Gastric sleeve surgery: a comprehensive guide to weight loss and costs in 1404
Dr. Farbad Emami Yeganeh
تهرانLaparoscopic surgery fellowship
عمل اسلیو معده چیست و چگونه به کاهش وزن کمک می کنید؟
عمل اسلیو معده نوعی جراحی لاغری برای کاهش وزن پایدار و همیشگی است. در این عمل جراحی بخش بزرگی از معده از بدن بریده و خارج می شود و معده باقی ماند یک موز خواهد شد. This new stomach causes the person to receive less food and by reducing the amount of food received during the day, the person will gradually lose weight.
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Why gastric sleeve operation is the best method for sustainable slimming?
People whose BMI is above 35 are unlikely to achieve sustainable weight loss through diet and exercise alone. Therefore, the goal of gastric sleeve operation is to make a permanent change in the amount of food received by the body by shrinking the stomach. With this method, the volume of the stomach will be permanently reduced (about 25% of the original stomach). This new and sleeved stomach has a volume of about 150 to 250 cc and will no longer be able to receive the large volume of food that has caused obesity. This issue causes a person to lose weight permanently.
Types of sleeve surgery
This surgery is performed in two ways. In the first method, laparoscopically and with incisions made from the abdomen. In this method, the surgeon uses a special instrument to operate inside the abdomen and cut about 75-80% of the stomach and remove it from the body. In the second method, through the mouth and by means of an endoscope, a tube enters the stomach through the mouth and staples the stomach from the inside. In the endoscopic method, no stomach is removed from the body.
In the laparoscopic method, the instrument is created through small incisions on the patient's abdomen, and the surgeon performs the surgery from the inside without an open incision.
In the endoscopic method, the surgical procedure is performed without making an incision and through the entrance channel of the digestive system (mouth) (of course, the endoscopic method has a high rate of return due to the absence of exiting the top of the stomach and is not very effective).
Advantages of gastric sleeve operation
Among the benefits of sleeve is reducing the secretion of ghrelin hormone and thus reducing appetite and controlling the feeling of hunger. Also, because this surgery is performed laparoscopically (closed and with several small holes), it is associated with minimal invasion, scarring and side effects.
This surgery has a very short recovery period and the weight loss process is very gentle. The treatment of most obesity-related diseases is also one of the advantages of sleeve gastrectomy. Also, the amount of changes made to the patient's digestive system in this surgery is less compared to bypass operation.
- Sustainable weight loss
- Suitable for bulky eaters
- Sometimes more weight loss than bypass in men
- Mild weight loss compared to bypass
- Low changes in the digestive system
- Non-invasive surgery
- Little pain or no pain
Stages of gastric sleeve surgery
Gastric sleeve is a series of surgeries on the patient's digestive system, which is performed in a maximum of one hour. First, the patient must be completely anesthetized, and the patient's abdomen will be sterilely prepared for small cuts on it. The different stages of this surgery are:
The patient is completely anesthetized and does not feel any pain during the operation. In the laparoscopic method, the instrument is created through small incisions on the patient's abdomen, and the surgeon performs the operation closed and without open incisions from the inside.
The surgeon makes several small incisions (usually 5) of 5 to 10 mm in size in the abdomen for the insertion of laparoscopic instruments.
The abdomen is filled with carbon dioxide gas to create enough space for surgery and to improve the surgeon's vision.
Laparoscopy surgical instruments, including a trocar (for inserting instruments) and a camera, are inserted into the abdomen through small incisions.
A large part of the stomach (about 70-80%) is cut using special tools and removed from the body through one of the small incisions.
The remaining edges of the stomach are closed using the same surgical staples to prevent any leakage of stomach contents.
Comprehensive patient guide for gastric sleeve operation
Gastric sleeve surgery is also performed in two ways, narrow and wide, according to the volume of the stomach that leaves the body. We should know that tight and wide sleeve is a highly specialized term. The surgeon who specializes in laparoscopic surgery and bariatric surgery may make the sleeve narrower or wider depending on the body conditions of each person.
