WELCOME TO SLEEVE SURGERY

The World’s Preferred Weight Loss Procedure
Over the last 10 years, Sleeve Gastrectomy has become the most performed weight loss operation throughout the world. According to statistics, in the United Arab Emirates, 8 out of 10 weight loss procedures are Sleeve Gastrectomies. The reason for this popularity is predictable and enduring weight loss, coupled with the relative lack of long term complications.

What is Sleeve Gastrectomy?

Sleeve Gastrectomy is a weight loss procedure which involves reducing the size of the stomach to about a volume of 120 to 150 ml. The surgery is carried out laparoscopically using small keyhole incisions. The stomach is stapled and cut at the same time using a stapling device and sutures are applied to reinforce the staple line to minimize the chances of a leak.

How does the Sleeve Gastrectomy work?

Weight loss following sleeve gastrectomy occurs due to several reasons:

  • A reduction in the volume of food that can be consumed at a time
  • A significant reduction in the levels of Ghrelin, a hormone responsible for generating hunger. Many patients also report a significant change in their food preferences, especially an aversion to sugars and carbohydrates
  • Inability of the residual stomach to expand, as the stretchable part of the stomach is removed and the part that is left behind is relatively less compliant. This makes the stomach able to accommodate a moderate intake of food, but does not allow one to overeat
  • The passage of food through the stomach is accelerated leading to early satiety which in effect reduces the intake without affecting the sense of satisfaction from eating.

Health benefits beyond weight loss

There are numerous other benefits from this operation that can improve the health of the person in remarkable ways. Improvement, and in some cases, resolution of comorbidities are well-established following sleeve gastrectomy.

An analysis of several clinical studies, with a follow up period of one to five years, has found that:

  • More than 80% of patients had improvement or remission of Type 2 Diabetes Mellitus
  • 77% resolved their high Cholesterol
  • 50% did not require medication for Hypertension immediately following the surgery
  • There was resolution of Sleep Apnea in over 60% of patients with this condition
These other health benefits are only partly due to the weight loss itself. Several well-conducted studies have demonstrated a profound change in the hormones that regulate the body chemistry and it is these hormonal changes that contribute to this dramatic improvements in the “biochemical health” of the person.

A 20 year long study conducted in Europe had shown clear evidence of a reduction in the incidence of heart disease, and death due to Heart Disease, in those who had bariatric surgery compared to those who did not (R).

Other benefits of Weight Loss surgery in the long term that have been found through several clinical studies include:
  • Significant improvement in arthritis and chronic back pain
  • Reversal of Polycystic Ovarian Syndrome
  • Improvement in fertility reduction
  • Reduction in the risk of Breast Cancer, ovaries and endometrial cancer
  • Better Quality of Life: Clinical studies of laparoscopic bariatric and metabolic surgery patients found that they felt better after the procedure, and spent more time doing recreational and physical activities. They also benefited from enhanced productivity and economic opportunities, and had more self-confidence than they did prior to surgery.
It is projected that Bariatric Surgery adds 5-7 healthy years to a person's lifespan ( R)

Preparing for your Surgery

As with most surgeries there are some steps in the preparation of your surgery that are designed to minimize complications during and after the surgery and to optimize the body’s ability to recover and heal without any adverse effects.

  • A set of blood tests are required to evaluate the general fitness for an operation.
  • An ultrasound scan will be required to evaluate the size of the liver and the presence of gallstones or other upper abdominal conditions that may require attention during the surgery.
  • A Gastroscopy may sometimes be required to evaluate the condition of the stomach and for the presence of a hiatal hernia, especially in those patients who may complain of acid reflux.
  • A physician may be asked to evaluate your general health, especially in those who may suffer from Diabetes, Hypertension, Heart Disease or other related co-morbidities.
  • A pre-surgery diet regime is advised which includes elimination of all fatty foods to shrink the liver size and make the surgery safer. Protein and Vitamin supplements are advised to build up a reserve in anticipation of a relative lack of nutrition in the first two weeks after surgery, when only liquids are allowed to be consumed.

THE SURGICAL PROCEDURE

The operation is performed by laparoscopic surgery (Keyhole surgery) using four to five small incisions of 5 mm to 10 mm on the abdomen.

MOBILIZING THE STOMACH

Stapling

The stomach is stapled with a calibration tube inside to ensure a residual volume of 120 to 150 ml.

Staple Line Augmentation

The staple line is oversewn to reinforce the staple line and the attachments of the stomach as restored. The rest of the stomach (around 60-70% is removed through one of the keyholes. The removal of the upper part of the stomach fully is a key step in the procedure that results in the reduction of the harmone Ghrelin.
Leak Test: A stress test using a dye is carried out at the end of the procedure to ensure the absence of weak areas that may potentially leak later and these are oversewn again until the surgeon is satisfied that the stomach is rendered leak-proof.

