Sleeve Gastrectomy - Stomach Reduction Surgery

Gastric sleeve gastrectomy is an operation in which the volume of the stomach is reduced by entering through small holes in the abdominal wall (laparoscopy). It is called sleeve gastrectomy because of the shape of the new stomach. With the removal of approximately 80% of the stomach, 150 - 200 cc volume of stomach tissue is left behind. Since the stomach volume will decrease with sleeve gastrectomy surgery, the person will feel full faster with less food and will not consume as much food as before. Since the upper large part of the stomach (fundus) is removed with sleeve gastrectomy, the hunger hormone ghrelin released from here is also reduced and most patients do not feel hunger after surgery. The ghrelin hormone is produced again from the small intestine after about 6 months and appetite returns. Although the appetite returns to normal, the stomach volume is reduced, so the person fills up quickly and continues to lose weight towards healthy weight. 

The sleeve gastrectomy is actually the first half of the more complex 'duodenal switch' surgery that has been performed since the 1960s for weight loss. Since the duodenal switch surgery is more complex and riskier, especially in the super obese, the surgery started to be performed in two stages. In the first session, only the stomach was reduced and patients were told to come back for the second stage after 6 months. In the second stage, the duodenal switch method would be completed, that is, the complex bypass part over the small intestines would be applied. But something unexpected happened, although the patients had super obesity, they lost weight at the rate they wanted with the sleeve gastrectomy and did not need the second stage. In this way, it was coincidentally understood that 'sleeve gastrectomy' is a sufficient weight loss surgery on its own! 

Gastric sleeve surgery can be summarized as follows: 

• Sleeve gastrectomy is the most common bariatric surgery method. 
• Before the surgery, the liver is reduced by a 2-3-day liquid diet. Comprehensive tests are performed on the morning of the operation or the day before. 
• Gastric sleeve surgery is performed laparoscopically (closed) under general anesthesia and takes 45-60 minutes. 
• After the operation, the patient waits in the recovery room for 30 minutes, then goes to his/her room and can get up and walk after 2 hours. 
• The patient can drink very little water 3 hours after the operation and can melt ice in his/her mouth and swallow the water. 
• The day after the operation, a medicated stomach film is taken and if it is normal, clear liquid food is started. You can take a shower while in the hospital. 
• After 2 nights in the hospital, the patient is discharged and can travel out of the city by land, air or sea. 
• After sleeve gastrectomy surgery, you can return to desk work on the 3rd day and to work that requires physical strength on the 7th day. 
• Nutrition after sleeve gastrectomy is explained by the dietician in the hospital and then support is provided at regular intervals through online or face-to-face meetings. 
• With sleeve gastrectomy surgery, there is less need for vitamin supplements compared to bypass methods. 
• In the first 6 months after sleeve gastrectomy, 80% of the excess weight can be lost. Weight loss takes 18 months. 
• Sagging skin after surgery is more common especially in women weighing 120 kg and over. Therefore, it is very important not to neglect excess weight. 
• Obesity brought by sleeve gastrectomy surgery, 
• Insulin resistance decreases. 
• Diabetes improves. 
• High blood pressure returns to normal. 
• Fatty liver disease improves. 
• Sleep apnea disappears. 

The most important feature of sleeve gastrectomy surgery, which can provide highly effective and permanent weight loss when performed in accordance with the standards, is that the food progresses naturally in the system, although changes are made in the digestive system. In this way, vitamin and mineral deficiencies after gastric sleeve surgery are less common and easier to correct compared to other methods. In a way, it can be considered as a more organic method. 

How Much Weight Should I Be?

Gastric sleeve surgery can be applied to anyone between the ages of 11 and 65 who cannot reach or maintain a healthy weight with diet and exercise. Gastric sleeve surgery can also be applied in older people (65+) with good fitness. Body fat ratio is roughly calculated by Body Mass Index (BMI). It is found by dividing our weight by the square of our height. If a person 1.65 meters tall weighs 91 kg; 91/1.65x1.65= 33.4 (BMI), that is, the fat ratio is considered to be approximately 33.4. You can calculate your BMI by entering your height and weight in the boxes below. 

