To lose weight effectively
The sleeve is to remove a large part of the stomach, to form a tube. Foods will first be slowed down while in the tube and then evacuated very quickly in the small intestine.
The Sleeve acts by several mechanisms that combine:
- A restriction (such as gastroplasty).
A decrease in the rate of grhelin, which is the hormone of hunger, resulting in a lack of interest in food. Free quote
- The selection criteria are rigorous, it is not necessary to have a BMI greater than 40 to be operated in Tunisia. We take care of patients with a BMI of 30.
Result of a Sleeve in Tunisia
A Sleeve can lose forty pounds in one year. Namely a loss of 70% of the excess weight. If it proves to be insufficient to obtain a greater weight loss, it can then be transformed into a bypass in good safety conditions.
Currently, some teams offer the Sleeve instead of gastroplasty (gastric band) for the following reasons:
- It causes a quick feeling of satiety, like gastroplasty.
- It does not require the placement of a foreign body (gastric band).
- Vomiting is less common than with gastroplasty.
- It reduces the rate of ghrêline, and therefore the feeling of hunger, as in the bypass.
- It is performed by laparoscopy
Detail of the intervention of sleeve gastrectomy under celioscopy step by step “with Illustrations”
Below you will find the key steps of a typical Sleeve Gastrectomy surgery. These illustrations of Sleeve Gastric can show patient patients exactly how the Sleeve operation works and helps them understand the basic steps and principles of this bariatric surgery. Free quote
- Small incisions are made in the abdominal wall for the introduction of trocars.
- Stomach inspection
The stomach is inspected. The blood vessels to the lateral side of the stomach are shared. The stomach is vascularized by two arterial circles:
- The circle of the small curvature
- The circle of great curvature
- Put the gastric tube to calibrate the part of the stomach that will stay
A candle tube or also called gastric tube is inserted into the stomach and serves as a size sizer for the new stomach.
Beginning of stapling of the stomach: Gradually the stomach is stapled following the calibration (candle) Free quote
In this stage of gastric sleeve intervention, the stapler is used to divide the stomach into two parts. From 4-6 cm of the pylorus (the valve between the stomach and the small intestine), at the beginning, the stapler is slightly farther from the candle tube to avoid causing narrowing (stenosis).
- The stapler cuts the stomach in two parts: The stomach is stapled along its length
The remaining part (on the left of the diagram), will look like an elongated tube, it has a sleeve shape, this is called sleeve gastrectomy which is carried out following a gastric tube or candle tube.
- Resection of the stomach: The stomach is completely divided into two parts
The cut portion (right) represents about 75 to 80% of the original stomach volume. Once this part of the stomach is decompressed, it is removed through one of the incisions made (15 mm trocar).
Some scientists believe that the upper part removed from the stomach (fundus) has the function of secreting hormones of hunger. Indeed, once this part of the stomach is removed, many patients do not feel hungry after surgery.
Note: The resected part is entrusted to the laboratory for analysis
- Finally the result of gastric sleeve intervention: new stomach has about 20-25% of the original stomach volume
The new form of the stomach (gastric tube) has about 20-25% of the original stomach volume. After this intervention, the patient eats much less, in view of the reduction of the stomach which leads to a quick sensation of satiety, but also the patient is less hungry, this is due to the sleeve gastrectomy which decreases the rate of ghrêline and therefore the feeling of hunger.
What are the risks of sleeve gastrectomy?
- Undernutrition and vitamin deficiencies are rare.
- No oral supplementation is necessary.
- A biological assessment after a weight loss of 25 to 30 kg is achieved. It sometimes shows small vitamin deficits that are easily compensated orally.
- The Sleeve is not reversible. However, in a number of cases, the tube may expand after 3 to 4 years, and is no longer effective.
- Eating habits should be changed, 3 meals and possibly 2 snacks.
- Vomiting is quite rare.
- Regular monitoring by a multidisciplinary team is mandatory.
- 2 Blood samples are needed the first year, then 1 blood test a year, to find a vitamin deficiency.
Hospitalization & tariff of an intervention of Sleeve gastrectomy in Tunisia
The duration of hospitalization is 4 to 5 nights for optimal monitoring.
For obvious reasons of security, the duration of the stay will be imposed, namely 8 days / 7 nights on the Tunisian territory. Deadline to make sure you can go home safely.