Sleeve Gastrectomy – Common Questions and Answers

Dr. Hector Perez, Bariatric Surgeon, Cancun

Dr. Hector Perez is an experienced board certified surgeon specializing in bariatric weight loss surgery in Cancun. Today he answers some common questions about the sleeve gastrectomy bariatric weight loss surgery.

Video Transcript

Hello. My name is Dr. Hector Perez here in Cancun working with Ready4aChange. Today we are going to talk about sleeve Gastrectomy.

Who is the Ideal Candidate for Sleeve Gastrectomy?

First, who is the ideal candidate for a sleeve gastrectomy? The ideal candidate is any patient with BMI above 33 With any co-morbidity like diabetes, high blood pressure, joint pain, infertility, or any other condition related to obesity.

Who should not have a gastric sleeve/sleeve gastrectomy?

Another question is, “Are there any patients that cant get a gastric sleeve?” Today, the only condition to avoid getting a gastric sleeve is Bipolar Syndrome. Patients that go from depression to mania, probably in the same day, it’s very risky for those patients especially. After getting surgery they can binge and eat too much after surgery and jeopardize their surgery and their health.

How is a sleeve gastrectomy performed?

Another question is, “How is the surgery executed?” This is a surgery done minimally invasive. This means we use something called a laparoscope. It’s a camera that we introduce through your umbilical and we place three or four more instruments in your abdomen with wounds no bigger than half a centimeter where we can dissect your whole stomach, cut it. We remove almost 75-80% of your whole stomach and we do this with staples and also stapling cuts your stomach. After doing that we suture on top of those staples to reinforce the stapling length and that’s the way we prevent leaks.

How is a sleeve gastrectomy tested for leaks?

This brings us to another important question that we get a lot, how do you know if there is a leak? Do you do leaking tests? Yes we do. We do three leaking tests during surgery because the best place to fix a problem is while the patient is still at the OR. That’s why we have currently after 8 years of doing this procedure here in Cancun 0% of leakages. What we do, we do air test during the surgery, we do water test during surgery, and we also do endoscopy during surgery. After discharging the patients 2 days post-op, we give patients a blue dye and we do a dynamic x-ray to check for any leaks. So, when we discharge patients we are certain there are no leaks.

Is it possible to get a leak in my sleeve gastrectomy after surgery?

But another question we get a lot is, “Can I get a leak a week or a month after surgery?” The answer is yes, but this is very unlikely. In those rare cases that have been reported in literature about getting leaks one week or one month after surgery, it’s usually related to patients that didn’t’ follow directions correctly. Instead of staying with clear liquids for the first week they start eating rice or potatoes instead of following directions.

Can the pouch of the gastric sleeve stretch?

Another question is, “Can the pouch of the gastric sleeve grow?” The answer is yes, especially with those surgeons that don’t reinforce the stapling line with sutures. Those stomachs might grow a little bit, but would never grow back to the original size.

Will a gastric sleeve prevent persistent reflux

Another question is, “Will a sleeve resolve persistent reflux?” The answer is no. When patients have persistent reflux and they want to go through bariatric surgery we always recommend to choose a gastric bypass instead of a gastric sleeve because gastric sleeve won’t resolve persistent reflux and a gastric bypass will.

I hope this answers most of your questions. Thank you for watching.