What Is Tube Stomach?

• The amount of food the stomach can hold at one time decreases.

• A feeling of fullness may occur earlier with smaller portions.

• Changes may occur in the production of appetite-related hormones.

• Meal patterns and eating speed become more important.

Reducing stomach volume does not mean that a person will never feel hungry or will lose weight while eating any food they desire. High-calorie liquids, frequent snacking, and uncontrolled eating behaviors may increase daily energy intake despite the reduced stomach capacity.

How Is Sleeve Gastrectomy Surgery Performed?

The procedure is generally performed under general anesthesia using a minimally invasive surgical technique.

The main stages of sleeve gastrectomy surgery may proceed as follows:

1. Several small incisions are made in the abdominal area.

2. A camera and surgical instruments are inserted into the abdomen through these incisions.

3. The tissues surrounding the stomach are carefully separated.

4. The width of the stomach to be preserved is determined using special measuring instruments.

5. A large portion of the stomach is separated using surgical staples.

6. The separated portion of the stomach is removed from the abdomen.

7. The staple line and any potential bleeding areas are checked.

8. A leak assessment is performed when deemed necessary.

Laparoscopic sleeve gastrectomy is performed through small incisions rather than a large abdominal incision. However, the minimally invasive approach does not mean that the procedure is minor or insignificant. It is an operation that requires general anesthesia and permanently changes the anatomy of the stomach. Official patient information sources also state that sleeve gastrectomy is generally performed laparoscopically and involves removing a large portion of the stomach.

Who May Be Eligible for Sleeve Gastrectomy Surgery?

The question of “Who is eligible for sleeve gastrectomy?” cannot be answered solely by considering how much a person weighs. Although the relationship between weight and height is important, the duration of obesity, accompanying diseases, previously attempted methods, and the ability to adhere to postoperative follow-up are also evaluated.

The following factors may be examined during the eligibility assessment:

• The severity and duration of obesity
• Accompanying conditions such as type 2 diabetes, hypertension, or sleep apnea
• Previously attempted dietary, exercise, and medical treatments
• Heart and lung health in relation to general anesthesia
• Eating behavior and psychological readiness
• Tobacco, alcohol, or substance use
• Ability to adhere to the postoperative nutritional program
• Ability to attend long-term follow-up appointments

Obesity surgery is not a procedure planned solely to change aesthetic appearance. Its primary purpose is to reduce the health burden associated with obesity and support sustainable weight management.

What Should the Body Mass Index Be for Sleeve Gastrectomy Surgery?

Body mass index is calculated by dividing a person's weight by the square of their height. However, this value alone is not sufficient to make a decision about surgery.

According to current approaches, obesity surgery may be considered for suitable adults with a body mass index of 35 or higher, even in the absence of an additional disease. For individuals with a body mass index between 30 and 34.9, surgical options may be considered if they have type 2 diabetes or obesity-related conditions that cannot be adequately controlled through non-surgical methods. Since national practices, hospital conditions, and individual risks may vary, these figures do not automatically indicate approval for surgery.

Who May Not Be Suitable for Sleeve Gastrectomy Surgery?

Eligibility requirements for sleeve gastrectomy are more comprehensive than simply wanting to undergo surgery. In some cases, the procedure may be postponed or a different treatment approach may be preferred.

These may include:

• Health conditions that increase surgical risk to an unacceptable level
• Active alcohol or substance use disorder
• Certain uncontrolled psychiatric conditions
• Untreated severe eating disorders
• Pregnancy
• Inability to understand the consequences of surgery and the need for follow-up
• Inability to adhere to the nutritional program and follow-up appointments
• Certain uncontrolled stomach or intestinal diseases

Some of these conditions are not permanent barriers. Reassessment may be possible after appropriate treatment and preparation. International guidelines also recommend that eligibility be determined through a multidisciplinary and individualized assessment.

These features do not mean that sleeve gastrectomy is the most suitable method for everyone. Severe reflux, certain metabolic diseases, previous surgeries, and a person's eating behavior may require consideration of a different procedure.

What Is the Difference Between Sleeve Gastrectomy and Gastric Bypass?

In sleeve gastrectomy, a large portion of the stomach is removed, but the intestinal pathway remains unchanged. In gastric bypass, a small stomach pouch is created, and a portion of the small intestine is connected to this pouch.

Gastric bypass may affect the movement and absorption of nutrients through the digestive system more extensively than sleeve gastrectomy. Sleeve gastrectomy, on the other hand, is performed without creating an intestinal connection. Reflux, diabetes, eating habits, the risk of vitamin deficiencies, and previous surgeries are considered when selecting a procedure. It cannot be said that one method is superior to the other for all patients.

Nutrition After Sleeve Gastrectomy Surgery

After stomach surgery the person's diet is particularly important during the first 6 months. It is important to follow the dietary plan after sleeve gastrectomy surgery. This postoperative process consists of 5 stages.

• Hospital Period (Days 1-4): This period covers the first 4 days. It is the period spent in the hospital during the first 4 days. During this time, liquid nutrition is provided intravenously.
• Clear Liquid Period (Month 1): During this one-month period, the patient should consume liquid nutritional supplements. The patient's body mass index is measured regularly, and the amount of fluid is adjusted accordingly. This amount varies between 2.5 and 3.5 liters. A total of 5 meals should be consumed daily. However, each serving should not exceed 150 ml.
• Pureed Food Period (Months 1-3): During this period, pureed foods are introduced in addition to liquid foods. Purees made from carrots, broccoli, cabbage, spinach, and artichokes may be preferred. However, mashed potatoes should be avoided due to their high carbohydrate content. Chicken or minced meat can be added to purees to increase protein intake. The prepared purees should be consumed as main meals. They should not be consumed at the same time as liquid foods. As in the liquid phase, purees are consumed in 5 meals.
• Transition to Regular Foods (Months 3-6): During the transition to regular foods, various soups, except those containing flour, boiled red and white meat, and grilled fish may be consumed. Food should be chewed thoroughly. There should be a half-hour interval between consuming liquid and regular foods.
• Regular Food Period (Month 6 and Beyond): The total number of meals consumed in a day should not exceed 4. Care should be taken to consume low-calorie foods. If vomiting occurs during the solid food phase, liquids should be consumed for 12-24 hours. 

• Click here for information about before and after sleeve gastrectomy surgery .