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Laparoscopic Sleeve Gastrectomy
What you need to know about laparoscopic sleeve gastrectomy:
A laparoscopic sleeve gastrectomy (LSG) is surgery to remove most of your stomach. The remaining stomach forms a tube or sleeve. 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.
How do I prepare for LSG?
- Your healthcare provider will talk to you about how to prepare for surgery. You will work closely with a dietitian before and after surgery. Your dietitian will talk to you about nutrition and the diet you should follow before and after surgery. You may need to follow a very low-calorie diet for several weeks before surgery.
- Your healthcare provider may tell you not to eat or drink anything after midnight on the day of your surgery. He will tell you what medicines to take or not take on the day of your surgery. You may be given an antibiotic through your IV to help prevent a bacterial infection.
What will happen during LSG:
- You will be given general anesthesia to keep you asleep and free from pain during surgery. Your surgeon will make 4 to 6 small incisions in your abdomen. He will insert small tools through these incisions. He will fill your abdomen with gas in order to see your stomach clearly.
- Your surgeon will cut away about 75% of your stomach. This will leave a narrow tube (sleeve) for food and liquid to pass through. The sleeve is secured with staples and your surgeon will check for any leaks. A drain may be placed near the sleeve to remove extra blood or fluid. The incisions will be closed with medical glue, medical tape, or stitches.
What will happen after LSG:
- A nasogastric (NG) tube may be put into your nose and down into your stomach during surgery. The NG tube helps prevent vomiting and may help get your intestines working. The NG tube is usually removed 1 day after surgery. If you have a drain in your wound, it will be removed when it stops draining blood and fluid. You may have a catheter in your bladder to help drain urine. This is usually removed the day after surgery.
- A test called a contrast swallow may be done the first day after surgery. This test checks for leaks in your stomach. You will be able to have clear liquids once your stomach starts working after surgery and tests show no leaks. You may be given ice chips at first. Then you will get clear liquids such as water, broth or juice.
- You may have chest or shoulder discomfort caused by the gas used during surgery. Apply heat on your abdomen, walk, or lie down with your knees as close to your chest as possible. This will help decrease the discomfort or pressure from the gas.
Risks of LSG:
You may bleed more than expected or develop an infection. Organs near the surgery area may be damaged. During surgery, you may need one large incision instead of several small incisions. A leak may develop along the staple line where it is holding your sleeve closed. This leak can cause a severe infection. You may have nausea, vomiting, or heartburn. You may not lose as much weight as you want or you may gain weight. You may get a blood clot in your leg or arm. This may become life-threatening.
Call 911 if:
- You have trouble breathing.
- You have chest pain that does not go away or gets worse.
- You cough up blood.
Seek care immediately if:
- Your arm or leg feels warm, tender, and painful. It may look swollen and red.
- Your wounds are draining pus or look red or swollen. They may feel warm, painful, or tender.
Contact your healthcare provider if:
- You have a fever higher than 101°F (38.3°C).
- Your pain does not get better with medicine, or it gets worse.
- You have nausea that does not get better with medicine, or it gets worse.
- You are vomiting.
- Your bowel movements are black or bloody.
- You are constipated.
- You have questions or concerns about your condition or care.
You may need any of the following:
- A multivitamin may be recommended by your healthcare provider or dietitian. This will help replace lost vitamins and minerals since you will be eating less food.
- NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
- Reflux medicine helps decrease stomach acid and heartburn.
- Nausea medicine may be needed to help decrease nausea and prevent vomiting.
- Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Do not drive while you take prescription pain medicine.
- Take your medicine as directed. Call your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
Care for your wound as directed:
Carefully wash your abdomen with soap and water. Gently pat the incisions dry with a towel. You may be able to shower and wash your hair 2 days after surgery. Dried blood and mild redness at your incision sites is normal after surgery. Check for bright redness, swelling, warmth, or drainage each day.
Follow the directions given to you by your dietitian. Drink at least 64 ounces of liquids each day to prevent dehydration. Water is the best liquid to drink. Sip liquids throughout the day rather than drinking a large amount at one time. Your dietitian may recommend a full liquid diet starting on day 3. This stage may last for up to 2 weeks. You may need to drink nutrition supplements, such as protein drinks up to 3 times each day. These supplements provide protein, vitamins, and minerals if you are not getting them through food. Do not drink carbonated liquids, such as soda. These liquids increase gas in the stomach. Limit or avoid caffeine because it can cause dehydration.
Cough and deep breathing:
Take deep breaths and cough 10 times each hour or as directed. This will help prevent pneumonia. You may need to hold a pillow on your abdomen for support and comfort. Take a deep breath and hold it for as long as you can. Let the air out and then cough strongly. Deep breaths help open your airway. You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece in your mouth and take a slow, deep breath, then let the air out and cough.
Take short walks often throughout the day. Walks help prevent blood clots. Do not do any strenuous activity or lift more than 10 pounds. Ask your healthcare provider about the best exercise plan for you at your follow-up visit.
Follow up with your healthcare provider as directed:
You may need to return for blood tests. Ask when you can return to work. Write down your questions so you remember to ask them during your visits.
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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.