Is there an age requirement to have the sleeve gastrectomy?
It is generally recommended that you be between the ages of 18 and 65 to undergo weight loss surgery, including the sleeve gastrectomy. However, this range may vary based on individual patient evaluations, specific comorbidities, and institutional policies. In some cases, patients under 18 or over 65 may be considered if their obesity poses significant health risks.
What medical problems will be improved by sleeve gastrectomy?
Many obesity-related illnesses can improve or even be resolved after weight loss surgery. These include sleep apnea, type 2 diabetes, high cholesterol, hypertension, stress incontinence, joint pain, osteoarthritis, and depression. Weight loss can also lead to improved outcomes in pregnancy, increased fertility, and a lower risk of certain cancers. While some patients experience relief from acid reflux, others may develop or worsen reflux symptoms after sleeve gastrectomy. Overall, the surgery can increase life expectancy and enhance quality of life.
Are there specific vitamins I need to be taking?
Surgery patients should take a complete multivitamin twice daily, along with 1200 mg of calcium citrate per day. Calcium supplements should include vitamin D3 to ensure proper absorption. A vitamin B12 supplement, either in sublingual or injectable form, is also recommended. In the initial weeks after surgery, it is preferable to use soluble or chewable multivitamins for better absorption. Your dietitian will recommend appropriate brands and formulations.
Is weight loss surgery considered a cure for obesity?
The surgery is considered a "tool" to help patients lose weight, but it is not a cure for obesity. Patients must use the effects of the surgery to adopt healthier eating and exercise habits to achieve and maintain weight loss.
Is sleeve gastrectomy reversible?
No, sleeve gastrectomy is not reversible. During the procedure, a portion of the stomach is permanently removed. Reversing any weight loss surgery, such as gastric band or gastric bypass, typically results in weight regain. You should not undergo weight loss surgery if you intend to have it reversed at any point. While the sleeve gastrectomy cannot be reversed, it can be converted to a gastric bypass if necessary.
Will the staples in the stomach set off metal detectors or be unsafe for MRIs?
Staples used in sleeve gastrectomy are made of titanium, which is non-magnetic and does not trigger metal detectors or cause issues with MRI scanners. Titanium staples are commonly used in surgeries involving the stomach or intestines.
Is it possible to regain the weight that I lose after sleeve gastrectomy?
Yes, weight regain is possible after any weight loss surgery, including sleeve gastrectomy. While many patients maintain significant weight loss long-term, regaining some weight is common. To prevent significant regain, patients must remain committed to a healthy diet, regular exercise, and consistent follow-up with healthcare providers. Support from dietitians, behavioral health specialists, and online groups can help maintain healthy habits and prevent substantial weight regain.
Is sleeve gastrectomy covered by my health fund?
Most health funds cover the majority of the expenses associated with sleeve gastrectomy. However, you should contact your health fund to confirm whether your specific policy covers the procedure. The MBS item number for sleeve gastrectomy is 31575, but there may be additional out-of-pocket costs as outlined in the fees section.
Is the sleeve gastrectomy available in public hospitals in NSW?
Unfortunately, there is limited funding for obesity surgery in NSW, making it challenging to access sleeve gastrectomy in public hospitals.
Before the Sleeve Gastrectomy
What is the purpose of the pre-op liquid diet?
Following a liquid protein diet for 14 days before your surgery is crucial. This diet helps to reduce the size of your liver, which in turn improves access to the stomach, reduces the risk of complications during surgery, and can decrease the likelihood of intraoperative bleeding.
Must I quit smoking before weight loss surgery?
Absolutely. Smoking increases the risk of surgical complications, including blood clots, poor wound healing, leaks, infections, and respiratory issues like pneumonia. Smoking can also cause ulcers and erosions in the new stomach. Patients should stop smoking at least six weeks before surgery and are encouraged to quit permanently after the procedure to avoid further health risks.
Do I need to take a bowel preparation before sleeve gastrectomy?
No. Bowel preparation is not required before sleeve gastrectomy. The two-week pre-op liquid diet ensures that there is minimal buildup in the colon, making a laxative unnecessary.
Are there any medications I should avoid before the sleeve gastrectomy?
Medications that thin the blood, such as NSAIDs (Nurofen, Mobic, Advil, Ibuprofen, Feldene), aspirin, Warfarin, and Plavix, must be avoided before surgery. Patients taking blood thinners for medical reasons will need to discuss safe alternatives or temporary discontinuation with their healthcare provider. Steroids, hormones, and birth control pills should also be avoided due to increased risks of blood clots and healing issues.
The Surgery and Beyond
Will there be a tube in my nose, a urine catheter, or a drain when I wake up from surgery?
No, you will not typically have a tube in your nose, a urine catheter, or an abdominal drain when you wake up from surgery. However, in longer or more complex surgeries, a urine catheter or drain may be placed based on individual needs.
