Nikan specialty and subspecialty hospital, constructed in 2010, is located in an area which is about 35000 square meters in the northeast of Tehran, Iran. This 102-bed hospital was opened in 2011 and has sixteen floors. All the members, including well-known knowledgeable professors, experts, and committed staff have gathered together to provide patients with services in a hospital which benefits from the most advanced science and medical standard devices. It includes many sections such as ICU-CCU's special department, maternity wards, and modern operating rooms. It’s important to note that in 2014, Nikan got the first place in Accreditation and Patient safety. Moreover, this center is known as the first Iranian private hospital to get the Green Award international certification in Berlin.
How this Procedure is Done
What is Sleeve Gastrectomy?
Sleeve gastrectomy, also called a vertical sleeve gastrectomy, is a surgical weight-loss procedure suitable for overweight people who have not successfully reduced their weight via exercise or diet. In this operation, about 80 percent of the stomach is surgically removed, which reduces the stomach volume to less than its half. This surgery will result in a tube-shaped stomach about the size and shape of a banana, restrict the amount of food you can consume, and prompt hormonal changes that are influential in weight loss. Accordingly, patients won’t be able to eat as much as they used to and will feel full quicker than before. In addition, undergoing this operation can extremely reduce the risk of potentially life-threatening weight-related health problems such as heart disease, high blood pressure, high cholesterol, and type 2 diabetes.
Who Can Benefit From Sleeve Gastrectomy?
This operation can be an effective solution for you if your body mass index (BMI) is 40 or higher (extreme obesity). However, if your BMI is 35 to 39.9 (obesity) and you struggle with a serious weight-related health problem such as type 2 diabetes or high blood pressure, you can still think of this operation as a suitable option since it can help you get rid of all these problems as well. You must also try your best to live a healthy lifestyle, have a well-balanced diet, and exercise regularly after the operation. Indeed, you should make permanent changes in your daily eating habits. You need to have checkups frequently as well to monitor your nutrition and evaluate your medical conditions.
This surgery usually takes about an hour. Doctors mostly prefer general anesthesia for their patients to ensure their comfort during the operation. At first, specialists make a few small cuts in the belly and insert a laparoscope, an instrument with a tiny camera that sends pictures to a monitor. Next, they will create a narrow sleeve by stapling the stomach vertically and remove the larger, curved part of the stomach. Finally, they will reattach the rest of the stomach to form the "sleeve" or tube.
You will have to stay in hospital for about 2 or 3 days following surgery which typically takes 40-70 minutes. It’s better to ask someone to take care of you for a while. During this period, you are recommended to drink plenty of water in order to stay hydrated. Feeling pain from the small incisions can usually be relieved with pain medications if prescribed by your doctor. You should start your clear liquid diet the morning after their surgery and are permitted to walk a few hours. This diet will be continued for a week, which will gradually progress to soft foods for three weeks and finally to regular foods almost four weeks after the surgery. You will need to take a multivitamin twice a day, a calcium supplement once a day, and a vitamin B-12 injection once a month for life. You should also have frequent medical checkups in the first several months after weight-loss surgery.
Majority of patients can go back to work and begin exercising after two to four weeks. You don’t need to worry if your skin becomes dry or your mood changes. These are totally natural since your body reacts to the rapid weight loss in the first three to six months after the surgery. If you follow your doctor’s instructions carefully, you can easily avoid such complications.
Normally, people will lose about 60-70% of their excess weight gradually after the surgery. The details are explained in the following:
- The first two weeks: 10-20 pounds; most patients lose about one pound a day
- The first three months: 35-45% of excess weight loss
- The first six months: 50-60% of excess weight loss
- The first year: 60-70% of excess weight loss
Fortunately, sleeve gastrectomy success rate is about 80-90%, and a long-term weight loss can be provided. Depending on your diet and the changes you make in your lifestyle, the amount of weight you lose will be changed. The other problems you may struggle with such as heart disease, high blood pressure, high cholesterol, or type 2 diabetes will be completely resolved as well. By enhancing your ability to do routine daily activities, it can significantly improve the quality of your life.
