Our Summary

This research paper discusses a rare complication that can occur after a type of weight loss surgery called a sleeve gastrectomy (SG). In this procedure, a large part of the stomach is removed, leaving the remaining portion without any support along its outer curve. This lack of support can potentially lead to a condition called volvulus, where the stomach twists on itself.

The researchers present a case of a 44-year-old patient who had undergone a sleeve gastrectomy 2.5 years prior to the study. The patient came to the emergency department with a recurring inability to eat for three months. After performing an examination, the doctors found that the patient’s stomach was blocked because it had twisted (volvulus). They performed surgery to untwist the stomach.

The authors of the study note that this complication is not often discussed in the medical literature. They suggest that surgeons should be aware of this potential issue following a sleeve gastrectomy, as this could help them diagnose and treat it effectively in the early stages. A video of the surgical procedure to untwist the patient’s stomach can be viewed online.

FAQs

  1. What is a potential rare complication of Sleeve Gastrectomy (SG)?
  2. How can awareness of this complication help surgeons in managing postoperative sleeve gastrectomy complications?
  3. What symptoms did the patient present with after having a Sleeve Gastrectomy (SG)?

Doctor’s Tip

One helpful tip a doctor might tell a patient about gastric sleeve surgery is to be aware of the potential complication of gastric volvulus, which is a rare but serious issue that can occur after the procedure. It is important for patients to promptly report any symptoms of intolerance to oral intake or other concerning symptoms to their healthcare provider so that any complications can be addressed quickly.

Suitable For

Patients who are typically recommended for gastric sleeve surgery, also known as sleeve gastrectomy, are those who have a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health conditions such as diabetes, high blood pressure, or sleep apnea. Patients who have tried and failed to lose weight through diet and exercise may also be candidates for gastric sleeve surgery.

It is important for patients considering gastric sleeve surgery to undergo a thorough evaluation by a bariatric surgeon to determine if they are a suitable candidate for the procedure. Additionally, patients should be committed to making lifestyle changes, including adopting a healthy diet and regular exercise routine, in order to achieve successful long-term weight loss results.

As with any surgical procedure, there are risks and potential complications associated with gastric sleeve surgery. Patients should discuss these risks with their healthcare provider and make an informed decision about whether gastric sleeve surgery is the right choice for them.

Timeline

Timeline before and after gastric sleeve surgery:

Before surgery:

  • Patient undergoes pre-operative evaluation and counseling with a bariatric surgeon and a multidisciplinary team
  • Patient may need to lose a certain amount of weight before surgery to reduce surgical risks
  • Patient may need to follow a specific diet and exercise regimen to prepare for surgery
  • Patient undergoes gastric sleeve surgery, which involves removing a portion of the stomach to create a smaller, sleeve-shaped stomach pouch
  • Surgery typically takes 1-2 hours and is done using minimally invasive techniques such as laparoscopy
  • Patient stays in the hospital for 1-2 days for monitoring and recovery
  • Patient gradually transitions from a liquid to a pureed to a solid diet over the following weeks
  • Patient follows up with the bariatric team for regular check-ups and monitoring of weight loss progress

After surgery:

  • Patient may experience some pain, discomfort, and nausea in the days following surgery
  • Patient may need to take pain medications and follow a strict diet plan to promote healing and weight loss
  • Patient may need to make lifestyle changes such as adopting healthy eating habits and increasing physical activity to support weight loss
  • Patient may experience rapid weight loss in the first few months after surgery
  • Patient may need to take vitamin and mineral supplements to prevent deficiencies
  • Patient may experience improvements in obesity-related health conditions such as diabetes, high blood pressure, and sleep apnea
  • Patient may undergo cosmetic procedures to remove excess skin after significant weight loss
  • Patient continues to follow up with the bariatric team for long-term monitoring and support in maintaining weight loss and overall health.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with gastric sleeve surgery, including rare complications like gastric volvulus?

  2. How will my diet and eating habits need to change after the surgery?

  3. What kind of follow-up care will I need after the surgery?

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

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

  6. How long will it take for me to recover from the surgery and resume normal activities?

  7. What kind of support or counseling is available for patients before and after gastric sleeve surgery?

  8. How will the surgery impact any existing medical conditions I have?

  9. Are there any long-term risks or considerations I should be aware of after gastric sleeve surgery?

  10. What measures can be taken to prevent rare complications like gastric volvulus after gastric sleeve surgery?

Reference

Authors: Batayyah E, Yaseen W, Althobaiti S. Journal: Case Rep Surg. 2022 Apr 8;2022:2157522. doi: 10.1155/2022/2157522. eCollection 2022. PMID: 35433069