Our Summary

This research paper discusses a single case where a patient experienced serious complications on the same day they underwent a weight loss procedure known as endoscopic sleeve gastroplasty (ESG). ESG is a procedure that reduces the size of the stomach by using a suctioning device or stapler to fold and secure the larger curve of the stomach. This makes the procedure less invasive and can be done as an outpatient surgery. However, the patient in this case experienced a lack of blood supply to the stomach (ischemia), a hole in the stomach wall (perforation), and inflammation of the lining of the abdomen (peritonitis) immediately after the procedure. The paper also discusses what was found during surgery and how the complications were managed.

FAQs

  1. What is endoscopic sleeve gastroplasty (ESG)?
  2. What are potential complications of endoscopic sleeve gastroplasty?
  3. How is an endoscopic sleeve gastroplasty procedure performed?

Doctor’s Tip

A doctor might tell a patient undergoing gastric sleeve surgery to follow a strict post-operative diet plan to ensure proper healing and successful weight loss. This may include consuming small, frequent meals, focusing on protein-rich foods, and avoiding high-calorie, high-fat foods. Additionally, the doctor may recommend regular exercise and close monitoring of weight loss progress to achieve optimal results. It is important for the patient to follow these guidelines carefully to avoid complications and achieve long-term success with their gastric sleeve procedure.

Suitable For

Patients who are recommended for gastric sleeve surgery typically have a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health conditions such as type 2 diabetes, high blood pressure, or sleep apnea. They have tried other methods of weight loss such as diet and exercise without success, and are committed to making lifestyle changes to support their weight loss goals. Additionally, patients should be in good overall health and have a willingness to adhere to post-operative dietary and lifestyle guidelines.

Timeline

Before gastric sleeve surgery:

  1. Consultation: The patient meets with a healthcare provider to discuss their weight loss goals and determine if they are a candidate for gastric sleeve surgery.
  2. Pre-operative testing: The patient undergoes various tests such as blood work, imaging studies, and psychological evaluations to ensure they are healthy enough for surgery.
  3. Pre-operative diet: The patient follows a specific diet plan to shrink the liver and reduce the risk of complications during surgery.
  4. Surgery: The patient undergoes gastric sleeve surgery, where a portion of the stomach is removed to reduce its size and limit food intake.

After gastric sleeve surgery:

  1. Recovery: The patient stays in the hospital for a few days to recover from surgery and receive pain management.
  2. Diet progression: The patient follows a strict post-operative diet plan, starting with clear liquids and gradually transitioning to solid foods.
  3. Follow-up appointments: The patient meets with their healthcare provider regularly to monitor weight loss progress, address any concerns, and make adjustments to their diet and exercise plan.
  4. Weight loss: The patient experiences gradual weight loss over time as a result of the reduced stomach size and changes in eating habits.
  5. Lifestyle changes: The patient incorporates healthy eating habits and regular exercise into their daily routine to maintain weight loss and improve overall health.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with gastric sleeve surgery?

  2. How long is the recovery time after gastric sleeve surgery?

  3. What dietary and lifestyle changes will I need to make after the surgery?

  4. How much weight can I expect to lose after gastric sleeve surgery?

  5. Will I need to take any medications or supplements after the surgery?

  6. How often will I need to follow up with my doctor after the surgery?

  7. What is the long-term success rate of gastric sleeve surgery?

  8. What are the alternatives to gastric sleeve surgery?

  9. How will my current medical conditions or medications affect my eligibility for gastric sleeve surgery?

  10. What is the experience and success rate of the surgeon performing the gastric sleeve surgery?

Reference

Authors: Stolz MP, Gibson BH, Vassy WM. Journal: Am Surg. 2023 Aug;89(8):3482-3483. doi: 10.1177/00031348231161663. Epub 2023 Mar 6. PMID: 36876386