Laparoscopic Sleeve Gastrectomy 
      With the severe damages caused by hypertension, high cholesterol, arthritis and sleep apnea and other obesity related diseases, obesity is one of the diseases that threats the person’s general health. The person becomes prone to heart diseases and atherosclerosis along with some fatal tumors such as cervical cancer and breast tumors. 
      For this reason, a surgical operation can be needed in order to reach an ideal weight and lower the risk of infection. Sleeve Gastrectomy is the most recent and successful surgery that has the least complications. Having emerged recently whilst also having good results, it became one of the best surgeries for the treatment of obesity. 

      What is Laparoscopic Sleeve Gastrectomy?

      It is called Laparoscopic Sleeve Gastrectomy, as approximately 80% of the stomach is removed on the vertical plane, capacity of stomach is reduced to 20% and the feeling of hunger is suppressed by removing the part of stomach, wherein the hunger hormone is secreted.

      How is Laparoscopic Sleeve Gastrectomy performed?
      The procedure is performed using a surgical endoscope that is inserted through 5 little holes (under 1 cm) opened in the abdomen and closed aesthetically.
      This procedure lasts about 30 to 45 days. Laparoscopic Sleeve Gastrectomy is among the surgeries that carries the least risk, because the stomach is resected on the vertical plane, it cannot be filled in by foods completely and weight loss can be achieved up to 75% of the optimal weight by suppressing the secretion of hunger hormone from the stomach.
      When does an obese patient need Laparoscopic Sleeve Gastrectomy?
      1. If BMI is 40 kg / m2.
      2. If BMI is 35 kg / m2 and the patient has chronic diseases like diabetes, hypertension or arthritis.
      3. If a patient cannot lose weight by the non-surgical means, such as gastric balloon or diet.
      4. If the patient has communication issues and chronic depression caused by a psychological condition.

      *** Calculation of Body Mass Index = weight in kilograms / height in square meters

      What is the appropriate age for Laparoscopic Sleeve Gastrectomy?
      Even if a Pediatric Laparoscopic Sleeve Gastrectomy can be done, it is recommended that the patient would be 18 or over.
      Contrary to the long-term activity observed for the adults (10 years or more), the long term side effects have not been shown in children yet.
      What kind of stapler is used in Laparoscopic Sleeve Gastrectomy?
      In surgical operations, modern staplers that are made of titanium with no adverse effect on human body are used for many decades. We use the best types of stapler for preventing leakages and complications since their quality can change from one type to the other.
      What are results of Laparoscopic Sleeve Gastrectomy?
      1. Reducing stomach capacity to approximately %20 of the original capacity strongly suppresses the feeling of hunger and the volume of food ingested.
      2. Fullness is felt early and the feeling of hunger delays, as secretion of hunger hormone (ghrelin hormone) is decreased
      3. Seventy percent of excess weight is lost in the first six months and weight loss continues until optimal body weight is reached.
      4. Gastrointestinal functions are not influenced, as digestive tracts are not altered. 
      5. The procedure is performed with laparoscopic technique and it is therefore safe and effective.
      6. An effective treatment for patients with diabetes. It has great effect on treatment of Type II diabetes and control over Type I diabetes as it is found that the absence of fat increases the sensitivity of insulin receptors.
      7. This surgery has a beneficial effect on patients with hypertension. After the Laparoscopic Sleeve Gastrectomy, it is noted that more than %75 of hypertension patients fully stopped or partially cut their drug intake.
      8. Improves blood cholesterol levels
      9. Eliminates joint pains and infections caused by being overweight.
      10. Eliminates sleeping disorders and respiratory problems caused by being overweight.
      11. Suitable for all types of obesity and weight levels.
      12. The patient is discharged one day after the surgery.
      13. Prevents all obesity related diseases, such as atherosclerosis and heart diseases.
      What are the complications of Laparoscopic Sleeve Gastrectomy?
      1. A leakage on one of the staplers used to close the remaining stomach. This problem can be avoided by using a high quality stapler. But in the case of a leakage, a stent is inserted by the mouth into the stomach without any surgical intervention.
      2. Bleeding secondary to surgical operation. This may happen based on the surgeon’s skills and experience.
       
      Does the stapler removed after surgery?
      No, the stapler is not removed. It is made of titanium with no adverse effect on human body and they are used for many decaades.

      What are benefits of laparoscopic surgery?
      1. Pain relief after surgery,
      2. Short hospital stay,
      3. Quicker return to work,
      4. Improved look (no scar),
      5. Quicker convalescence than classic surgery,
      6. Quick return to daily life.

      Which tests are needed before the surgery?
      1. Fasting blood glucose,
      2. Complete blood count,
      3. Blood type,
      4. Liver functions,
      5. Kidney functions,
      6. Thyroid functions,
      7. Gallbladder and liver imaging to identify gallbladder stones and size of liver.

      What is the duration of this surgery?
      The procedure only takes two days; a day is needed for the surgery and a day is needed to check the patient.

      Some people think that they have lost their appetite after Laparoscopic Sleeve Gastrectomy. Is this normal?
      Yes it is normal considering the size of the new stomach and the reduced hunger hormone (ghrelin). Appetite increases in time but never to the preoperative level and it takes approximately 3 months. In this period, it is recommended to have smaller meals and increase fluid intake even if not feeling hungry.

      Is there any problem with being pregnant after Laparoscopic Sleeve Gastrectomy?
      There is no medical conflict between pregnancy and Laparoscopic Sleeve Gastrectomy; however, in order to ensure adaptation of the body to the reduced size of digestive system and food intake, the pregnancy should be delayed for at least a year after surgery.

      Would I feel pain after Laparoscopic Sleeve Gastrectomy?
      Compared to conventional surgeries, the pain is minimal after Laparoscopic Sleeve Gastrectomy. This is one of the most beneficial qualities of Laparoscopic Surgery in treating obesity. We control the pain with painkillers postoperatively to accelerate the convalescence. The absence of pain after surgery surprises most patients. Pain tolerance differs from one patient to the other and the pain goes away in time.

      When can the patient walk after Laparoscopic Sleeve Gastrectomy?

      The patient can walk two hours after the surgery and patient should walk every two hours throughout the  hospital stay. This is one of the most beneficial qualities of Laparoscopic Surgery in treating obesity
      Because it prevents many complications especially like vein thrombosis that is caused by immobility after the surgery.
      Does Laparoscopic Sleeve Gastrectomy treat the complications of obesity?
      Sleeve gastrectomy treats complications of obesity like diabetes and joint diseases along with hypertension and heart functions. Laparoscopic Sleeve Gastrectomy improves reproductive capacity of women

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