Procedure Videos

The Immediate period after the operation

Since the operation is performed using minimally invasive techniques, the recovery following a Sleeve Gastrectomy is quite rapid. The average hospital stay is just overnight, unless there are other health reasons to keep the patient in the hospital for a longer period. Drinking of clear fluids is started two to four hours after return to the ward. The patient is encouraged to move about and be out of bed from the evening after the surgery. A Respirometer (a breathing stimulation device) is used to encourage deep breathing to minimize the chances of lung collapse and infection. Pain after the operation is controlled using drugs that do not make a person drowsy, but are still very effective in controlling pain. Some patients may experience nausea, but again this is controlled well with effective drugs to counteract this tendency.

Discharge from the Hospital

When the surgeon is satisfied that the clinical condition is stable, and the patient is able to drink at least 2 liters of liquids in a day, and pain is under control, it’s time to go home. Some medications will be prescribed primarily to control pain and to prevent clots in the leg. Most patients are able to go home in the afternoon the day after the surgery. Bed rest is not required or desirable after a Sleeve Gastrectomy. You are encouraged to be ambulant and this helps to accelerate the recovery process. Most patients are back to work one week after their operation

ADVANTAGES OF THE SLEEVE GASTRECTOMY

    The stomach is reduced in volume but tends to function normally so most food items can be consumed, albeit in small amounts.
  • Eliminates the portion of the stomach that produces the hormones that stimulates hunger (Ghrelin).
  • No dumping syndrome because the pylorus is preserved.
  • Minimizes the chance of an ulcer occurring.
  • By avoiding the intestinal bypass, the chance of intestinal obstruction (blockage), anemia, osteoporosis, protein deficiency and vitamin deficiency are almost eliminated.
  • Very effective as a first stage procedure for high BMI patients (BMI > 50 kg/m2).
  • Results appear promising as a single stage procedure for low BMI patients (BMI 35-45 kg/m2).
  • Appealing option for people with existing anemia, Crohn’s disease and numerous other conditions that make them too high risk for intestinal bypass procedures.
  • Can be done laparoscopically in patients weighing over 225 kg.
  • It can be converted / upgraded to almost any other weight loss procedure.

POST-OP DIETARY PLAN FOLLOWING SLEEVE GASTRECTOMY

A carefully designed dietary plan follows the surgery. Patients must stick to a liquid-based diet for 2 weeks after surgery. A soft Diet follows for a further 2 weeks. About 4-5 weeks after the operation, patients graduate to a 600-800 calorie/ day solid diet. Generally, patients are able to consume a reasonable meal around 6 months after surgery.

Bariatric Surgery is a starting point to changing the eating behavior that led to the weight gain. It’s important to remember that if these habits do not change after the operation, one finds it difficult to lose weight or regain weight later.

Long-Term Weight-Loss Results

On average, patients who undergo Sleeve Gastrectomy experience 60-80% loss of excess weight. The rate of weight loss is generally quite predictable following the operation. In the first month it will be in the range of 6-10 kgs of weight loss. By 3 months, we expect to reach around 18 kgs of weight loss on an average. By 6 months, it would be in the range of 22 -26 kgs. And thereafter 2-3 kgs a month until the target weight is reached.

Meet
Our Team

We provide the highest quality care to each patient.

Adiba Tasnim
faruq@surgery.ae
+971 556550869

Dr. Faruq Badiuddin

General Laparoscopic and Bariatric Surgeon

One of the early adaptors of Minimally Invasive Surgery, Dr. Faruq started his surgical career in India as a General Surgeon in 1982 and migrated to UK and Ireland in 1991 for Higher Surgical Training in Laparoscopic Surgery. He was then conferred the fellowship of the Royal College of Surgeons of England in 1993. He further received higher training in Obesity surgery at highly renowned training centers in Brussels, Belgium, Strasbourg, France, and at Mount Sinai Hospital, New York. Over the last 14 years, Dr. Faruq has been residing and practicing surgery in Dubai. He is an expert in Advanced Laparoscopic Surgery of all types, especially Laparoscopic Hernia Surgery, Weight Loss Surgery (Bariatric) and Upper Gastrointestinal Surgery including surgery for Gastro-Esophaggeal Reflux Disease.

View More About Dr. Faruq

Iffat Tasnim
g.lopez@surgery.ae
+971-55-9546068

Gretchen Lopez

Registered Nurse

Assistant to Dr.Faruq

Gretchen Lopez, is a Bachelor of Science in Nursing Graduate with an attainment of Magna Cum Laude at Riverside College in her home town in the Philippines. She works as a professional nurse in Dubai, for more than five years, assisting Dr. Faruq Badiuddin. She projects a very strong undertaking on her selected profession ranging from Bariatric and General Surgery, whilst, making her a highly qualified staff in her chosen field. Gretchen, has paramount experience in assisting patients for weight loss surgery and has proven only top quality service over the years. The many thank you cards and appreciation given by patients shows the kind of nurse she is. Currently employed with Dr. Faruq Badiuddin at Mediclinic in Dubai Mall, he work hand in hand to provide a top of the notch quality patient care, from point A to point Z. The major qualifications that make her unique is her bubbly attitude, integrity towards the job she is assigned to do, and being the most reliable point of contact to all potential and existing patients alike.

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