If your BMI and fat percentage are above 30, you have an OBESITY problem.

If the body mass index (BMI) and fat percentage are above 30, there is a problem of OBESITY. 

Those with a body mass index (BMI) of 40 and above, 
Those with a body mass index (BMI) between 40 and 35 with co-morbidities such as diabetes, high blood pressure, sleep apnea and fatty liver disease, 
Those with a body mass index between 30 and 35, who have comorbidities and for whom the social and psychological burden of obesity is greater than the complications of the surgery, may be considered suitable for sleeve gastrectomy. 
Those with a body mass index between 27-30 may be suitable for non-surgical methods. 
When answering the question “Can someone who weighs 90 kg have gastric sleeve surgery?”, taking into account that 80% of our patients are women and the average height of women in Turkey is between 1.65 - 1.68m, BMI is in the range of 32-33 when calculated. Although it is recommended that the BMI or body fat ratio should be above 35% in order to be able to undergo sleeve gastrectomy surgery, due to the increasing technology and the decrease in the complication rates of sleeve gastrectomy surgery, the decision of sleeve gastrectomy surgery can be taken by discussing the issue mutually in selected patients with a BMI in the range of 30-35. 

Similarly, the questions such as “Can someone who weighs 80 kg have sleeve gastrectomy?” or “Can a person who weighs 100 kg have sleeve gastrectomy?” should be answered by calculating BMI, in other words, body fat ratio, as we have explained above. 

What is the Age Limit for Surgery? Can it be performed on children? 

Although the age limit for sleeve gastrectomy surgery is classically given in the range of 18-65, in the light of increasing experience and knowledge in obesity surgery, these limits have been exceeded up and down today. 

In adolescents under 18 years of age or children in general, the decision for sleeve gastrectomy surgery is made with parental consent. In our practice, we seek the opinion of an endocrinologist before deciding on obesity surgery in children. While gastric sleeve surgery in children does not disrupt their physical development, it is positively effective in their psychological development and self-confidence. The team performing gastric sleeve surgery in children and especially the surgeon must be experienced in the field of obesity surgery. In our clinic, dozens of children have undergone gastric sleeve surgery under appropriate conditions over the years and continue their healthy lives. 

In people over 65 years of age, gastric sleeve surgery can be applied depending on the physical condition of the person. We have performed gastric sleeve gastrectomy operations up to the age of 74 in our clinic. We have observed the increased physical and mental development after surgery, especially in this group over the age of 65. 

Preoperative Preparation

Diet before gastric sleeve surgery is especially done in people with fatty liver disease. The duration of the diet before gastric sleeve surgery is adjusted depending on the body mass index of the person. Fatty liver is more common in people with a large abdomen and thin arms and legs, i.e. those with central obesity. The size of the liver poses the most serious technical difficulty in sleeve gastrectomy surgery. Therefore, a liquid diet is given before surgery and the liver shrinks within days. Gastric sleeve gastrectomy surgery becomes easier and its duration shortens, and complication rates decrease. It is very important for your health to follow the diet sent to you by your dietitian before sleeve gastrectomy surgery. 

In the days before surgery, some habits such as alcohol and cigarettes can be continued with a partial reduction. It is allowed to smoke 10 cigarettes a day. Those with asthma chronic lung disease should reduce smoking up to 5 cigarettes a day before surgery. Lung fluid production, secretion and cough increase in those who suddenly stop smoking before sleeve gastrectomy surgery, which we do not prefer. Smoking may partially affect wound healing. Therefore, smoking can be continued in limited numbers (5-8 per day) in the first 15 days after sleeve gastrectomy surgery. 