But this difference is not so much that you imagine, for example, instead of 75% of the stomach volume, the surgeon wants to remove about 40%. This is because for any surgery to be more effective, it must be performed with the correct and complete technique. Therefore, the difference between narrow and wide sleeves is a few millimeters, which will be performed by the surgeon in a specialized manner.
Weight loss process after gastric sleeve operation
The process of weight loss after gastric sleeve surgery is a gradual and continuous course that starts at a high speed at the beginning of the period and over time, its speed decreases. In the first weeks after surgery, due to the severe limitation in the amount of food consumed and the body's metabolic changes, a significant weight loss is observed. This initial weight loss is mainly due to lower caloric intake and metabolic reactions to the surgery. As time passes and the body adapts to new conditions, the rate of weight loss is moderated and becomes a more stable process.
Generally, the greatest amount of weight loss occurs in the first 6 to 12 months after the operation, and after that, the weight loss process slows down and moves towards weight stabilization. At this stage, maintaining the lost weight and preventing its return is of great importance. To achieve this goal, it is necessary to change the lifestyle and adhere to the principles of healthy eating and regular physical activity.
| Duration after operation | Lose extra weight |
| The first two weeks | 5 to 10 kg |
| one month | 10 to 15% extra weight |
| three months | 25 to 35% extra weight |
| Six months | 35 to 50% extra weight |
| Nine months | 50 to 70% extra weight |
| one year | 70 to 80% extra weight |
It should be noted that the exact amount of weight loss in each person will be different, depending on factors such as initial weight, age, gender, health status and the degree of commitment to medical and nutritional recommendations. Therefore, it is very important to consult a doctor and nutritionist and get personal guidance to achieve the best result.
The cost of performing a slave operation 1404
The cost of gastric sleeve surgery in 1404 is between 130 and 140 million tomans.
| Cost Description | Approximate price |
| Preoperative consultation | 8 million Tomans |
| The cost of gastric staplers and the handle required to use them | 42 million Tomans |
| Hoteling and hospitalization and hospital and surgery cost | 45 million tomans |
| Cost of postoperative supplements | 10-15 million Tomans |
| Total cost | 130 to 140 million tomans |
Some of this cost is related to operating room equipment and hospital accommodation, and part of it is related to the surgeon's salary and assistants. Of course, if you want to enjoy special conditions or a private room and sometimes VIP, this cost may increase.
Long-term effects of sleeve operation
Possible side effects of gastric sleeve surgery are as follows:
- Creating Acid Reflux into the Esophagus: The return of stomach acid into the esophagus which can cause heartburn and other unpleasant symptoms.
- Possibility of causing stenosis in the future: Narrowing of a part of the stomach body that can cause difficulty in passing food.
- Gastric rotation: This complication is largely preventable with modern surgical techniques.
- Nutrient deficiency: Due to the reduction in the amount of food consumed, there is a possibility of a deficiency of some nutrients such as vitamin B12, vitamin D, folate, zinc and iron.
Many of these complications are caused by not following a balanced and sufficient diet after gastric sleeve surgery. Normally, the absorption of nutrients after this procedure is done well, but some people do not consume enough nutrients after the sleeve. Therefore, it is very important to follow a complete and balanced diet after gastric sleeve. By reducing the volume of the stomach after surgery, it is necessary to ensure that all food groups and essential nutrients are included in the diet.
Diet after sleeve operation
Diet after gastric sleeve surgery is one of the most essential needs of patients; Because, like Mini Bypass Surgery, due to the changes made in the digestive system, these people will not be able to eat normal foods for a few weeks after the surgery. Therefore, patients should follow a special and phased diet until the new stomach is fully ready to accept solid foods. Failure to follow these dietary precautions after gastric sleeve surgery can cause serious damage to the patient's new stomach.