After the gastric sleeve of stomach, which normally takes 1 to 2 hours, depending on the patient's condition, 1 to 3 days of hospitalization is prescribed. The patient will have to rest and avoid work from 1 to 3 weeks. After 6 weeks, the patient can resume their daily activities.
This procedure is suitable for those with the Body Mass Index or BMI above 40 and are aged between 18 and 65. Also, those who have BMI over 30 with obesity-related conditions like hypertension(high blood pressure), high cholesterol, type 2 diabetes, An obstructive sleep apnea (sleep apnea), and joint problems are candidates for this procedure.
Gastric sleeve surgery is generally a safe procedure and if performed by a competent surgeon the mortality or death rate is close to zero.
Every surgery operation has short and long term side effects. In this case, the short term side effects could be pain, bleeding(1.2%of the patients), staple line leaks(2.1%), gastric strictures(0.6%)amongst others. The long-term side effects could involve reflux, nausea, sagging skin because of rapid weight loss, and regaining weight.
Some people may feel pain in the place of the incision. Pain in the neck and shoulder area after laparoscopy operations are common and normal.
Obesity may be one of causal factors of stomach cancer. If someone is on course to stomach cancer before a gastric sleeve procedure, it may continue and this surgery does not expedite stomach cancer. Nonetheless, gastric sleeve, as a result of following weight loss, could reduce or eliminate the risk of cancers like ovary cancer.
To know if you are a good candidate for gastric sleeve, you have to know your BMI. People with BMI over 40 or over 30 who also suffer from obesity conditions like diabetes, high cholesterol, high blood pressure(hypertension), sleep apnea, etc. can opt for this procedure.
If you have tried all other weight loss methods and have not gotten results or suffer from obesity side effects like diabetes, hypertension(high blood pressure), etc. you might be better off with this low-risk procedure and try it after expert consultation.
Sleeve gastrectomy is believed to be simpler than gastric bypass. Instead of rearranging the anatomy of the stomach and small intestine, the stomach is resized to affect weight loss in sleeve gastrectomy. The significant advantage of gastric sleeve surgery is that it does not create a new connection between the stomach and small bowel. Long term complications which are common in gastric bypass surgery are less likely to happen in gastric sleeve procedure. In addition, if some patients are too heavy for gastric bypass surgery, doctors will choose to perform sleeve gastrectomy.
Definitely yes. Before carrying out the operation, specialists will elaborate on the features of a healthy diet. If you want to enjoy the results of such surgeries permanently and maintain your ideal weight, you should live a healthy lifestyle and have a well-balanced diet.
It remarkably reduces the size of your stomach and restricts the amount of food that can be eaten at one time. After eating a small amount of food, you will feel full very quickly. This feeling usually lasts for several hours since your appetite is suppressed by reducing the amount of "hunger hormone" produced by your stomach.
This procedure is highly recommended to patients who cannot lose weight through exercise or diet. Those individuals who have a very high body mass index (BMI) or are at risk for undergoing anesthesia because of heart or lung problems may think of this surgery as an effective solution to tackle their weight-related problems.
Depending on patients’ weight before the operation, they can expect to lose at least 40% and at most 70% of their extra weight gradually following surgery. Many obesity-related problems such as diabetes, hypertension, or abnormal cholesterol levels will be completely resolved by getting bariatric surgery.
For obese patients who suffer from esophageal dysmotility (difficulty swallowing), gastroparesis (food stays in the stomach for too long), and severe Gastroesophageal Reflux Disease (GERD), the gastric bypass surgery is a better option. Nonetheless, if they struggle with mild reflux, gastric sleeve can be performed without causing any problems.
The stomach can be considerably stretched after eating. During the gastric sleeve surgery, doctors insert a tube from the mouth into the stomach, and all the gas and liquids are removed to totally decompress the stomach. Almost about 80% of the stomach is removed after it is decompressed. During this process, the stomach is detached and pulled through a very small incision, which is only about 2-3 cm.