The “sleeve gastrectomy” consists in resecting most of the stomach by a stapling technique to keep only one tube connecting the esophagus to the duodenum, with a volume equivalent to 100-150 cc with preservation of the gastric antrum.
It was initially developed as the first stage of a two-stage surgery (bypass or duodenal diversion) for super-obese patients (BMI> 50 kg / m2) due to its greater technical ease.
• Dilation of the gastric tube with decreased satiety. This may require a new intervention such as re-stapling to reduce the volume of the tube associated or not with a bypass conversion.
• A risk of reflux in the esophagus (20% at 1 year)
• The irreversibility of the technique.
• D0- the pral alimentation of the patient is not allowed
• D1- An eso-gastro-duodenal transit scheduled to assess the remaining stomach and check for the presence of a complication. The patient will be fasting until the examination. If the exam is normal, then the patient is allowed to drink water (small amounts and spaced throughout the day). The patient is also advised to mobilize, the first mobilization will be carried out with an accompanying person (nurse or physiotherapist) to avoid vagal mechanisms and a temporary loss of consciousness with a subsequent fall.
– An oeso-gastroduodenal transit is performed to check the correct sealing of the stapling line
• D2- The patient is authorized to return home if the control biology is within physiological parameters. The authorised diet is liquid.
– The dietetician will see the patient before leaving hospital to explain the regime.
In the postoperative period, PPIs are also administered and continued for 3 months in order to reduce nausea and risk of anastomotic ulcers. Semi-liquid diet for 10 days, followed by a specific diet for 3-4 weeks.
– Anastomotic leak
– Intestinal obstruction
– Internal hernia