Laparoscopic Sleeve Gastrectomy
What you should know
Laparoscopic Sleeve Gastrectomy (Precare) Care Guide
- Laparoscopic Sleeve Gastrectomy Aftercare Instructions
- Laparoscopic Sleeve Gastrectomy Discharge Care
- Laparoscopic Sleeve Gastrectomy Inpatient Care
- Laparoscopic Sleeve Gastrectomy Precare
- En Espanol
- A laparoscopic sleeve gastrectomy (LSG) is surgery done for obese people to help them lose weight. Obesity is when your body has much more weight from fat than it needs. Having too much body fat puts you at a higher risk of having medical problems, such as diabetes and heart disease. Obesity is a long-lasting problem that may get worse over time. Using your height and weight, your caregiver will learn your body mass index (BMI). Your caregiver uses this measurement to see if you are overweight. You are obese if your BMI is between 30 and 39. A BMI of 40 or more means that you are morbidly (very) obese.
- LSG is commonly done as a first surgery before a more involved weight-loss surgery can be done. During LSG, a portion of the stomach is removed so that 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 also decreases the amount of hormones (body chemicals) in your stomach that increase your appetite. Having LSG will help you lose weight, and you may have more energy. Losing weight may decrease your risk of getting heart problems, diabetes, and certain other diseases.
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.
- 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 (upset stomach), vomiting (throwing up), and heartburn. Eating less food after surgery may cause you to have low levels of vitamins and minerals in your body. You may get stones in your gallbladder (organ in your abdomen) that cause you 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 can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and breathing trouble. This problem can be 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.
- If you do not have LSG, your obesity may cause your health problems to become worse. You may also develop new health problems because of your obesity. You may become depressed (deep sadness), have trouble breathing, and suffer from asthma and sleep apnea. You may have new or worse joint pain and inflammation (swelling). You are more likely to have high blood cholesterol (fat), high blood pressure, and diabetes (high blood sugar). You are at higher risk for gallbladder and kidney problems, and you may begin to leak urine. 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. Talk with your caregiver if you have questions or concerns about your surgery, condition, or care.
Before your surgery:
- 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 nutrition caregiver to talk about your before and after surgery diet. You may need to eat a very low-calorie diet for up to six weeks before surgery to help prepare you for surgery. Ask your caregiver to help you plan a diet program that is right for you. Ask if you should keep a food diary.
- You will talk with a mental health caregiver about how to cope with the dietary changes after your surgery.
- 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, electrocardiogram (ECG), and pulmonary (lung) function tests. You may need a sleep study to check you for sleep apnea. Sleep apnea is when you stop breathing briefly many times while sleeping. Ask your caregiver for more information about these and other tests that 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.
- If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your surgery. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before surgery. You may need to check your blood sugar more often before and after having surgery.
The day of your surgery:
- Write down the correct date, time, and location 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 may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.
- You may get antibiotics to help prevent an infection caused by germs called bacteria. You may also be given medicine before your surgery to help prevent blood clots.
What will happen:
- You will be taken to the surgery room, where you will lie on your back on an operating table. You will be given anesthesia medicine to keep you asleep and free from pain during surgery. A circular tool called a trocar is inserted through a small incision (cut) in your abdomen. Your caregiver inserts tools through the trocar to do your surgery. Your abdomen is filled with gas so your caregiver can see your stomach better. Three to six 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 cut area is stapled closed.
- Extra staples may be used to secure the stomach sleeve. Caregivers may also use a special tissue 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 wounds (surgery cuts) to help decrease pain.
After your surgery:
You will be taken to a room to rest until you are fully awake. Do not get out of bed until your caregiver says it is okay. If you have pain, you may be given medicine to help decrease or take away the pain. When caregivers see that you are not having any problems, you may be taken to your room.
This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.
Contact a caregiver if
- You cannot make it to your surgery on time.
- You have a fever.
- You have questions about your surgery.
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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.