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The laparoscopic or open sleeve gastrectomy is one of the newer surgical procedures which has gained increasing popularity over the past few years. The sleeve gastrectomy is also a surgical component of the laparoscopic or open duodenal switch procedure. When performed alone or as a stand alone procedure it has shown surprising and better than expected results.

With this procedure, the surgeon removes approximately 60 percent of the stomach laparoscopically so that the stomach takes the shape of a tube or "sleeve". This procedure is usually performed on super obese or high risk patients with the intention of performing another surgery at a later time. The second procedure can either be a gastric bypass or duodenal switch.

What is Laparoscopic Lap Sleeve Gastrectomy?

The vertical sleeve gastrectomy, more simply called the sleeve gastrectomy, is an operation in which the left side of the stomach ("greater curvature") is surgically removed. This results in a new stomach that is roughly the size and shape of a banana. Since this operation does not involve any "rerouting" or reconnecting of the intestines, it is a simpler operation than the gastric bypass or the duodenal switch.

Unlike the LAP-BAND® procedure, the sleeve gastrectomy does not require the implantation of an artificial device inside the abdomen.

In some cases, the sleeve gastrectomy is performed as a definitive therapy for obesity. For certain patients, in particular those with a body mass index greater than 60, the sleeve gastrectomy may be the first part of a 2-stage operation.

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How does the Sleeve Gastrectomy promote weight loss?

The sleeve gastrectomy works through 2 mechanisms:

• It makes the stomach smaller, so you feel full after eating a smaller meal.
  
• The fundus of the stomach is removed. This is the area that secretes ghrelin, a hormone that makes you feel hungry. So, the sleeve gastrectomy helps you to feel less hungry through a hormonal mechanism.

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What Are the Advantages of the "Sleeve Gastrectomy?"

The sleeve gastrectomy has a number of advantages over other bariatric procedures:

• It does not require disconnecting or reconnecting the intestines
  
• The stomach is reduced in volume but tends to function normally so most food items can be consumed, albeit in small amounts.
  
• Eliminates the portion of the stomach that produces the hormones that stimulates hunger (Ghrelin).
  
• It is a technically simpler operation than the gastric bypass or the duodenal switch. Some data suggest that the operation may be safer than gastric bypass or duodenal switch
  
• Unlike the Lap-Band procedure, the sleeve gastrectomy does not require the implantation of an artificial device inside the abdomen.
  
• It is known to reduce hunger by removal of hunger stimulating hormone producing part of stomach
  
• Unlike gastric bypass & gastric band, patients feel full with liquids as well.
  
• No dumping syndrome because the pylorus is preserved.
  
• Minimizes the chance of an ulcer occurring.
  
• By avoiding the intestinal bypass, the chance of intestinal obstruction (blockage), anemia, osteoporosis, protein deficiency and vitamin deficiency are almost eliminated.
  
• Very effective as a first stage procedure for high BMI patients (BMI>55 kg/m2).
  
• Limited results appear promising as a single stage procedure for low BMI patients (BMI 35-45 kg/m2).
  
• Appealing option for people with existing anemia, Crohn's disease and numerous other conditions that make them too high risk for intestinal bypass procedures.
  
• Can be done laparoscopically in patients weighing over 500 pounds.

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What is a 2-Stage Operation?

Certain patients may have a body shape that makes their surgery more technically difficult. For example, patients with a BMI over 60 -- particularly those who carry their weight in their belly area -- may be at increased risk for bariatric surgery. If you fall into this category, you may benefit from a 2-Stage bariatric surgery.

In the staged approach, a multi-step operation like the gastric bypass or the duodenal switch is broken down into 2 simpler and safer operations. In the first stage, a sleeve gastrectomy is performed. This allows losing 80 to 100 pounds or more, which will make the second part of the operation substantially safer.

The second stage operation is usually performed 8 to 12 months after the first. The "sleeve" stomach is converted into a formal gastric bypass or duodenal switch. This will permit additional weight loss and will provide a much more permanent result than sleeve gastrectomy alone.

Both stages of the surgery can be performed laparoscopically, giving the advantage of shorter recovery, shorter incisions, fewer incision-related problems and less pain.

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Am I a good candidate for Lap Sleeve Gastrectomy?

If you:

• Are at least 100 pounds above ideal body weight
  
• Are at least 80 pounds over weight and have life-threatening obesity related problems such as diabetes, hypertension, sleep apnea, etc.
  
• Have failed non-surgical attempts at weight loss, specifically a combined regimen of diet and exercise,

You may be a good candidate for Lap sleeve Gastrectomy procedure.

If you are interested in weight loss surgery and want get the expert opinion about your candidacy for the surgery, fill up the obesity surgery eligibility form and send it to us.

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How do I know what kind of surgery is the best for me?

Your surgeon will work with you to determine what type of surgery is best for you.

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How long is the average recovery period after Lap sleeve Gastrectomy?

You would need to stay in the hospital for about 3/4 days after the surgery. Typically, it'll be about a week before you can go back to work, and about a month to six weeks before you can start exercising again.

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How much weight loss can I expect after the surgery?

Most patients can expect to lose 30 to 50% of their excess body weight over a 6 - 12 month period with the sleeve gastrectomy alone and overall 60 percent to 80 percent of their excess body weight. The timing of the second procedure will vary according to the degree of weight loss, typically 6 - 18 months.

