Sleeve Gastrectomy | Prof. Dr. Haluk Ünalp

Sleeve Gastrectomy


One of the most popular surgical methods for weight loss is sleeve gastrectomy. In this attempt, the stomach is cut longitudinally and 75-80% of it is removed. The remaining stomach is similar to banana or sausage. Stomach volume shrinks and the amount of food taken decreases at this rate. The part extracted from the stomach is the easiest and most enlarged part of the stomach. In the remaining part, the expansion capacity is low. For this reason, the foods consumed immediately cause tension and a feeling of satiety occurs with a small amount of food. As the volume of the stomach is low and the amount taken is small, the foods leave the stomach rapidly. Therefore, rapid emptying does not allow the stomach to expand.


While it is ensured that the food taken in sleeve gastrectomy is reduced, the foods that rapidly pass from the stomach to the small intestine stimulate the reflexes in the small intestine. This causes the intestines to work faster. Fast-running intestines provide support for permanent weight loss by reducing the absorption of high-calorie foods.


Gastric sleeve surgery can be applied to all obese patients who need treatment.


Although the rate is low, the two most important risks that can occur during or after surgery are leakage and embolism (clotting).


In this surgery, special materials and devices are used while the left side of the stomach is removed. Therefore, a stitch line remains in the stomach. One or more of the stitches may not hold from this suture line after the operation. This is called a fugitive. In short, it can be said that the stitches do not hold and the stitches break.

The causes of these leaks may depend on both the surgeon and the patient. Surgery related reasons are the surgical technique, the materials used and the experience of the surgeon. The reasons belonging to the patient mostly depend on the burden of obesity. In other words, the more weight the patient is, the higher the risk of leakage. Because obesity itself can lead to weakening of the immune system. On the other hand, surgical trauma may cause the wound to heal a little longer and harder. Failure to follow the rules reported to the patient after surgery also creates the risk of leakage.

Leakage risk is around 1%. However, some of the leaks are micro-leaks and most of them heal unnoticed and do not cause any problems. In some of the cases, small abscesses may develop due to these leaks. In these cases, it may be necessary to drain the abscess from the outside (drainage from the wig) and appropriate antibiotic treatment. Even surgery may be required again.


Embolism is usually the presence of a standing clot and it goes elsewhere in the body and clogs the vein somewhere. There is a risk of clots in obese patients, even if they do not have surgery. The risk of embolism that already exists in these patients increases a little more with surgery. However, the risk is considerably reduced by administering blood thinners to the patient before and after the operation, carrying the patient early, using special socks and anti-embolic pump systems in the surgery.

As the weight increases, the risk of embolism increases, but in general, the risk of embolism can be roughly 04% (4 per thousand).


Other risks in sleeve gastrectomy are similar to those that can be seen in gallbladder, appendicitis or other stomach surgeries. There is no surgery without risk. Risks other than leakage are not much higher than other surgeries. The rate of risks that can be seen in every surgery such as bleeding (1%), lung infection, wound infection, is as much as other surgeries.


Hunger hormone (ghrelin) secreted from the removed part of your stomach after sleeve gastrectomy is reduced by 70-90% after surgery. For this reason, you will almost not feel hungry again after eating. The feeling of fullness in the stomach is due to the stretching of the stomach. You will be satisfied with a little food. However, you will not feel hungry for a long time. For this reason, although it is called diet, you will be able to easily lose weight without disturbing your eating and eating style. Because it will get full easily and your feeling of fullness will continue for longer.


After this surgery, patients may lose 50-60% of their excess body weight. If the diet to be given is followed and dietary habits are regulated, even more weight can be lost.


It gives similar results to surgical gastric bypass in later periods.

The amount of food is limited.

Faster and fullness are felt. You stay full for a long time.

Weight loss starts from the moment of surgery..

If he is overweight, the patient may lose weight over 50-60% on average.

The digestion and normal absorption of the foods taken are not impaired in the intestine.

Even if it fails, it can be converted to other surgeries such as gastric bypass, duodenal switch.


In the short term, weight loss may not be as fast as gastric bypass.

Gallstones may develop due to rapid weight loss. Normally, the risk rate in the society is 1%, while the risk after sleeve gastrectomy is 2%. Therefore, an operation may be required to remove the gallbladder.

The change made for surgery is a permanent procedure, the stomach cannot be restored.

It may be necessary to use stomach-protective medications for a while after the operation to reduce stomach acid.

Reflux may occur.


Before Obesity Surgery, taking into account your weight and accompanying diseases, applying a special diet program for the recommended period will make your surgery more comfortable and facilitate your postoperative recovery process.

During this period, our first goal is to reduce our swollen and fatty liver to a healthier level in our normal nutritional process, therefore, we should completely remove fat and sugar from our nutrition table and follow a diet as high as possible in terms of protein, vitamins and minerals.


You should consume 2500- 3000 cc of water a day.

✓ You should not drink acidic drinks.

You should have a protein-based diet in all your meals.

✓ You should not especially use refined sugar.

You should not smoke.

One week before your surgery, Aspirin and its derivatives Coraspin Alcaseltzer etc. You should not use blood thinners.

You should not take foods containing flour, fried, bulgur, rice, starchy and sugary foods that will instantly increase your insulin.


There are two main rules that you must follow throughout your life after bariatric surgery.

You should not consume solid food and beverages at the same time.

You should not consume acidic drinks. While planning your diet, where we will progress gradually in the first 45 days after surgery, our first goal is not to lose weight, but not to force the incision line until the wound healing is completed. Weight loss will necessarily occur due to the nature of your surgery.

Clear liquid in the first 10 days

Fluids with consistency of 10 to 15 days

You should eat foods with a mash consistency that you will achieve gradually by thickening for 15 to 30 days.

As of the 1st month, your meal amount will be 150 cc for one meal.

Our body needs the most protein, especially during periods of rapid weight loss. For this reason, you should give priority to protein-containing foods in your meals.

You should start consuming foods that swell when wet, such as bread, pasta, bulgur, rice, after the 3rd month at the earliest.

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