Pre-Operative Checks

Prior to gastric sleeve surgery, we had to undertake a number of pre-operative checks to ascertain that we were suitable candidates and ensure minimal risks; this was done one day prior to the surgery. The checks included the following:

1. Full Blood Test:
   • This was done to check general health and to determine underlying conditions which could affect the surgery or recovery. Activities conducted under this included checking anaemia, liver and kidney functions, and electrolyte levels.
2. Electrocardiogram (EKG):
   • This test was conducted to determine if there were any hidden heart conditions, which could complicate the surgery. It mainly re-checked the heart’s electrical activity.
3. X-Ray:
   • The chest and abdominal x-ray is done to produce a clear image of the chest and abdomen for an examination of any anomalies in a patient which may need attention before surgery.
4. Ultrasound:
   • This was done to evaluate the abdominal organs, especially the liver and gall bladder, for any abnormalities like gallstones or liver changes which might have hampered the smooth progress of the surgery.
5. Endoscopy:
   • This is done to inspect the oesophagus, stomach, and the initial part of the small intestine, looking for the signs of GERD or any other illnesses that may affect the kind of surgery to be conducted.
6. Nutritional and Psychological Assessments:
   • Consultations with a dietician and psychologist evaluate preparation and ability to maintain changes in lifestyle after surgery.
7. Pre-Surgery Diet:
   • Usually, a two-week low-calorie diet aimed at shrinking the liver and diminishing fat around the stomach for easier and safer surgery.

Consultation with the Surgeon

After we finished all of the pre-operative checks, we had a thorough consultation with our surgeon. During this consultation, the surgeon went through our test results with us and explained the best surgical option for each of us. Here’s what happened:

1. Review of Results:
   • He explained to us the results of our blood tests, EKG, X-ray, ultrasound, and endoscopy. This would have checked all the potential risks and dealt with them.
2. Surgical Recommendation:
   • Based on the results of the endoscopy, the surgeon would then recommend that this would be either a gastric sleeve or a gastric bypass. In our case, our surgeon recommended the gastric sleeve, and this was what we wanted.
3. Decision Based on Endoscopy:
   • If indeed reflux had been observed during this endoscopy or other conditions that could instigate gastroesophageal reflux disease, gastric bypass would have been recommended as opposed to the sleeve. This is because a bypass forbids GERD, which the sleeve could further fuel.

The Gastric Sleeve Procedure

Once we were cleared to go ahead with the surgery, the procedure itself was usually performed laparoscopically, involving small incisions – it’s minimally invasive. Here’s briefly how it goes:

1. Anaesthesia:
   • First, we were administered general anesthesia to make sure that we were properly asleep and would not feel any pain during the surgery.
2. Surgical Steps:
   • Incisions: Small incisions in the abdomen allowed a laparoscope—a small camera—and surgical instruments to be inserted into the stomach.
   • Resection: About 75-80% of the stomach was removed, leaving a tube-like structure called a sleeve.
   • Completion: The remaining portion of the stomach was then stapled shut, thereby creating a smaller stomach that would hold less food and therefore help with weight loss.
3. Duration:
   • The surgery took about 30-45 minutes for us.

Immediate Aftercare

After the surgery, we had to spend some days at the hospital for monitoring and initial recovery. The following are some of the major points regarding immediate aftercare:

1. Recovery Room:
   • We were moved to a recovery room where we were kept for monitoring until the effects of the anaesthesia had worn off.
2. Hospital Stay:
   • We stayed in the hospital for 2 days postoperatively.
3. Pain Management:
   • Oral medications were provided to manage pain if it occurred.
4. Diet Progression:
   • Day 1: Able to have small sips of water or only clear fluids
   • Week 1: Progress slowly to a liquid diet: broths, sugar-free gelatine, and diluted juices.
   • Next Few Weeks: Progression to pureed foods, followed by soft foods, and then, finally, to regular small portions over weeks.
5. Activity:
   • We were told to begin walking as soon as possible after surgery. This was to promote the free flow of blood and avoid its clotting.
6. Follow-Up Appointments:
   • Regular visits to our surgeon and dietitian. This is for close monitoring of our progress in losing weight, general nutritional status, and overall health.
   • Blood tests. This helps them assess whether there may be any deficiencies in levels of vitamins or minerals.
7. Medications:
   • We were prescribed medications aimed at reducing stomach acid and supplementing vitamins.
8. Emotional and Psychological Support:
   • Continued assistance from a psychologist or support groups to help us adapt to the changes in our lifestyle and to deal with any emotional difficulties after surgery.

Long-Term Considerations

1. Diet and Nutrition:
   • Commitment to a lifelong healthy diet that includes small, nutritionally dense meals.
   • Permanent use of vitamins and minerals to prevent deficiencies.
2. Physical Activity:
   • Including regular physical activity to maintain weight loss as well as other health gains.
3. Monitoring and Adjustments:
   • Follow up with healthcare providers regarding weight management and all its possible complications and problems.

We hope that sharing the journey and step-by-step process will enable you to have clear, realistic expectations of what happens before, during, and after gastric sleeve surgery. This procedure has changed our lives in so many ways by improving our health and giving us a better quality of life. Please do remember that this is our experience and not medical advice. For medical guidance, always consult your GP.

The Hospital Room