Drinking alcohol before surgery may not pose as great a risk as smoking. However, this is a serious problem in people with alcohol addiction. Gastric surgery is not performed in people with alcohol addiction. The reason for this is that the person does not pay attention to nutrition after sleeve gastrectomy and the risk of starting to drink again due to alcohol addiction. People with alcohol addiction after sleeve gastrectomy both regain the weight they lost and experience muscle wasting and digestive system disorders more frequently due to unhealthy nutrition. People who drink alcohol socially should not drink alcohol on the last night before surgery. 

Before sleeve gastrectomy surgery, medications such as aspirin, which has a blood thinning effect, should be discontinued 4 days in advance. In the meantime, you should use your blood pressure medications until the morning of surgery. 

In the evening before surgery, you can take plenty of fluids while taking light liquid food suitable for your diet. While there is no obstacle in taking liquid and watery food until 24:00 at night, it is recommended that you wake up rested in the morning with a good sleep without taking anything by mouth afterwards. You should be at the hospital by 08:00 in the morning unless otherwise instructed. You will be admitted to the hospital as directed by our coordinator and your blood will be drawn for some blood tests, ECG and chest X-ray will be taken. An anesthesiologist will then see you in your bed and examine you. Sometimes, depending on your condition, other specialists may also be asked to examine you. If you have regular blood pressure medications, you should take them in the same way and at the same time with a little water. You can also inform the anesthesiologist about this.  

When you are admitted to the hospital in the morning before sleeve gastrectomy surgery, your blood tests are performed. Your ECG and chest x-ray are taken. The anesthesiologist will come to your room, talk to you and examine you. If necessary, he/she will ask other internal specialists to evaluate you. 

Endoscopy, Colonoscopy Before Gastric Sleeve Gastrectomy

Endoscopy before sleeve gastrectomy can be performed to detect cancer or precancerous lesions in people over the age of 50 and who have not undergone endoscopy in the last 3 years. It is not necessary to routinely perform endoscopy before gastric sleeve surgery for everyone. Colonoscopy, on the other hand, is an examination for completely different diseases of the large intestine and is suitable for people over the age of 50 and with complaints.

Approximately 10 minutes before your surgery, Koray will come and visit you in your room. You will be given a blood thinning injection 1 hour before the surgery, and just before the surgery, you will be given a sedative drug and you will be lowered into the operating room with your bed.  

Your surgery will be performed under general anesthesia, so your hour-long surgery will seem like 1 second to you. You will stay in the postoperative recovery room for 30 minutes. When you go to your room, the nurse will give you painkillers and anti-nausea medication for your pain and nausea. There will be no drain or catheter in your body. You will be able to get up and walk on your own 2 hours after you arrive at the room. One companion can stay with you in the hospital. There is also no harm in staying alone. The morning after your surgery, you will go down to the Radiology department and your stomach film will be taken. Here you will be given a medicine mixed with cherry juice. After the scopy, you will start drinking water and apple juice. When you are discharged after two or three nights in hospital, you can drive or travel by plane. 

During your hospital stay, your dietitian will visit you and give you information about the diet plan. The booklet prepared for you contains all the information you need. 

Our surgery and follow-up nurse or Koray teacher will inform you about the medications you will use at home after surgery. 

When you go home, both our dietitian and nurse will continue to support you on what to do. You will be able to return to your daily life. Thanks to the closed surgery technique, there will be no harm in heavy lifting and daily movements. The postoperative shower starts in the hospital, but for the first 5 days you go home, you should cover your stitches with waterproof bandages during the shower. Your stitches are hidden and there is no need to remove them. You will start using your prescribed medicines at home. Nutrition will be explained to you by your dietitian at the hospital, you will meet face to face with our dietitian again on the 15th day and your measurements will be made. Online meetings will be provided for those outside the city. You can come to monthly controls during your weight loss process. Every 3 months you will have your blood tests done and sent to us. 

