This information will guide you through the post- operative stages step-by- step after gastric bypass or sleeve gastrectomy surgery. Levy JL, Levine MS, Rubesin SE, Williams NN, Dumon KR. Stenosis of gastric sleeve after laparoscopic sleeve gastrectomy: clinical, radiographic and endoscopic findings. Br J Radiol. 2018;91(1089):20170702. doi:10.1259/bjr.20170702 Figure reprinted from Alban et al. Obes Surg 2018;28(9):2923-2931, with permission from the publisher, Springer Nature [ 26]. Another method for hemostasis involves the use of buttressing materials. Several buttressing products made from different materials have been introduced into the market, including bovine pericardium (Peri-Strips Dry with Veritas, Synovis, Deerfield, IL, USA), absorbable synthetic polymer membranes (SEAMGUARD ®, Gore ®, W. L. Gore & Associates, Inc., Newark, DE, USA, or Tri-Staple™ 2.0 Reinforced Reload, Medtronic, Minneapolis, MN, USA). Many previous studies have been conducted to elucidate the efficacy of these buttressing products in preventing bleeding from staple lines and leakage from staple line disruption. Although the results from these studies were not entirely consistent, using the buttressing product along the staple line during SG appeared to reduce the incidence of staple line bleeding; its efficacy on leakage has not been clearly demonstrated [ 4, 11, 15, 16]. However, these buttressing products are not commercially available in Korea yet.

Al-Sanea O, Al-Garzaie A, Dernaika M, Haddad J. Rare complication post sleeve gastrectomy: Acute irreducible paraesophageal hernia. Int J Surg Case Rep. 2015;8C:88-91. doi:10.1016/j.ijscr.2015.01.040 Cheyne Child Development: while you wait leaflet - Pre-School Age (Kensington and Chelsea and Westminster children) Once you have completed the puree stage you can move onto soft foods. It is important to follow this stage as your stomach is still healing and recovering from surgery. What is soft food? Endoscopic internal drainage (EID) with double-pigtail stents is another method to treat sleeve leaks. The stent keeps the fistula tract open and facilitates drainage of the abscess in the gastric lumen, which eventually leads to the collapse of the abscess cavity and the closure of the leak. It can be used for well-contained leaks and usually requires a nasojejunal feeding tube for enteral feeding for a couple of weeks. EID with endoscopic pigtail stents showed a success rate of up to 95% at relatively lower costs and fewer complications than SEMS, as well as minimal discomfort for the patients [ 39, 40, 41]. Therefore, it is rapidly gaining popularity as a therapeutic modality for leaks among bariatric experts. Surgery usually takes one to two hours. After surgery, you awaken in a recovery room, where medical staff monitors you for any complications. After the procedureDumping syndrome occurs when fatty or sugary foods are emptied or ‘dumped’ from the stomach into the small intestine too rapidly. It is usually easy to identify dumping syndrome and the food or drink that has triggered it, as symptoms usually occur within 30-60 minutes after consumption. If you experience dumping syndrome then try to sit or lie down until your symptoms improve. In the long term avoiding fatty and sugary food will help you manage dumping syndrome, as well as helping you to achieve your weight loss goal. Hair loss Sleeve gastrectomy surgery can also improve your ability to perform routine daily activities, and can help improve your quality of life. When weight-loss surgery doesn't work Wang Y, et al. Mechanisms ofweight loss after sleeve gastrectomy and adjustable gastric banding: Far more than just restriction. Obesity. 2019; doi:10.1002/oby.22623. After sleeve gastrectomy, your diet begins with sugar-free, noncarbonated liquids for the first seven days, then progresses to pureed foods for three weeks, and finally to regular foods approximately four weeks after your surgery. You will be required to take a multivitamin twice a day, a calcium supplement once a day, and a vitamin B-12 injection once a month for life. Abdominal CT after contrast swallow in a patient with a sleeve leak. Disruption of the staple lines (a), extralumination of the contrast medium to the left subphrenic area (b, c), reactive pleural effusion (d).

Continue to eat 3 regular meals each day and try not to leave more than 4-5 hours between meals. You should not graze (eat small amounts of food constantly through the day) or go for a long-period of time without eating. Bariatric surgery procedures. American Society for Metabolic and Bariatric Surgery. https://asmbs.org/patients/bariatric-surgery-procedures. Accessed June 8, 2020.When surgical exploration was performed on leak patients in the earlier period, the goal of surgical management was not a definitive repair of the leak but to wash out and remove the necrotic debris and to place proper drains. A simple primary repair might be attempted in acute leaks within three days after surgery when promptly diagnosed [ 30]. Nonetheless, it is usually less successful, with a high incidence of recurrence owing to extensive inflammation in the surrounding tissue. In the latter phase, when non-surgical management fails after three to six months, surgery can be used as a step-up or salvage therapy. This includes conversion to RYGB and fistulojejunostomy.

You must also be willing to make permanent changes to lead a healthier lifestyle. You may be required to participate in long-term follow-up plans that include monitoring your nutrition, your lifestyle and behavior, and your medical conditions. Musella M, Vitiello A, Berardi G, Velotti N, Pesce M, Sarnelli G. Evaluation of reflux following sleeve gastrectomy and one anastomosis gastric bypass: 1-year results from a randomized open-label controlled trial. Surg Endosc. 2021;35(12):6777-6785. doi:10.1007/s00464-020-08182-3 The Cheyne Child Development Service - School age Autism (ASD) Assessment Pathway Parent Information Abdel-Sater R. Marriage dissolution in the United States: A survival analysis approach. J Divorce Remarriage. 2022;63(4):235-61. doi:10.1080/10502556.2022.2042788 Abou Rached A, Basile M, El Masri H. Gastric leaks post sleeve gastrectomy: review of its prevention and management. World J Gastroenterol. 2014;20(38):13904-13910. doi:10.3748/wjg.v20.i38.13904

Overview

You will now have completed 6 weeks of texture progression and your stomach should have healed enough for you to gradually introduce regular texture foods and begin to increase the variety of foods in your diet.