Being obese may not only have an adverse effect on one's personality, it also makes one susceptible to various serious medical conditions. No wonder, people grappling with this problem are often on a lookout for effective ways to lose weight. At times, genetic elements or the lifestyle choices one makes may predispose one to severe obesity. In severe cases, weight loss cannot be induced just by following a diet and an exercise regimen. Under such circumstances, people may have to undergo a bariatric surgical procedure to lose weight. Such people have the option of undergoing surgical treatments such as gastric bypass, gastric band operation or gastric reduction duodenal switch procedure.
However, some of the surgical procedures may not be viable for people with a very high BMI (Body Mass Index). Sleeve gastrectomy, which is also referred to as vertical sleeve gastrectomy or greater curvature gastrectomy, is one such restrictive weight loss surgery that may be recommended for such people. Though sleeve gastrectomy is considered to be relatively safer, one cannot completely rule out the possibility of sleeve gastrectomy complications. Before we look into sleeve gastrectomy post surgery complications, let's find out about the sleeve gastrectomy procedure.
Sleeve Gastrectomy Procedure
Sleeve gastrectomy is a bariatric surgery that is performed on obese people having a body mass index of 40 or more. The aim of this surgical procedure is to limit the amount of food the patient can eat. It involves the removal of a portion of the stomach, followed by the creation of a thin, banana-sized vertical sleeve of stomach. Sleeve gastrectomy is a non-reversible surgery that is done laparoscopically. It involves stapling the stomach by using harmonic stapling devices. This surgery is generally conducted on the major curve of the stomach. It reduces the overall size of the stomach by 15-35% and gives it a shape of a tube or sleeve, hence the name sleeve gastrectomy. Since the section of stomach that is removed is the one that is responsible for secreting ghrelin, which is a hormone that induces hunger, this surgery leads to reduction in one's appetite. Since the size of the stomach is reduced, one may also feel full after consuming lesser amount of food. This helps one to lose weight.
If the patient doesn't lose considerable weight after this surgery, doctors may suggest the patient to undergo other procedures such as a gastric bypass or duodenal switch. Under the gastric bypass procedure, a portion of the small intestine is directly connected to the stomach pouch. Thus food bypasses certain parts of the small intestine. This induces malabsorption. Since the body absorbs lesser number of calories, excessive weight gain can be prevented. Since this procedure is performed laparoscopically, the number of incisions that are made are less and their size is also smaller. Post-operative pain is lesser and recovery period may be shorter in comparison to other bariatric surgeries. But this surgery can also cause certain complications.
Complications From Sleeve Gastrectomy
The most significant complications associated with this bariatric surgery are leakage, sleeve dilation and a number of other general problems. Let's take a look at them.
As mentioned earlier, a portion of the stomach is removed and the edges of the stomach are stapled or fixed together during the sleeve gastrectomy surgery. Sometimes, the staple line may show leakages and hemorrhages due to intra-abdominal pressure. However, such sleeve gastrectomy complications can be easily treated by conducting a second procedure that strengthens the staple line of the sleeve.
Gastroesophageal reflux refers to the regurgitation of gastric content into the esophagus. When the acids present in the stomach flow towards the esophagus, it is likely to cause irritation of the esophagus. This leads to heartburn, thereby causing a burning sensation in the chest. This is one of the most common complications of laparoscopic sleeve gastrectomy, that is probably a result of the change in the shape of the stomach.
The irregular, hollow and tube-like passage connecting the stomach to the wall of the abdomen is called gastric fistula. It is created, either pathologically or by surgery. In some 3-5% of sleeve gastrectomy cases, it comes as a post-operative result. This is one of the possible complications resulting from sleeve gastrectomy.
Narrowing of Stoma
Sleeve gastrectomy procedure may cause narrowing of stoma, which is an opening between the stomach and intestine. Another surgery may be required to fix this condition. In some cases, it can be corrected with the help of an instrument. The stoma can be expanded with the help of a dilating tube.
If the vertical sleeve of the stomach is too tight, it could create problems associated with the sphincter muscle that is located between the esophagus (food pipe) and the stomach. Hiatal hernia is one of the common complications from sleeve gastrectomy. Hiatus refers to an opening in the diaphragm through which the esophagus passes. If this opening widens, the stomach may protrude from the opening into the chest.
Malabsorption of Vitamins and Minerals
One long-term complication of sleeve gastrectomy is malabsorption of certain vitamins and minerals. This leads to deficiency of particular vitamins and minerals, which may further cause a number of other disorders. Deficiency of iron results in anemia while deficiency of vitamin B12 can cause neurological disorders. Changes in absorption of calcium, phosphates and oxalates can lead to the formation of kidney stones. Similarly, deficiency of calcium, phosphates and vitamin D can give rise to various bone diseases.
Other Possible Gastrectomy Complications
Vertical sleeve gastrectomy may also give rise to some common complications associated with other bariatric surgeries. The most prominent among those is microbial infection at the wound site. Another problem topping the list is deep vein thrombosis (DVT) or formation of blood clot in the leg. There is yet another complication that is sometimes seen after sleeve gastrectomy. At times, dilation of the vertical sleeve could lead to an increase in the food intake capacity of the patient.
In addition to all the problems listed above, sleeve gastrectomy complications may include hair loss, hair thinning, mood swings, dry skin and a general feeling of weakness. Any issue with sleeve gastrectomy needs a high level of medical attention and care. Do not try to be your own doctor. It is best to seek medical help. Strictly follow the advice and comply with the guidelines given by your surgeon.