How long will it take before I'm able to walk?
You will be able to walk on the day of your surgery, as there are no restrictions on walking. Walking is encouraged to prevent blood clots, and patients should aim for 30 minutes of walking daily for six weeks post-surgery to reduce clotting risks.
How long will I be kept in the hospital?
Gastric sleeve patients generally stay in the hospital for 2-3 days, depending on individual recovery.
When can I start driving again?
Most patients can drive again 7 after sleeve gastrectomy, but only when:
- You are no longer taking strong painkillers (like opioids)
- You can brake suddenly and turn comfortably
- You feel alert and in full control
There are no fixed rules in NSW, but the Royal Australasian College of Surgeons advises not to drive until you are physically and mentally fit to do so.
How much time will I need off work?
Most people need 2 to 4 weeks off work after sleeve gastrectomy. This depends on the type of job you do and how your recovery progresses:
- Desk-based or light duties: Some patients return as early as 2 weeks if they feel well.
- Physically demanding jobs: You may need 4 to 6 weeks off to avoid strain on your healing body.
It’s important to:
- Take it slow during the first few weeks
- Avoid heavy lifting (more than 10 kg) for 4 to 6 weeks
- Listen to your body. If you do something that hurts then you need to stop.
What will my diet be like post-op?
Your post-operative diet will progress through several phases:
- Phase I: Liquid diet for the first week.
- Phase II: Pureed foods for two weeks.
- Phase III: Soft foods for three weeks.
- Phase IV: Transition to a normal diet, emphasizing high-protein and low-carbohydrate foods. This diet should be maintained for life.
Are there medications I should avoid after surgery?
Avoid NSAIDs for at least three months post-surgery, as they can cause ulcers and hinder staple line healing. Oral steroids like Prednisone should also be avoided unless prescribed by your doctor for a specific condition.
After surgery, am I able to attend social events where food is involved?
Yes! Patients are encouraged to maintain a social life. With some preparation and adjustments to eating habits, you can enjoy social events and dining out while sticking to your diet.
Do I need to exercise?
Yes, regular exercise is crucial for achieving long-term weight loss success. It also promotes cardiovascular health, mental well-being, and better muscle tone. Your healthcare provider and dietitian can create a personalized exercise plan for you.
Will I be able to fly on a plane after surgery?
Yes, you can fly six weeks after surgery. It is recommended to book an aisle seat to facilitate walking during the flight, which helps prevent blood clots. Wearing compression stockings during travel is also advised.
How soon after sleeve gastrectomy is it safe to get pregnant?
You should wait at least 18 months after sleeve gastrectomy before becoming pregnant. This waiting period allows for stable weight and nutrition, ensuring a healthier pregnancy. Always consult your surgeon and obstetrician before planning a pregnancy.
Will I lose hair after sleeve gastrectomy, and if so, is it permanent?
Hair loss may occur between 3 to 6 months post-surgery due to rapid weight loss and nutritional changes. However, this is typically temporary, and hair usually regrows. To minimize hair loss, ensure adequate protein intake and consistent use of multivitamins. Supplements like Biotin may also help.
How much fluid should I drink throughout the day after going home?
You should aim to drink at least 1.5 to 2 liters of fluids daily to stay hydrated. Remember to sip slowly throughout the day.
How much protein should I eat daily?
You should aim to consume 60-70 grams of protein daily to support muscle maintenance and overall health. Lean animal proteins (chicken, fish) and plant-based proteins (lentils, beans) are recommended, and protein shakes can help you reach your daily goal.
What can I do about constipation?
Ensure you get enough fiber, fluids, and regular exercise. Fiber supplements like Benefiber or Metamucil can help, but should be taken with adequate fluids. If constipation persists, try using over-the-counter laxatives like Coloxyl and Senna or Movicol.
Will I need to have plastic surgery after weight loss surgery?
Plastic surgery for excess skin is not always necessary, but it may be an option if excess skin becomes a hygiene or comfort issue. Non-surgical body-contouring devices can also be helpful. If excess skin remains problematic, discuss surgical options with a qualified surgeon.
How do I look after my incisions (wounds)?
Remove wound dressings five days after surgery if they are still in place. Leave the Steri-strips in place; they will curl and fall off within 10 days. If still present after two weeks, they can be removed in the shower. Incisions may itch during healing, which is normal. Apply sunscreen to incision sites if exposed to sunlight, as new scars are sensitive.
When should I come for urgent review?
Seek immediate medical review if you experience any of the following:
- Increasing redness, swelling, heat, or pain at an incision site.
- Drainage from an incision.
- Fever greater than 38.5°C.
- Abdominal or shoulder pain.
- Frequent vomiting.
- Shortness of breath.
- Leg swelling.
- Inability to drink enough fluids.
- General feeling of unwellness.
