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Practiced procedures

Gastric Sleeve

The Gastrectomy vertical or also known as gastric sleeve, is to remove three quarters of the stomach to reduce your ability to receive food. Used to control the overweight.

Michel Gagner American surgeon, was the first to apply this technique for the control of the overweight in their super obese patients (BMI by top of 60 indices)

This procedure can be performed by surgery laparoscopica, using stapplers.

An important advantage of this procedure is that not modifies the normal feed, way since no skips any portion of the intestine, avoiding future complications such as anemia, intestinal obstruction, osteoporosis and protein deficiency. Also does not require introduce an artificial material into the abdomen as gastric band, also this procedure for the management of obesity, but requires additional care after their placement.

Another advantage is that you can perform regular, i.e. in those with a BMI from 35 index patients. This allows you to use it both patients adolescents and those with advanced age and quality of life.

Finally, compared with the gastric bypass, has a lower risk, but the advantage to achieve similar results and if necessary this last, you can perform as a complementary procedure in superobesos patients who want to achieve your ideal weight.

About operation

The surgery is realized by laparoscopic surgery with four or five ports of 1 cm. There are use linear staplers that shoot three lines of clamps guaranteeing an impermeable stamp. It begins in the portion of the stomach near to the pylorus (low gastric valve). To obtain an approximate 2 cm of diameter followed by placed a probe inside the stomach in right side, in the minor curvature, reaching the left union of the gastric esophagus, leaving it in a tubular form or of sleeve, with a capacity near to 100 ml.

The cut stomach is removed from the abdominal cavity across one of the ports.

Two days after the surgery, to confirm that there is no leak of liquid form the stomach, in the X-rays room, the patient drink contrast medium, after taking it a X-ray photography is take to demonstrate that in the places where the clamps were placed there are no fugues.

It is needs to take two days in the hospital and from 5 to 7 days in house, before initiating any daily activities.

On having withdrawn 2 thirds of the stomach, with little food ingestion, the patient will have a satiety sensation, due to the decrease of the hormones called ghrelinas.

In most cases, in the following 12 to 18 months, the reduction of the overweight will be evident, with a loss from 40 to 60 %, without a new profit.

In some cases has been observed that, with time, the gastric pipe grows and weight is gained. This one is the indication to fulfill a gastric bypass as a complement of the first one, will allow to obtain the weight reduction wished.

The reduction of weight favors the relief or facilitates the control of the diseases related such an arterial high pressure (63 % to 12 and 18 months), diabetes (70 % to 12 months and 77 % to 18 months) and, as direct consequence of this it improves the quality of life significantly.

Postoperative follow-up

Assist to your programmed doctor visits, after going out of the hospital, it is another important part of your managing.

Such as any surgical procedure, the obesity surgery has complications, some of them serious.

The visits to the doctor will be; once a month during the first semester. Once every three months during the second semester and, when the weight has become stable, it(he,she) will come as minimum once a year.

The change of food habits is one of the most important factors to maintain the weight that got lost.

It is necessary to remember that the nutritional support and the multidisciplinary group of managing is relevant to achieve the major success of the obesity surgery.

Operation Recovery

Habitually the patient gives himself(herself) of discharge of the hospital in the third day of the postoperatory.

The drainage pipe that was placed in the surgery can be removed from this day or on the 7 º day after when stiches points are removed.

The diet will be only water or tea after the first day of the operation followed by liquid diet for one more week and semiliquid another week, ending with a mashes diet for 2 or 3 weeks. It is very important to eat in small quantities and in balanced form. It is necessary to chew slow and very well. To avoid the profit of calories, there must be restricted the sugar liquids ingestion (sweets, chocolates, malted etc.), alcohol and carbonated drinks.

The physical exercise can be done from the second week of the surgery.


Preparations for the operation

The surgeon will explain you how to be prepared for the operation. For example, if you smoke he will ask you to avoid it, because to smoke can increase the risk of an infection in and delay the recovery.

You should be visit the nutriologist to take a previous liquid diet before the surgery due to the fact that the liver of the obese person has a bigger size therefore having a liquid diet lower it size and facilitates the surgery.

The operation generally it is under an anesthesia, this means that it will be slept during the operation and requires a night stance in the hospital.

You must be willing to ask to follow the fasting diet instructions. Normally you must not eat or drink for approximately six hours before the general anesthesia. However, some anesthetists allow taking occasional water sips two hours before.

In the hospital your nurse can verify your cardiac rhythm, arterial pressure and take a urine test.

Your surgeon will ask you to sign a assent form. This confirms that you understand the risks, the benefits, the possible alternatives for the procedure and has given you permission to continue forward.

Your surgeon will ask you to sign a consent form. This confirms that you understand the risks, benefits, alternatives to the procedure and have given your permission for it to go ahead.


What are the risks?

Before the surgical procedure it must be thinking in the advantages and disadvantages, meaning that had to carefully think about the good and bad thing.

The postoperatory risk complications is from 3 to 5 in 100, including infection, pneumonia and bled. The risk of death is of 3 in 1000.

The decision to surrender to surgery cannot be taken carelessly for that it will be a permanent change forever.

de Cirugía
Colegio Mexicano de Cirugía de la Obesidad y Enfermedades Metabólicas Colegio Mexicano
de Cirugía de la Obesidad
y Enfermedades Metabólicas
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