Surgical Technique

Gastric sleeve gastrectomy is performed closed (laparoscopically) through small holes in the abdominal wall. Since the abdominal wall is not cut in sleeve gastrectomy, the person can stand up and walk on his/her own after 1-2 hours. The large part of the stomach on the left is separated from the surrounding tissues, then the anesthesiologist advances a silicone 12 mm diameter tube through the mouth into the stomach. The name “sleeve gastrectomy” is given because a new stomach is created in the shape of a tube in this way. Under the guidance of this silicone tube, the stomach is cut on the vertical axis using a stapler (stapler) tool and the stomach is tubularized in the shape of a banana following the esophagus. The large part of the stomach (about 70%) is removed through the hole in the abdominal wall. The stapler line is reinforced with a second suture line before the end of the gastric sleeve surgery. Unlike many other clinics, no resistance is placed in our clinic after sleeve gastrectomy surgery. Thanks to this inward folding suture technique, the risk of bleeding and leakage, one of the complications of sleeve gastrectomy surgery, is minimized.  

Gastric sleeve surgery takes approximately 45 minutes. In super obese patients and patients with extremely fatty liver, gastric sleeve surgery may take 1.5 hours.

Weight Loss Process

How Much Weight Is Lost With Gastric Sleeve Gastrectomy? When Does Weight Loss Stop? 

In the first six months after sleeve gastrectomy surgery, 70% of the excess weight is lost. Weight loss slows down and continues until 18 months. With sleeve gastrectomy surgery, it becomes possible to take fewer calories during the day, while the person gets rid of the stress of starvation in diets. The change in hormones (decrease in Ghrelin and Glucacon) after sleeve gastrectomy reduces hunger and contributes to weight loss. Weight loss after sleeve gastrectomy surgery stops at the 18th month and then a few pounds are regained and the plateau period begins. People who can create a healthy lifestyle do not gain weight again. 

Will I become extremely weak with sleeve gastrectomy surgery? 

Excessive weight loss after sleeve gastrectomy is not a common condition. It often happens due to an unintentional technical error in gastric sleeve surgery. During sleeve gastrectomy surgery, there may be a spiral rotation in the stomach, especially when surgery is performed through fewer holes. This torsion can lead to stenosis and therefore excessive weight loss after sleeve gastrectomy. 

Will I Gain Weight Again After Gastric Sleeve Gastrectomy? 

Weight regain after sleeve gastrectomy surgery has been found to be 18% and 28% in scientific articles in 5 and 10-year follow-ups, respectively. After sleeve gastrectomy, those who eat arbitrarily, do not live actively, sleep irregularly, have a habit of snacking, and develop frequent eating habits gain weight again. Despite gastric sleeve surgery, this weight gain does not return to the preoperative weight. For example, a gastric sleeve gastrectomy patient who goes down from 104 kg to 60 kg can go up to 83 kg after 2 years. Click for more detailed information about the reasons for weight regain after gastric sleeve surgery 

How much weight can be lost in 1 month with sleeve gastrectomy? 

The first month after sleeve gastrectomy is the fastest weight loss month. Approximately 10% of the total weight is lost in the first month after sleeve gastrectomy. A person who is operated with 120 kg loses 12 kg and becomes 108 kg one month later. The reason for the rapid weight loss of 10% in the first month after sleeve gastrectomy surgery is the liquid and pureed diet for the first 2 weeks and edema in the inner part of the newly formed banana-shaped stomach, especially in the first week of surgery. The hunger hormone called ghrelin also decreases after stomach reduction surgery. This reduces the desire for food intake due to decreased appetite. 

Does anyone regret having sleeve gastrectomy surgery? 

After sleeve gastrectomy surgery, as the patient loses weight, his psycho-social status improves and he starts to lead a more outgoing life. Rarely, some patients may feel regret after surgery. They may express their regrets as “Why did I have such an operation?”. In general, we see that the quality of life improves a lot, comorbidities improve, and patients with diabetes stop taking insulin and oral anti-diabetic drugs. Again, as they lose weight, we see that high blood pressure improves, knee and back pain improves, their activities increase, in short, life gets better. 

Let's also talk about those who regret why they did not have surgery before. With sleeve gastrectomy surgery, the excess weight that they have been used to for many years and that actually feels normal is gone with sleeve gastrectomy surgery and reaching a healthy weight leads to comments such as why I did not have this surgery before. 