1- the first week; The hardest time
It is very important to follow the nutrition tips in the first week after the gastric sleeve, because this period may be the most difficult time for the patient. However, the stomach gradually gets used to a variety of foods and the patient can resume eating different foods after a while. During the first week, strictly avoid the following:
- Drinking liquids with a straw
- chewing gum
- Consumption of industrial juices and sugary drinks
- Consumption of sweet and high-calorie drinks
- Consumption of carbonated and alcoholic beverages
- Consumption of coffee and caffeinated drinks
- Consumption of solid and semi-solid foods
- Consumption of the combination of warm milk and egg yolk
- Consumption of milk (alone)
- Hooping while drinking liquids
2- the second week; Increasing the variety of fluids consumed
In the second week after the gastric sleeve, it is recommended to drink liquids like the first week, 8 to 10 glasses of clear and diluted liquids during the day, and still avoid solid foods due to the possibility of nausea and vomiting. Consumption of low-fat milk (1.5%) is allowed in case of diarrhea and flatulence, maximum one to two cups per day. Consuming protein shakes and supplements is possible only with the prescription of the doctor and the nutrition team, and a maximum of 25 to 30 grams (sometimes twice a day) and must be well dissolved in water. Also, the consumption of low-fat yogurt (maximum of a quarter of a cup per meal, two meals a day) or Greek yogurt (with slow chewing) and warmed low-fat butter without gas and a cup of sugar-free diet jelly (with complete chewing) is safe. is.
3- the third week; Semi-solid and pureed food
In the third week after the gastric sleeve, the consumption of soft and cooked foods (such as baby food and pureed with a blender) is allowed, and solid foods should still be avoided. It is recommended to have three main meals and two snacks, first each meal is half a cup and gradually increase to a small bowl. If there is a problem with any food item, remove it and stop eating as soon as you feel full.
Each meal should include 30 grams of cooked and pureed vegetables and 30 to 50 grams of pureed protein, and each meal should take 20 to 30 minutes. To prevent dehydration, drink 8 to 10 glasses of water a day (avoid half an hour before and an hour after meals) and avoid lying down immediately after meals (at least 45 minutes apart).
4- the fourth week; Texture diversity in diet
In the fourth week after the gastric sleeve operation, you can add soft and semi-solid foods to your diet, but the foods should still be very soft and each bite should be chewed 30 to 40 times. It is necessary to consume 6 to 8 glasses of water and liquids a day, and three main meals and two snacks should be observed, spending 20 to 30 minutes for each meal and stopping eating as soon as you feel full.
- Minced meat
- skinless and soft fruits
- Chicken, soft and cooked meat and fish
- Soups and soups with soft and cooked ingredients
- low-fat and low-salt cheese
- Boiled Egg
- low-fat yogurt
- soft baked potato
- boiled and cooked rice (recommendation to read the article about the consumption of rice and bread after gastric sleeve)
5- the fifth week; Return to normal diet
In the fifth week after gastric sleeve surgery, it is possible to gradually return to the usual diet. It is recommended that in the beginning, the consumption of softer foods should be prioritized and each bite should be chewed carefully 30 to 40 times. Continuation of the correct eating habits practiced in the previous weeks is also important in this period. Drinking enough liquids during the day should not be forgotten.
Avoid the consumption of carbonated drinks and spicy and spicy foods that can irritate the digestive system. There is a possibility of unwanted reactions such as nausea to some foods, in which case, it is recommended to eliminate that food in consultation with the attending physician. Avoiding high-calorie foods, sweets and chocolate will also be effective in preventing weight gain.
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Opinions of patients after gastric sleeve surgery
The experience of those who have performed gastric sleeve surgery can be very useful for others. Using the experiences of loved ones can be very helpful for you to make better decisions.
35 kg weight loss in 5 months
I started a healthy life without any complications and returned to my normal routine two weeks after the operation. I am extremely satisfied with my new life and if I go back, I will do this procedure again with Dr. Emami.
12 kg weight loss in two weeks
I am very satisfied. Currently, I walk for half an hour a day. Before the operation, my blood pressure was high, my blood fat was high, and my liver was fatty. I thank you for doing me a good deed.
40 kg weight loss in one year
31 kg weight loss in 6 months
After two months of the sleeve operation, my hair loss stopped completely. I didn't have any loose skin at all, and I thank Dr. Emami's wonderful team.