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What health conditions show improvement with sleeve gastrectomy Surgery?

Most sleeve gastrectomy patients find that their obesity related health conditions either improve or disappear completely as they lose weight. If you have medical conditions such as type 2 diabetes, high blood pressure (hypertension), obstructive sleep apnea, and knee pain, it is likely that you too will see your health improve as you lose weight.

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What diet and lifestyle do I have to follow after the surgery?

After surgery, your surgeon will have you slowly advance thru varying stages of the post-op diet. It is important to follow your doctor's recommendations in order to heal properly, be properly nourished, and avoid complications. Your doctor will monitor your healing process, which will take about 4 to 8 weeks.

The diet program after the surgery is one of the most important conditions for good weight loss and for avoiding the complications of method failure or even risk to heath state! It is possible and very appropriate to start with adequate exercise approximately two weeks after the surgery, which helps to loose weight.

The essential change is in drinkable regime. It is not allowed to drink after a meal only between each food intake. It is though necessary to drink at least 2 liters a day, always in between the meals.

You can eat only liquid food during first days after the surgery. It prevents damage of the suture line of the stomach wall by excessive expanding of the rest of the stomach. You can switch from mixed food to normal, diverse, diet and rational food after another two weeks. You will have to limit the calories intake by yourself.

It is very important that you bite thoroughly the food before every swallow, much more than you were used to before the surgery. It is recommended to avoid raw, unpeeled fruit and vegetable or insufficiently prepared meet. It is necessary to keep classic food layout:

Breakfast, snack, lunch, snack, dinner. The amount that is possible to eat at once is substantially lower than before the surgery. The food has to remain reducing with low content of fat and sufficient intake of proteins and vitamins.

Exercise is important in the recovery from any operation. Walking is one of the most effective forms of exercise for this purpose. A regular exercise program is highly recommended. Begin with very short walks several times a day and gradually increase the distance. Walking also improves muscle tone while you are losing weight. Do not, at first, engage in strenuous exercise. For example, do not lift more than ten pounds at a time. About six weeks after surgery, you should be able to tolerate all but the most strenuous exercises.

Do not sit or stand in one place for a long period of time. Light housekeeping chores may be performed when you feel you are able. Driving a car is usually permitted one week after surgery. Sexual activities may be resumed unless otherwise specified. Most people are able to return to light work after ten days and to heavy labor after six weeks. The time of your return to work will depend upon the physical demands of your job and the rate of your recovery.

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How do I begin to undergo the Laparoscopic sleeve gastrectomy Surgery?

Having bariatric surgery is a life-changing procedure and is one that should be considered carefully. The following steps can help you prepare you for surgery and the changes that you will go through.

• Educate yourself about bariatric surgery. Learn everything you can about bariatric surgery.
  
• Make lists of the following:
  
• Medications (both prescription and over-the-counter) and the dosages you take.
  
• Foods you like and those you can not tolerate.
  ◦Medical records, especially any recent cardiac stress testing, to minimize repeat tests.
  
• Start making important changes in your eating and exercise habits. Doing this can help prepare you for the life changes that you will need to make after surgery. These are some of the necessary dietary and behavioral changes that you need to start:
  
• Drink at least 64 ounces of water daily.
  
• Switch from caffeine to decaffeinated beverages
  
• Keep a detailed written food diary.
  
• Eat at least three meals per day and avoid snacking in between. Don't worry about the calories for now, focus on the behavior.
  
• Begin a walking program if able.
  
• Stop smoking. Smoking slows the healing process and may cause respiratory problems after surgery. If you need help, ask your doctor.
  
• Write down your feelings every day to remind yourself of your commitment to begin a new and healthier lifestyle and the alternatives if you don't.

Attend support groups. Having an environment that is filled with support and encouragement is necessary for any patient that undergoes bariatric surgery.

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Please guide me step by step to have Gastrectomy surgery done in India

• About two weeks before your surgery, the surgeon will have you begin a special diet. The pre-op diet is important because it is designed to get your body ready for surgery and make recovery easier. You will need to lose fat around your stomach and liver, as well as shrink the liver itself. The diet helps reduce potential bleeding that can accompany surgery by reducing fatty triglycerides from around the liver and spleen. A primary part of the pre-op diet is a protein supplement. Myocel, a protein powder, is designed to lower the fat content of the liver, maximize recovery, and promote weight loss. Myocel can be mixed in with skim milk, water, fruit juice, or fat-free yogurt. Foods that will need to be decreased in your diet include high-sugar foods, high carbohydrate foods (including bread), fats (such as butter), fatty meats, fried foods, whole milk products, and alcohol. Your diet will be limited, but foods that may be included are yogurt, fruit, cereal, eggs, oatmeal for breakfast and lean meat or fish with green vegetables for dinner. Pre-op diets may vary between surgeons and patients, but you should always follow the recommendations of your doctor. You would be asked to quit smoking a few days before the surgery.
  
• You can choose to combine the procedure with a spa treatment or Ayurveda rejuvenation package or side trip in India before the surgery.
  
• The case manager would make a detailed itinerary for you, with the quote. .
  
• Please make a deposit to secure the booking for you.
  The case manager keep in touch with you regularly with the pre op diet plan and surgeon’s instructions.

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