Risks of Surgery
The risks of sleeve gastrectomy surgery can be analyzed in two ways. This distinction can be listed as early period risks and late period risks. 

Early period risks: 

Leakage (leakage from stitches) 
Bleeding 
Infection 
Anesthesia complications 
Respiratory tract problems 
Coagulation problems 
Late-term risks: 

Nausea and vomiting 
Reflux disease 
Malnutrition 
Herniation at incision sites 
Fall in blood sugar 
Sleeve gastrectomy surgery is generally in the group of low-risk surgeries. The technique of the surgery is not difficult. What is difficult is to shape the stomach well. This requires high experience and expertise. In order to minimize the risks of sleeve gastrectomy surgery, the surgeon who performs it must initially have received appropriate training in bariatric surgery. Learning and practicing the correct technique will make gastric sleeve surgery very safe with increasing experience. 

Leakage After Sleeve Gastrectomy

Leakage after sleeve gastrectomy, that is, partial rupture of the staple line, may cause symptoms of high fever and to a lesser extent abdominal pain in the patient. Leakage after sleeve gastrectomy often occurs between 5 and 15 days. It is not normal for the patient who goes home after surgery to have a fever. In this case, you should contact your nurse and doctor immediately. Although leakage is an undesirable complication that may occur rarely after sleeve gastrectomy surgery, if it is diagnosed early and the correct treatment methods are applied, it can mostly be cured without risking the patient's life. For this, you should contact your doctor immediately if you experience symptoms of high fever, chills, abdominal pain, shoulder and neck pain, especially between 5 and 15 days after surgery. The definitive diagnosis is usually made with the help of computed tomography. 

When a leak is detected, this condition can be corrected without surgery with antibiotics and a stent placed with the help of an endoscope when an abscess has not yet formed in the abdomen. If an abscess has formed, it can be drained into the prison with radiology support without surgery. With appropriate non-surgical treatment methods, 80% of leakages after sleeve gastrectomy can be treated. Leakages that are noticed late after sleeve gastrectomy surgery may require surgical intervention. This surgery is also mostly performed closed. Here, the inflammation in the abdomen is removed and the stent placed in the stomach is tried to prevent more intragastric fluid from flowing into the abdomen. 

Bleeding After Gastric Sleeve Gastrectomy 

Bleeding may occur after sleeve gastrectomy surgery. This usually occurs on the first day after surgery and sometimes on the second day while in the hospital. The most common bleeding is from the staple line in the stomach. Bleeding after sleeve gastrectomy is treated according to the severity of the bleeding. Most bleeding stops spontaneously, sometimes it may be necessary to give blood when the amount is moderate. However, bleeding that does not stop and high speed bleeding requires intervention with the closed method again. In this intervention, bleeding on the staple line of sleeve gastrectomy surgery is controlled with sutures. Due to the inward folding suture technique we use in our series, bleeding after sleeve gastrectomy surgery has decreased almost to zero. Therefore, we do not apply resistance after sleeve gastrectomy. 

When you go home after sleeve gastrectomy surgery, bleeding from the urinary tract or gums may occur in the first month when you use blood thinners. You should share this situation with your nurse immediately. If your urine is dark, tea-colored after sleeve gastrectomy surgery, this may be a sign of bleeding. Blood thinners should not be used for a while. If you experience such a situation, you should consult your doctor. 

Vomiting blood after sleeve gastrectomy surgery 

It is normal to have vomiting in the form of a mixture of blood and saliva while hospitalized in the first days after sleeve gastrectomy surgery. However, if you have bloody vomiting after you are discharged and go home, you should contact your doctor. After sleeve gastrectomy surgery, there may be bleeding from the staple line into the abdomen, and sometimes there may be bleeding from the mucosa into the stomach. These usually stop spontaneously. When bleeding after sleeve gastrectomy surgery does not stop spontaneously, it may sometimes be necessary to treat it endoscopically by giving blood and hospitalization. 

