Ambulatory Sleeve Gastrectomy
Conveniently located to serve the areas of Houston and Katy
Sleeve gastrectomy can be safely performed as an outpatient procedure or ambulatory surgery. Our surgery center is a Center of Excellence in Bariatric Surgery as designated by the American College of Surgeons. One of the challenges in outpatient surgery is achieving adequate pain control during the recovery process.
Dr. Ricardo M Bonnor with contributions from the anesthesia care team has developed a protocol for perioperative pain and nausea control providing high patient satisfaction and rapid recovery. Contact Texas Endosurgery Associates at (281) 579-5638 to schedule a consultation.
Contents
Before and After Photos
Positive Health Impact of Sleeve Gastrectomy
Sleeve gastrectomy is the most popular bariatric surgery worldwide. (1) The benefits of ambulatory sleeve gastrectomy extend beyond just weight loss. Many patients experience improvements in obesity-related comorbidities such as type 2 diabetes, high blood pressure, sleep apnea, and joint pain. (3) In addition weight loss surgery has been proven to help with PCOS and thus increase fertility rate. Furthermore, the psychological impact of achieving significant weight loss can greatly improve self-esteem, body image, and overall quality of life.
Same-Day Discharge
Traditionally, sleeve gastrectomy requires a hospital stay of one to two nights. However, advancements in surgical techniques, anesthesia, and patient management have made it possible for eligible candidates to go home on the same day as their surgery. Studies have demonstrated that this type of ambulatory sleeve gastrectomy treatment plan is both feasible and safe. (4)
Candidates for Ambulatory Sleeve Gastrectomy
Candidates for ambulatory sleeve gastrectomy require a BMI of 30 or greater with a maximum BMI of 50 without significant comorbidities. Patients with sleep apnea are typically not candidates for ambulatory sleeve gastrectomy. The main concern when considering sleeve gastrectomy for individuals with sleep apnea is the potential exacerbation of breathing difficulties. During the surgery, the patient is placed under general anesthesia, which can temporarily suppress the respiratory system. This suppression, combined with the already compromised airway function in sleep apnea patients, can increase the risk of postoperative complications and breathing-related issues. To find out more about candidacy requirements, please see the Am I a Candidate for Weight Loss Surgery?
Ambulatory Sleeve Gastrectomy
Prior to your surgery date, you will meet with the Bariatric Nurse Coordinator as well as the anesthesia care team for a preoperative evaluation and education session to discuss expectations on the day of surgery and postoperative care instructions.
The total procedure time for a sleeve gastrectomy is usually one hour. After the conclusion of the operation, highly qualified healthcare personnel will monitor you for an additional 4 to 6 hours in the recovery area.
Preoperative Tests
Dr. Bonnor will require preoperative tests such as upper GI which is a radiology test to see your anatomy prior to surgery. In addition, you will need basic blood work, imaging, and an electrocardiogram (ECG).
Medications
Our healthcare team may advise you to adjust or temporarily stop taking certain medications prior to surgery. It is crucial to follow these instructions carefully to minimize any potential complications during the procedure.
IMPORTANT: If you are taking a GLP-1 agonist such as Ozempic, Monjauro or Wegovy, you will need to stop these medications at least one week prior to surgery.
Post-Surgery Recovery
We recommend that you sleep reclined at approximately 30 to 45 degrees the night of surgery. Maintaining a good hydration regimen using the instructions provided to you will avoid complications, dehydration, and potential return to the emergency room. Patients with a sleeve gastrectomy can start taking their multivitamin two weeks after surgery using over-the-counter 1 a day or Centrum. Most patients can return to work within a week. After two weeks, patients can get into a pool or use a bathtub if desired and can work out and resume exercise gently after three weeks post surgery.
Nutrition
Adhering to specific dietary guidelines is crucial during the recovery period to promote proper healing and achieve desired weight loss results. This includes two weeks of liquid nutrition surgery post-surgery followed by two weeks of puree diet, followed by a soft diet for three months.
Commonly Asked Questions (FAQ)
What are the advantages of sleeve gastrectomy?
Sleeve gastrectomy offers numerous benefits beyond weight loss. It can improve or resolve obesity-related health conditions such as type 2 diabetes, high blood pressure, sleep apnea, and infertility. Additionally, patients often experience increased energy levels, improved mobility, and enhanced self-confidence.
What are the alternatives to a sleeve gastrectomy?
While there are other weight loss surgery options available, including gastric bypass surgery, sleeve gastrectomy has become increasingly popular due to its effectiveness and low-risk profile. However, the best option for you will depend on your individual needs and medical history. Consulting with a qualified bariatric surgeon is essential to determine the most suitable approach for your weight loss journey.
What dietary changes will I need to make after a sleeve gastrectomy?
Following surgery, you will start a two-week liquid diet consisting of clear and liquid protein. Subsequently, you will advance to a pure diet. And these specific instructions will be handed to you on the amount and types of foods. Then you will be on foods that have a soft texture consistency and provide high-quality protein while maintaining lower carbohydrate and fat intake. It is also crucial to add exercise to maximize the effectiveness of the surgery.
Can I remove a gastric band and opt for a sleeve gastrectomy?
Some patients may experience complications from gastric banding or find that the gastric band does not provide the desired level of weight loss. In such cases, removing the gastric band and revising to a sleeve gastrectomy in the same surgery setting is a realistic alternative. This decision should be made in consultation with an experienced bariatric surgeon who can evaluate your unique situation, medical history, and weight loss goals.
References
- Barqawi A, Abushamma FA, Akkawi M, et al. Global trends in research related to sleeve gastrectomy: A bibliometric and visualized study. World Journal of Gastrointestinal Surgery. 2021;13(11):1509-1522. doi:https://doi.org/10.4240/wjgs.v13.i11.1509
- Bhatia P, Bindal V, Singh R, et al. Robot-Assisted Sleeve Gastrectomy in Morbidly Obese Versus Super Obese Patients. JSLS : Journal of the Society of Laparoendoscopic Surgeons. 2014;18(3):e2014.00099. doi:https://doi.org/10.4293/jsls.2014.00099
- Kheirvari M, Dadkhah Nikroo N, Jaafarinejad H, et al. The advantages and disadvantages of sleeve gastrectomy; clinical laboratory to bedside review. Heliyon. 2020;6(2). doi:https://doi.org/10.1016/j.heliyon.2020.e03496
- Safiya Al-Masrouri, Abdulaziz Alnumay, Vourtzoumis P, et al. Ambulatory sleeve gastrectomy: a prospective feasibility and comparative study of early postoperative morbidity. Surgical Endoscopy and Other Interventional Techniques. 2022;37(7):5553-5560. doi:https://doi.org/10.1007/s00464-022-09721-w