Surgeon from Las Vegas, US talks about the steps involved in sleeve gastrectomy.
Gastric sleeve surgery is performed on individuals with BMI of 35 or more. Patients with BMI 30 are also sometimes accepted. This surgery is also used as a first step procedure for gastric bypass surgery and duodenal switch. Shown above is the weight loss video and following is its narration.
“In Gastric Sleeve, what we are doing is, we are shrinking the stomach down to a sleeve or a long narrow tube and we do that by freeing up majority of the stomach and taking a stapler and going up and cutting off about 85% of the stomach.
We use something called a bussie or sizer to make the tube appropriate size. We don’t want too narrow, we don’t want too big, we want just right. And we use that buzie as a sizer and we along aside that and staple up on the stomach and taper it down to a long narrow sleeve, that empty’s down the bottom. And it’s a nice operation. I really like the gastric sleeve because it seems to give us all the benefits of the band because now you have lots of restrictions like in lap band what we do, you realize band, you have lots of narrow restriction but it also gives us benefits of the bypass.
The hormonal changes that we see in the bypass are so powerful that we see in the sleeve. So for example hunger, when you are hungry, when you diet and eventually fail the hunger hormone Ghrelin, that’s produced in the stomach and that’s taken out of the sleeve. So with this sleeve, it’s a tapering of the stomach, making it small and narrower and we are getting two things out of it – we are getting good restriction and we are getting good hormonal changes as well.
The steps for sleeve: Actually the most important part of any operation begins way before yet to the operating room. Most important part is to have a surgeon’s experience and a patient who is very very comfortable with that doctor. This is the most important thing. You have to feel comfortable with your doctor because that allows somebody to relax and allows somebody to have a safe procedure.
If you are not comfortable, if you are nervous, if you are anxious, you are going to have more problems after surgery. So that’s so far the most important and that’s what we concentrate on a lot. I see every patient, every time, on every visit to my office and part of that is making people comfortable with me and me with them.
So, when they get to the hospital or to the surgery center, we start out by giving them pain medicine. Even before I am on the surgery, I give them pain medicine. It relaxes people, make them comfortable, again enables us to operate safely. So those are all important steps in any surgery.
For the Gastric Sleeve, what we are doing is, we are freeing up the stomach from its attachments. It’s attached to the spleen – up on the top, its attached to the large intestine in the bottom and we free up those attachments and we do that by coming in, starting at the top of the stomach and taking the stomach off the diaphragm. We move it from the diaphragm so that it’s free.
We come below on the sleeve, we open up an area below and then we take our stapler and come back up to that open area from above and divide it. Once we have freed all the attachments, once the stomach is been stapled off, we now have a section of stomach that can be taken out and believe it or not, it’s been out from a hole which is that big, very easily in the operating room. We take that out. The next important step for this operation is to check what you have done. So we test the connections, test all the stapling.
We do that by clamping things from below and an anesthesiologist inject blue dye. The sleeve will actually distant blow up real tight and if there is going to be a leak, you will see it right then and there. We do that persio test and we know whats good. The last we want to do is make sure at the top, where the opening is through the diaphragm, is not too wide. If that opening is too wide, people have problem of reflux.
So what I do in my operations is that I actually clear up that opening and put it next to suture in there to help reinforce that area so that reflux is kept on the minimum after the surgery. So we put an extra stitch there typically after the surgery to prevent reflux.”
The surgeon explains the steps involved in sleeve gastrectomy. In it, the stomach is tapered down to a narrow tube with a sizer. It is then attached to the spleen at top and large intestine at the bottom. Stomach is freed from the diaphragm and stapled off. The hunger hormone – Ghrelin, is consequently reduced.
To test leakage in spleen, anesthesiologist injects blue dye highlighting it. Another test is performed to check if the opening of the stomach through the diaphragm is not too wide. An extra stitch is used to prevent reflux after the surgery.
The surgeon also specializes in other weight loss surgeries like lap band surgery, duodenal switch and gastric bypass in Las Vegas. Apart from getting weight loss procedures done from there, one can enjoy the benefit of visiting many sights.
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