
Before gastroplasty, it is necessary to study several parameters to decide whether or not intervention, and proper technique.
Therefore it is important to discuss with a dietitian before deciding.
As soon as the treatment plan is approved by the surgeon, the doctor prescribes a pre-operative evaluation with blood work, endoscopy, œsogastroduodénale (technique for the study of the lining of the digestive tract).
If necessary, the surgeon can request reviews clinical and x-ray to assess the function of the lung, and heart.
The choice of the molecule and the technique of anesthesia will be done after a visit to the doctor anesthesiologist.
Before the intervention, the patient will have to sign a sheet of informed consent describing the procedure and the possible risks.
It will be recommended that the patient not to take aspirin 10 days before the intervention and to stop taking the pill a month before.
It will also be recommended to stop smoking one month before and after the intervention, at a minimum.
The procedure of sleeve gastrectomy
Anesthesia
The procedure of sleeve gastrectomy is performed under general anesthesia.
The patient must be fasting on the day of the operation.
The procedure requires a hospital stay of 3 to 4 days.
The operative time
The principle of the sleeve gastrectomy or sleeve gastrectomy longitudinal is to remove two-thirds of the stomach, including the part where the cells that secrete ghrelin (hormone that stimulates appetite).
Following a gastrectomy longitudinal, the stomach will be in the form of a vertical tube and speeds up the passage of food in the intestine.
The sleeve gastric, therefore, is a technique restrictive, which decreases the appetite and does not interfere with the digestion of food.
The time of the operation is an average of two hours.
Sleeve gastrectomy longitudinal is done through incisions in the abdomen (at least four incision).
Then, the surgeon forms a tube that goes from the esophagus and ending at the level of the gastric antrum by eliminating two-thirds of the stomach with staples.
After sutured, the surgeon will place a bandage around the belly.
After the procedure of sleeve gastrectomy
Postoperative course
Following the sleeve gastrectomy, the patient may feel moderate pain, which require a prescription painkiller adequate.
Possible Complications
As with any surgical procedure, sleeve gastrectomy presents complications :
- Bleeding postoperative
- Nutritional deficiencies
- Shrinkage, leakage, or ulcer at the level of the remaining part of the stomach.
- Gastroesophageal Reflux disease and esophagitis
- Dilatation of the stomach
In Tunisia, the sleeve gastrectomy is a procedure performed under optimal conditions and by qualified surgeons to avoid these complications.
Recommendations
Following a sleeve gastrectomy to a judgment of the professional activity of two weeks is necessary.
The patient should follow a specific diet to avoid complications, and above all, the lack of food.
A period of adaptation is necessary, and the patient will have to eat only liquid foods during the first postoperative week and then a diet soft during the second week, and a diet mixed from the third week.
The return to a normal diet takes a bit more time as it is recommended to mix the meat up to three months after the intervention.
It is also advisable for the patient to be well chewed before swallowing.
After the gastrectomy longitudinal, the patient will have to follow certain rules of the diet
- Ingestion is made slowly in small amounts.
- Meals must be taken sitting down.
- As soon as the first signs of fullness to stop eating.
- It is necessary to vary her diet to avoid nutritional deficiencies.
- It is necessary to avoid very sweet drinks.
Follow-up postoperative
After a sleeve gastrectomy, the patient will be hospitalized for 4 days, and the surgeon will be able to visit for a consultation of convalescence, during which he reminds him of the recommendations, and postoperative reassures him on the proper conduct of the intervention.
At the hotel, a nurse will provide care if necessary.
The surgeon remains attentive to the issues of the patient even after the start, and can send it to a colleague who represents it.
Result
During the first few months postoperatively, the weight loss will be fast and reach a peak after 12 to 18 months it is at this point that the patient has reached a stable weight, and then it slows down.
The complications due to obesity, for example, high blood pressure, diminishes.
The gastroplasty by sleeve gastrectomy allows for a loss of 45% to 65% at the end of two years, which corresponds to 25 to 35 kg.
Rate
The price of a sleeve gastric Tunisia is, on average, of the order of 4100 €
| Intervention | Price | Stay |
|---|---|---|
| Price Sleeve gastric | 3990 € | 4/3 |