40 kg weight loss in one year
In this one year, I lost 40 kg and I feel really good. In this one year, following the advice and prescriptions of the doctor, I did not find any sagging or drooping. I don't know how to thank the doctor and his team. I feel really good now.
39 kg weight loss in 6 months
My sister had already been operated by the doctor and she was very satisfied, and I was also encouraged to consult and operate with the doctor. By following the diet prescribed by the doctor and exercising, you can reach your ideal weight without sagging and sagging skin.
Is gastric bypass better or gastric sleeve?
Usually, gastric sleeve is recommended to the bulky eaters and gastric bypass to the small and sweet eaters, but the final decision is better to be made under the supervision and advice of a specialist doctor. Watch the video below for more details.
Dr. Farbad Emami Yeganeh
bariatric surgery specialist in Tehran
advanced obesity surgery and laparoscopy in Tehran
- Official member of the International Federation of Bariatric and Metabolic Surgeons (IFSO)
- Official member of the American Society of Bariatric and Metabolic Surgeons (ASMBS)
- Member of Physicians and Surgeons of the United Arab Emirates (DHA)
- Member of the Iranian Endoscopic Surgeons Association
FAQ
People who suffer from uncontrolled binge eating and are unable to lose weight will be good candidates for this surgery. Of course, people who have a low BMI should choose exercise and diet to lose weight. Bariatric surgery is performed only in people with BMI>35. Of course, people with BMI>30 who have diseases such as high blood pressure, diabetes, obstructive sleep apnea, etc. are also suitable candidates for this surgery.
The length of the recovery period after gastric sleeve is between 2-3 days on average and may reach 2-3 weeks in some patients. After a few days, patients will be able to resume their physical activities such as walking and be on the road to recovery.
It is often thought that gastric sleeve is only a bariatric surgery that is performed with the aim of weight loss. Meanwhile, this surgery has other therapeutic aspects as well. What are the other therapeutic aspects of gastric sleeve? Helping cardiovascular health, improving type 2 diabetes, improving high blood pressure and blood lipids, treating sleep apnea or breathing interruptions, reducing joint pain, reducing symptoms of polycystic ovary syndrome, and improving fatty liver are among the most important therapeutic aspects of this surgery. Of course, this surgery plays an important role in the treatment of infertility, asthma, migraine, depression, gout, urinary incontinence and preventing the occurrence of all types of cancers.
Weight return after gastric sleeve surgery is an important and worrying issue for many patients who perform this surgery to lose weight. Gastric sleeve surgery in itself is an effective way to lose weight, but without the necessary care and follow-up, there is a possibility that the weight will return.
The cost of gastric sleeve surgery varies depending on the country, hospital, surgeon's experience and insurance coverage. Usually, this cost includes pre-surgery consultations, surgery itself, post-surgery care and follow-up visits. Currently, in 1403, the cost of gastric sleeve operation costs about 110 million Tomans.
Many insurances cover the cost of gastric sleeve surgery, especially if it is necessary due to obesity-related health problems. It is better to consult with your insurance company before surgery to know the details of insurance coverage.
The appropriate weight for sleeve surgery depends on the patient's height and BMI. However, on average, it can be said that this surgery is suitable for people who are overweight up to 50 kg.
In excess weight above 50 kg, this surgery will not be as powerful as bypass surgery in weight loss. Also, this surgery is not performed in cases where the excess weight is up to 10 kg. In cases where excess weight is very high, the sleeve will be performed first, and then after two years, the bypass operation will be performed.
Gastric sleeve operation is performed only for patients who are between the ages of 16 and 70.
The patient can leave the bed immediately after the anesthesia effects of gastric sleeve disappear, and this will be the beginning of his activity after surgery. Sitting on the edge of the bed and shaking your legs is enough at this stage. This is done with the aim of preventing complications such as pulmonary embolism. Leg exercises should be repeated 2-3 times a day.
The intensity of the patient's activity is determined by the surgeon, but physical activity can increase the speed of his recovery. At least 15 minutes of walking during the day is recommended for all patients. Physical activity and exercise help to restore the patient's physical strength after surgery. The patient should avoid heavy work. Therefore, the patient may need 10 days to 2 weeks off from work.
