Sleeve Gastrectomy: Pre Operative Checklist

June 7, 2009 · Filed Under vertical sleeve surgery · Comment 

The most important consideration for sleeve gastrectomy is knowing about your surgeon.One should always meet with the surgeon prior to the surgery and discuss potential issues. One should have absolute faith in one’s doctor. The quality of aftercare program should be accessed prior to the surgery as a short stay and regular check up is required after the surgery.



The education of the patient is very important. There are a number of educational seminars conducted free of cost where one can get information required for sleeve gasectromy.Some institutions offer video based education in their offices. One may also collect printed procedure related information including what to expect and how to deal with it. Some hospitals offer direct interaction with the staff and surgeon where they impart education on various subject related to the operation. They answer the questions of the patients clearly and explain the exact details of the procedure, the extent of recovery period and the reality of the follow-up care that will be required.



After becoming thorough with information about all aspects of the surgery, comes the physical and psychological evaluation. Each patient is required to have a physical with their primary care physician within six months prior to surgery. This is done to determine that the patient does not have any underlying medical conditions that would prohibit them from having surgery. Many surgeons require these letters or copy of these reports to be sent to their office even before scheduling the appointment. Some surgeons perform Endoscopy is performed on the patients if there is a doubt about stone formation.



A pre operative psychological evaluation is an essential part of preparing for Sleeve Gastrectomy. The comprehensive psychological evaluation consists of a detailed clinical interview and objectively scored psychological tests. Many insurance companies require an evaluation for benefits and our surgeons require an evaluation for all patients. Some hospitals offer education and counseling for family also available but it is optional.


Patients who have high intake of caffeine are suggested to gradually decrease the amount of caffeine they consume. Patients who stop caffeine suddenly at the time of surgery may experience withdrawal symptoms such as intense headaches. Remember that there is a significant about of caffeine in coffee, tea and many soft drinks.

If one consumes carbonated drinks regularly, he should stop this habit before the surgery. When cold compressed gas hits our stomach which is a 99.5 closed system it expands and in turn expands the stomach too. It can be very problematic after the surgery. So it is wise to put a full stop to this habit. It is also advisable to reduce the amount of intake of refined carbohydrates one consumes. This group includes food such as white rice, pasta and cookies.

One more pre operative condition is to get into a habit of exercising. After surgery regular exercise etc are prescribed by the surgeon. So it is wise to start some aerobic activity such as walking or swimming for 20 minutes, four times a week. This should be done after the approval of your physician.

Stop smoking. This is another condition before sleeve Gastrectomy. Cigarettes interfere with the lung’s ability to exchange oxygen and nicotine can impair circulation, which can impede healing after surgery and increase the chance of infection.

There are some pre operative tests to be performed. A convenient day is decided beforehand by the patient and the surgeon. The patient gets to meet with the anesthesiologist before the surgery. Hospital tour can be done if the patient is interested.

Some hospitals provide the facility of support groups for the pre operative patients. There are structured monthly meeting at offices and hospitals where the patients get to meet some post operative patients.


Lastly, one should check with their Insurance companies if Sleeve Gastrectomy is included in their list. The benefit department should be consulted  and asked if one has benefit for bariatric surgery.


lma Orozco is a certified patient coordinator of the
Ready4Achange team at Monterrey, Mexico. If you are NOT leading a normal life due to your weight, its time to think about other alternatives. Weight Loss Surgery is one of those options.

Precisely How Does the Sleeve Gastrectomy Form of Weight Loss Surgery Work?

May 29, 2009 · Filed Under vertical sleeve surgery · Comment 

With obesity continuing to increase in the West weight loss surgery has become a routine form of surgery in many medical facilities.

The sleeve gastrectomy is a restrictive type of weight loss surgery in which approximately 85% of the stomach is removed leaving a sleeve shaped stomach with a substantially reduced capacity of somewhere between 60 and 150 cc. Unlike most other types of weight loss surgery, the outlet valve and nerves to the stomach are left in place and, while the stomach is severely reduced in volume, its function is unaltered. Additionally, unlike other types of weight loss surgery such as the tried and tested Roux-en-Y gastric bypass the sleeve gastrectomy cannot be reversed.

Because the newly created stomach functions normally there are far fewer restrictions when it comes to the foods that patients can consume following surgery, although the quantity of food consumed will be considerably reduced. Many patients see this as being one of the chief advantages of the vertical sleeve gastrectomy, together with the fact that the removal of the greater part of the stomach also results in the effective elimination of hormones which are produced within the stomach and that stimulate hunger.

Perhaps the biggest advantage of the vertical gastrectomy lies in the fact that it does not bypass the intestines and patients do not therefore experience the complications of bypass including anemia, intestinal obstruction, vitamin deficiency and protein deficiency. It also makes it an appropriate form of surgery for individuals who already suffer from anemia, Crohn’s disease and various other conditions which would place them at high risk for intestinal bypass surgery.

Finally, it is one of the few types of bariatric that can be performed laparoscopically in patients who are extremely overweight.

Probably the chief disadvantage of the vertical gastrectomy is that it does not always result in the weight loss that people want and may even lead to weight regain in the longer term. This is of course the case with any form of purely restrictive weight loss surgery although it is possibly particularly true of the vertical sleeve gastrectomy.

Because the procedure requires stapling of the stomach patients do run the risk from leaks and other complications that are directly related to stapling. Additionally, as with any operation, patients are at risk from complications including post-surgical bleeding, small bowel obstruction, pneumonia and even death. The chances of experiencing these complications is nevertheless extremely small and varies from about 0.5 and 1%. This said, the risk of death from this form of surgery at about 0 .25% is very small indeed.

As a general rule the sleeve gastrectomy is most suited to patients who are either very overweight or whose health rules out other types of weight loss surgery. In the case of the first category of patient the sleeve gastrectomy would usually form the first of a two-part plan of weight loss, with further bariatric surgery being undertaken once the patient’s weight has dropped sufficiently to allow other types of weight loss surgery to be done. provides detailed information on the gastric sleeve and the sleeve gastrectomy with duodenal switch including detail of the duodenum function and the role of the jejunum tubes