Embolism after sleeve gastrectomy surgery 

In sleeve gastrectomy surgery, especially during surgery, a bad situation may rarely occur in the thick veins in the legs. This clot may break away from here about 2-3 weeks after the patient is discharged and go to vital organs such as the lung (pulmonary embolism after sleeve gastrectomy), brain and partially close the circulation here. This is what we call an embolism. While embolism is harmless when it is small, it can cause serious problems when it is large. In gastric sleeve surgery, blood thinners are applied before surgery to prevent clots in the veins in the legs, and cuffs that apply positive pressure to the legs are wrapped during surgery. After the surgery, the patient is allowed to stand up early and the circulation returns to normal early. In addition, intra-abdominal pressure is kept low during surgery to facilitate blood return from the legs. Embolism after sleeve gastrectomy surgery is almost non-existent. 

Portal vein thrombosis after sleeve gastrectomy surgery

After sleeve gastrectomy, blood clots in the vein system that carries blood from the intestines to the liver may rarely occur. This condition is quite serious and can be life-threatening. Early diagnosis is very important. This condition, the cause of which is unknown, is more common in individuals with a familial tendency to blood clots. Symptoms vary from mild nausea to severe abdominal pain.  

Fever After Gastric Sleeve Gastrectomy 

The most feared risk of gastric sleeve surgery is leakage. Especially since the upper part of the newly created stomach tube is thinner and weak-walled, the staple line can open after surgery, stomach contents and acid spill into the abdomen and abscesses form. If the 'leakage', which manifests itself with high fever and abdominal pain, is not diagnosed and treated, the patient's condition worsens and intensive care conditions are required. In order to minimize this leakage complication that may occur after sleeve gastrectomy, the staple line must be strengthened in some way. In our clinic, we have been folding the staple line inward and applying a second suture line on it for the last 9 years. This special suture applied in sleeve gastrectomy surgery dissolves and is removed from the body in 90 days. This leakage complication, which can be seen in 1 in every 300 patients, has been eliminated since our suture technique has been applied. 

Vitamin deficiency may be seen after sleeve gastrectomy surgery. Vitamin deficiency after sleeve gastrectomy is temporary in most people. In general, all people who have undergone gastric sleeve gastrectomy are given multi vitamin support during the first month during the liquid-weighted nutrition phase. Especially in female patients with preoperative vitamin deficiencies, normal vitamin levels are reached thanks to the multi vitamin support given after sleeve gastrectomy surgery. The need for vitamin support after sleeve gastrectomy surgery decreases significantly after the 1st year. 

Benefits of Surgery

Which Diseases Are Improved While Losing Weight with Gastric Sleeve Gastrectomy? 

In the first 3 months with sleeve gastrectomy surgery, there is approximately 24% decrease in body weight. This decrease is mostly from adipose tissue. With the decrease in adipose tissue, insulin resistance improves first. Since salt intake also decreases, high blood pressure disease, which is present in most patients, also decreases. Since the fat in the neck decreases, the person after sleeve gastrectomy starts to breathe comfortably while sleeping at night and snoring stops. Sleep apnea improves within a month after sleeve gastrectomy. The load on the heart decreases and effort capacity increases. Blood sugar levels tend to decrease after sleeve gastrectomy surgery, most diabetics get rid of insulin. Fertility increases in women who cannot have children. Sexual capacity increases significantly in men. Blood fats, which were elevated after sleeve gastrectomy, decrease. Many chronic diseases that threaten health in general improve. 

Return to Normal Life

Return to normal life after sleeve gastrectomy is fast. At the end of the surgery, you can go to your room and you will be able to walk after 2 hours. The question “Will there be pain after sleeve gastrectomy?” may come to mind. This issue is completely related to how much painkillers are used. Thanks to our inward folding suture technique used in the surgery, bleeding is almost non-existent, there is no need to use drains and thus the pain after sleeve gastrectomy surgery is minimized. Since we use narcotic painkillers at the appropriate dose after surgery, our patients are able to walk comfortably in the early period. Of course, pain after sleeve gastrectomy may show individual differences. Nevertheless, the use of adequate doses of painkillers minimizes the problem. 

