What is it?

Step 2 is a keyhole surgical operation called a Sleeve Gastrectomy and is designed to reduce the size of the stomach.

How does it work?

Sleeve gastrectomy is a restrictive weight loss operation. This is normally performed keyhole (laparoscopically) and reduces the stomach in size and volume. The outer part of the stomach is removed to create a long narrow tube; the volume of the stomach is reduced from in the region of 2 litres to about 100 mls. This is an irreversible procedure. This is normally performed laparoscopically (keyhole) with only a few days in hospital.

Click here to see an Animation of the Sleeve Gastrectomy Surgery.

Successful weight loss will be achieved by working with the team to ensure that healthy eating is combined with the restriction of the surgery and regular exercise. Healthy eating consists of three small meals per day of lean source protein, low starch carbohydrate, adequate fruits and vegetables and maintaining a calorific intake of less than 1500kcal per day. The sleeve gastrectomy ensures that you feel full with these lower volumes of food and takes away the stimulus of hunger.

How does it compare?

In comparison to the laparoscopic gastric band (Lap band) which is also restrictive; the patient feels full rather than the obstructive pattern of eating of the lap band. This means there are less food intolerances and a near normal healthy and more balanced diet can be maintained.

In summary sleeve gastrectomy in comparison with the Lap band

The sleeve gastrectomy achieves more rapid weight loss.
There is no foreign body.
There is no need for further adjustments.
Achieves greater weight loss.

Compared to the gastric bypass the sleeve gastrectomy:

Avoids micronutrient problems.
Avoids stomal ulcers.
Avoids problems of small bowel obstruction.

What are the risks of surgery?

These are risks that are associated with any operation. There is a risk to life with this surgery which will be discussed. More specifically these are some of the recognised risks of surgery: bleeding, splenectomy (removal of the spleen), pain, fever, thrombophlebitis, blood clots, pneumonia, atelectasis, wound problems, infection, intra-abdominal abscess, leaks, pancreatitis, ventral hernia, small bowel obstruction, vitamin and salt problems, hair loss, depression, mood swings, vomiting, diarrhoea and various neuropathies.

We take many precautions to avoid these complications. You will realise by our team approach and early mobilisation how we try to minimise these risks to you. If you smoke you should stop; this will help before and after surgery.

How will I feel after a sleeve gastrectomy?

The weight loss occurs primarily over the first 12 months. At first there is a large restrictive component but as the stomach recovers it should be possible to eat 3 small meals a day. For the first 3 weeks after surgery the diet is pureed; this is followed by a soft diet. By 6 months most people can eat about a quarter of their previous meals. This means when going out to restaurants that you should be able to eat entrée sized meals and feel satisfied. Whereas with a diet you would still feel hungry, the small meal will satisfy you because of the restrictive size of the stomach after surgery. Some people will find that they have been using food as a form of comfort or release from tension and stress. After surgery we suggest you seek help from the counsellor if you find this a problem.

Some people discover that their relationships with others is altered after surgery. The counsellor is here to help you approach these issues.

Initially there is very early fullness and usually a lack of hunger. The operation is only a tool to maintain good health and there should be a focus on drinking at least 1 litre of fluid a day, 1 multivitamin per day and 60-80 g of protein per day, regular exercise and lifestyle changes.

The degree of weight loss is variable. To achieve the best possible weight loss, it is important to make the necessary changes in your lifestyle and the team will work with to achieve this goal.

<< Previous - Step 1: Preoperative Assessment

>> Next - Step 3: Lifestyle Change

Healthy Mind

Step 1: Prior to surgery where our surgeon, counsellor and dietician will meet with you on an individual basis.

This is a time to empower you by discussing and heightening your awareness of your general life long patterns.

Healthy Body

Step 2: One of our surgeons will discuss the issues related to obesity and talk in depth about the various surgical options that are available so that you are fully informed and can make an educated decision.

Healthy Living

Step 3: The key to a good long term outcome is the restriction conferred by surgery combined with healthy eating and exercise.

It is important that we find you an graduated exercise program that you enjoy and the lifestyle coach is trained to help you achieve this goal.