Understanding the Risks of Sleeve Gastrectomy

Sleeve gastrectomy (tüp mide) is one of the most frequently performed procedures in obesity surgery, especially for patients unable to achieve adequate weight loss through diet and exercise. During this operation, about 80% of the stomach is removed, leaving behind a tube-shaped gastric pouch. The remaining portion of the stomach is stapled along the cut edges.

This is a non-reversible procedure, which is why the experience of your surgeon and the psychological preparedness of the patient are both very important. Like all surgeries, sleeve gastrectomy carries certain risks—some inherent to any operation and others specific to this procedure. Additionally, factors such as the patient’s overall health and compliance with dietary guidelines can affect the likelihood of complications.

Before surgery, your medical team will perform evaluations and tests to assess potential risks. In some instances, they may decide not to proceed if certain conditions are present, including:

1. Severe psychiatric illness impairing the patient’s ability to understand the procedure’s risks and benefits
2. Alcohol or substance dependence
3. Severe hormonal imbalances
4. Refusal to follow the recommended postoperative diet plan
5. Contraindications for general anesthesia
6. Active cancer
7. Pregnancy or planning to become pregnant in the near future

General Risks of Sleeve Gastrectomy

As with any major operation, sleeve gastrectomy comes with possible complications:

• Anesthesia-Related Complications
  Risk factors include reactions to anesthetic agents or sudden intraoperative issues.
• Infection
  Potential causes include suboptimal operating-room hygiene or inadequate postoperative wound care.
• Blood Clots and Embolism
  As in other surgeries, there is a risk of thrombosis. Medications (e.g., blood thinners) may be prescribed to reduce this risk.

Is There a Risk of Death?

Although the mortality risk associated with sleeve gastrectomy is generally low, it cannot be entirely eliminated. Certain high-risk patients may face greater peril, but appropriate patient selection, careful preoperative preparation, and an experienced surgical team can minimize these dangers.

While sleeve gastrectomy has proven effective in treating obesity, it is crucial for patients to recognize the operation’s possible complications. Collaborating closely with your surgeon and following all instructions are key to a safer outcome and minimized risks.

Postoperative Period and Recovery

The sleeve gastrectomy is widely favored for its effectiveness, yet recovering from it requires particular attention:

• Hospital Stay
  Usually lasts from a few days up to a week. During this time, closely follow the medical team’s guidelines.
• Gradual Dietary Progression
  To allow for healing, start with liquids, move to pureed or soft foods, and eventually transition to solids.
• Diet Plan
  A specialized postoperative meal program supports weight loss and helps establish healthy eating habits.
• Exercise and Activity
  Gentle, regular activity speeds recovery and promotes weight maintenance. Overly strenuous activities should be avoided until your surgeon approves.

Possible Early Postoperative Issues

Some side effects or symptoms can arise shortly after surgery:

• Pain
  The patient may experience abdominal, back, or leg pain. Contributing factors include the patient’s menstrual cycle (for females), bowel health, and preoperative eating habits.
• Temporary Numbness or Tingling
  Mild symptoms in the legs or abdomen can occur for around ten days. Medications can be provided to manage discomfort.
• Nausea
  This can happen if the patient attempts to eat too quickly or fails to follow dietary guidelines.

Staple-Line Leaks: Risk and Signs

A staple-line leak is one of the most significant hazards after sleeve gastrectomy. The stapled edge of the stomach can develop tiny openings through which stomach contents may leak into the abdominal cavity or within the stomach itself.

To watch for leaks, patients are monitored for at least three days in the hospital. Typically, a special X-ray test with contrast fluid is done to identify any leak. High fever, severe abdominal pain, or an increased heart rate can all be warning signs of a leak. If you notice such symptoms, seek immediate medical care.

Infection Risks and Precautions

All surgeries carry a risk of infection, but careful measures can help prevent it:

• Wound Infection
  It may present with itchiness, redness, or oozing around the incision site.
• Proper Wound Care
  Following sterile techniques when dressing or cleaning the incision reduces the risk. If an infection arises, antibiotics are typically required.

Nutrition and Dietary Guidelines

A specialized postoperative diet is vital for successful weight loss and healing:

1. Liquids (first 1–2 weeks)
2. Pureed Foods (as the stomach heals)
3. Soft and Solid Foods (around weeks 3–5)

Your caloric intake should focus on low-fat and low-calorie foods. Adhering to the diet plan reduces complications like vomiting, heartburn, or nutrient deficiencies.

Long-Term Risks and Management

Certain long-term complications can occur, especially if lifestyle changes are not sustained:

• Digestive Challenges
  Difficulty digesting certain foods, ongoing nausea, or vomiting.
• Narrowing or Strictures
  In rare cases, a stricture can occur, sometimes corrected endoscopically.
• Insufficient Weight Loss
  A small percentage of patients do not lose enough weight and may require revision surgery.
• Nutrient Deficiencies
  Patients must maintain proper hydration, electrolyte balance, and vitamin intake.
• Gallstones
  Rapid weight loss can increase gallstone risk; some patients need gallbladder removal.
• Psychological Issues
  Inadequate weight loss or complications can provoke stress or depression.
• Incisional Hernias
  Weakness around the surgical site can lead to herniation.
• Hair Thinning
  Temporary hair loss is common during rapid weight loss.
• Liver Function
  Rarely, complications can lead to liver-related problems.

By properly using medications, following postoperative instructions, and maintaining regular medical checkups, patients can significantly reduce most of these risks. Adequate hospital hygiene and modern surgical equipment also play a crucial role.

Frequently Asked Questions

1. Is sleeve gastrectomy dangerous?

• Like any major surgery, it has risks. However, these are typically low if performed by a skilled surgical team on carefully selected patients.

2. What about long-term outcomes 10 years after surgery?

• Generally positive, provided the patient adheres to healthy lifestyle habits and attends regular follow-up visits.

3. What else should I expect post-surgery?

• Strict diet progression (liquids → purees → soft → solids), possible side effects like mild pain or fatigue, and ongoing medical guidance.

4. Any special advice for sleeve gastrectomy patients?

• Commit to regular checkups, stay hydrated, follow dietary plans, and incorporate recommended vitamins and exercise into your daily routine.