It is possible to return to daily life after 2 nights in the hospital. When you are discharged after sleeve gastrectomy surgery, you can drive, travel by plane, and lift weights up to 10 kilograms. It is not recommended to sit for a long time or be sedentary in the first days after sleeve gastrectomy surgery. Walking also helps you lose weight and minimizes the risk of developing embolism. 

Postoperative sport starts with brisk walks. After the 15th day, swimming is highly recommended. Swimming is the sport that minimizes sagging. Indoor sports are started on the 45th day.  

Return to sexual life is possible after the first week is completed.  

Alcohol Use After Sleeve Gastrectomy

Alcohol consumption can be started after 15 days after sleeve gastrectomy surgery. Since alcohol is a high-calorie drink, it may slow down weight loss. Therefore, daily consumption is not recommended in the first months, a small amount of consumption not exceeding one or two days a week is not a problem. Raki, wine or beer can be consumed after sleeve gastrectomy surgery, but it is recommended to limit it to a maximum of two days a week as mentioned above. After the first 3 months after sleeve gastrectomy, alcohol consumption can continue at the level of social drinking. Even when alcohol is consumed in smaller amounts after gastric sleeve surgery, it still provides the same effect as before. This partially reduces the unnecessary calorie intake caused by alcohol. 

Constipation after sleeve gastrectomy

The incidence of constipation generally increases after sleeve gastrectomy. The main reason for this is that less food is taken after sleeve gastrectomy. Less pulp in the large intestine can make the intestine lazy. The increase in the rate of constipation after sleeve gastrectomy is also related to drinking less water. People who have undergone sleeve gastrectomy with less food and therefore insufficient salt intake do not want to drink water. For this reason, it is often recommended to add extra salt to the foods taken after sleeve gastrectomy surgery. If the patient pays attention to postoperative nutrition, constipation is less common. 

Some medications are prescribed by your doctor to minimize constipation after sleeve gastrectomy surgery. 

Postoperative Hair Loss

Approximately 30% of patients who undergo gastric sleeve gastrectomy may experience hair loss. Hair loss after sleeve gastrectomy is not actually hair loss. Hair loss that starts in the third month after gastric sleeve surgery ends in the ninth month. After the ninth month, hair starts to grow again in the form of thin strands. Although hair loss that may occur during this period may demoralize the person, it is pleasing that it is not permanent. It is not always correct to attribute hair loss to vitamin deficiencies or malnutrition. There are people who have hair loss even though there is no vitamin deficiency in blood tests. Nevertheless, attention should be paid to protein intake after sleeve gastrectomy surgery, especially the consumption of undercooked red meat should not be ignored. Of course, deficient vitamins can be supplemented externally. Vitamin B, folic acid and iron levels are checked every three months. Special shampoos can be used during the period of hair loss, and sometimes vitamin E supplements can also be used. 

Gastric Sleeve Gastrectomy Price

The price of gastric sleeve surgery varies depending on many factors. First of all, since it is a high-tech surgery method, increasing medical equipment prices are reflected in the general cost of sleeve gastrectomy surgery. 

It is necessary to stay in the hospital for 2 or 3 nights after sleeve gastrectomy surgery and hospitalization fees in full-fledged hospitals have increased by 80% in the last 1 year. This, in turn, increased the cost of sleeve gastrectomy surgery in 2023. 

Sleeve gastrectomy surgery is very common. The experience of the surgeons and their level of education on the subject vary, and the surgery fees of experienced surgeons who only focus on obesity surgery are higher. 

As a result, the factors that determine the prices of sleeve gastrectomy surgery: 

The experience of the surgeon performing the surgery, 
The hospital where the surgery took place, 
Materials used, 
Whether there is SSI support or not. 
To find out the price or cost of sleeve gastrectomy surgery in our clinic, please click on the “get price” button on the page or call us on our contact number or send us a message via WhatsApp.