Laparoscopic Sleeve Gastrectomy

What you should know

A laparoscopic sleeve gastrectomy (LSG) is surgery to remove part of the stomach so the remaining stomach forms a small tube. Once the stomach is made smaller, you will feel full faster and have a decreased desire for food. LSG is commonly done as a first surgery before a more involved weight-loss surgery can be done.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • LSG is surgery that cannot be reversed. During and after surgery, you may bleed more than expected. After surgery, you may have abdominal and shoulder pain, nausea, vomiting, and heartburn. Eating less food after surgery may cause you to have low levels of vitamins and minerals. You may get stones in your gallbladder that cause pain. You may get a wound infection, and your stomach may leak into your abdomen and cause a serious infection. You may need another surgery to fix the leaking area.

  • You may get a blood clot in your leg or arm. This may become life-threatening. Even with surgery, you may not lose as much weight as you want. Your stomach sleeve may get bigger, and you may gain weight.

  • Without surgery, your obesity may cause your health problems to become worse, or you may develop new health problems. You may become depressed, have trouble breathing, and suffer from asthma and sleep apnea. You may have new or worse joint pain and inflammation. You are more likely to have high blood cholesterol, high blood pressure, and diabetes. You are at higher risk for gallbladder and kidney problems. Obesity also increases your risk for certain cancers, heart disease, stroke, and death. Obese women may have problems getting pregnant or may have health problems during pregnancy.

Getting Ready

The week before your surgery:

  • Write down the correct date, time, and location of your surgery.

  • Arrange a ride home. Ask a family member or friend to drive you home after your surgery or procedure. Do not drive yourself home.

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.

  • You will need to see a dietitian to talk about the diet you should follow before and after surgery. You may need to follow a very low-calorie diet for up to 6 weeks before surgery to help prepare you for surgery. Ask your caregiver or dietitian to help you plan a diet that is right for you. Ask if you should keep a food diary.

  • You will have a physical exam and blood tests done before your surgery. You may need an abdominal ultrasound, upper gastrointestinal (stomach and intestines) study, and a barium swallow. These tests are done to check your stomach and nearby areas for problems. Your caregiver may also do certain tests to check how well your lungs and heart work. These tests include a chest x-ray, ECG, and lung function tests. You may need a sleep study to check you for sleep apnea. Sleep apnea is a condition that causes you to stop breathing briefly many times while you sleep. Talk to your caregiver about these or other tests you may need. Write down the date, time, and location of each test.

The night before your surgery:

Ask caregivers about directions for eating and drinking.

The day of your surgery:

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

  • Ask your caregiver before you take any medicine on the day of your surgery. Bring a list of all the medicines you take, or your pill bottles, with you to the hospital. Caregivers will check that your medicines will not interact poorly with the medicine you need for surgery.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.

  • You may get antibiotics to help prevent an infection caused by bacteria. You may also be given medicine before your surgery to help prevent blood clots.

Treatment

What will happen:

  • A circular tool called a trocar is inserted through a small incision in your abdomen. Your surgeon will insert tools through the trocar to do your surgery. Your abdomen is filled with gas so your surgeon can see your stomach better. Three to 6 more trocars are placed throughout your abdomen. Tools are inserted through the trocars and a piece of your stomach is cut away and removed through a trocar. The area is stapled closed.

  • Extra staples may be used to secure the stomach sleeve. Your surgeon may also use medical glue to secure the area. Blue dye may be put through a tube and into your stomach to check for leaks in the stapled area. A drain may be placed near the staple line to remove excess blood and fluids. All of the trocars are removed, and the cuts are closed with stitches. Numbing medicine may be injected into your incisions to help decrease pain.

After your surgery:

You will be taken to a room to rest until you are fully awake. Caregivers will monitor you closely for any problems. Do not get out of bed until your caregiver says it is okay. When your caregiver sees that you are okay, you will be able to go home or be taken to your hospital room.

Contact a caregiver if

  • You cannot make it to your surgery.

  • You have a fever.

  • You get a cold or the flu.

  • You have questions or concerns about your surgery.

Seek Care Immediately if

  • Your symptoms get worse.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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