Gastric Sleeve Gastrectomy

In Australia, a gastric sleeve, or otherwise known as a sleeve gastrectomy, is considered a permanent weight loss solution and is designed to last the lifetime of the patient. This surgery will remove around 70 to 80% of the stomach, and significantly reduce its size and the amount of food you can eat. To ensure the long-term success of the gastric sleeve surgery, there has to be an ongoing commitment to a healthy diet and regular exercise. This will ensure you see the greatest results you can.

Most people lose weight quickly in the first 3 months following surgery and then the weight loss gradually slows down. We aim for around 30% total body weight loss at the end of 12 months. However, you can continue to lose weight depending on your diet and exercise which is key.

The short answer is YES, gastric sleeve surgery is partially covered by Medicare; however, the coverage is for only a small portion of the surgery (approximately $700).

Gastric sleeve surgery still carries out-of-pocket costs for the patient. It is also important to take into account that Medicare will only cover a portion of the surgery if you meet the required medical criteria.

In most cases, the people who qualify for a sleeve gastrectomy, otherwise known as gastric sleeve surgery, are those who are considered to be severely obese (those with a BMI of >40 or BMI of >35 with more than one present disease or condition are usually required).

If you are someone who has or is at risk of developing a serious medical condition as a result of your body weight, then a gastric sleeve can be the perfect way to improve or even eliminate disease risk.

Some common diseases or conditions that gastric sleeve surgery can improve include:

• Type 2 diabetes (partial or complete remission)
• Hypertension and hypertensive heart disease (reduced blood pressure)
• Sleep apnoea (weight loss from gastric sleeve can eliminate or reduce sleep apnoea severity)
• High cholesterol (hyperlipidemia) and arterial disease (improves cholesterol and reduces cardiovascular risk over time)
• Osteoarthritis & joint pain (reduces pressure on knees, hips, and spine and improves overall mobility)
• Depression & anxiety from obesity (improvements in self-image, mobility, and health often lead to better mood and lower depression scores)
• Nonalcoholic fatty liver disease and steatohepatitis (reduces liver inflammation and can reverse early liver damage)

You can expect your diet to undergo rather significant changes after gastric sleeve surgery to ensure that your body makes the necessary adjustments to your smaller stomach size.

This usually involves a multi-stage post-operation diet to ensure that your body recovers in the way that it needs to.

• Stage 1: Recovery Phase Post Surgery (1-2 Weeks) - Liquid only diet (water, tea, sugar-free drinks) to allow your body to heal and avoid any complications. Do not drink anything with sugar in it, and avoid beverages that contain caffeine or are carbonated.
• Stage 2: Pureed, Soft Food and Full-Liquid (2-4 Weeks) - Once you have passed through the first two weeks, you can begin to slowly incorporate (smooth soups, scrambled eggs, silken tofu, hummus, baby food, Greek yoghurt). It is integral that you eat slowly and chew thoroughly. In this period, it is essential that you focus on increasing your protein intake. Keep portions to small amounts to avoid stretching the stomach.
• Stage 3: Soft and Slightly Solid Foods (4-8 Weeks) - When you reach just over a month post-surgery, you can begin to incorporate the softer side of solid foods back into your diet. These options include chicken, fish, turkey, soft vegetables, sweet potato, eggs, and soft fruit such as bananas. Taking your time to slowly digest and chew your food is essential to reducing any discomfort or nausea.
• Stage 4: Going Forward (Long Term) - To make the most of your surgery and see the biggest changes, you will want to keep the focus on consuming lean proteins, vegetables, fruits and healthy fats so that you can monitor your body’s reaction. It is also recommended to consume vitamin supplements to avoid any deficiencies due to reduced food intake. Consult with your dietitian or healthcare provider to ensure that you are meeting your nutritional goals. It is always essential that you follow a medical professional's recommendations closely.

You need to have a BMI>40 or BMI>35 with obesity associated illnesses. This can include diabetes, high blood pressure, high cholesterol, polycystic ovaries, sleep apnoea and osteoarthritis.
a. Can you get gastric sleeve if you are not obese? No.
b. Can you be too overweight for weight loss surgery? Yes. There are risks associated with the surgical procedure which increases with your BMI. We then aim to commence the weight loss process with life style changes, meal replacements (VLCD) and/or weight loss medications prior to proceeding with surgery

While generally, gastric sleeve surgery is considered a highly effective procedure for weight loss, there are some considerations you’ll have to take into account when deciding whether or not a gastric sleeve is right for you. - Permanent Decision: A gastric sleeve is a permanent and irreversible procedure that removes 70 to 80% of the stomach. - Risks of Surgery: Infection, bleeding, blood clots, and anaesthesia complications are all risks associated with gastric sleeve. - Heartburn and Reflux: Many clients who have had the procedure report increased acid reflux. Serious cases of this may require lifelong medication. - Nutritional Deficiencies: After surgery, you will be eating less, and that can mean there’s a higher risk of vitamin and mineral deficiencies. This means daily supplements may be required. - Mental Health: Post-surgery, some people may experience body image issues, emotional eating, or feelings of isolation, and may benefit from psychological support. Despite these downsides, many Australians find the benefits of gastric sleeve surgery worth it, and the risks associated with it can be easily managed with proper lifestyle and medical support.

The cost of gastric sleeve surgery in Australia can vary depending on whether you have private health insurance, self-fund the surgery, or use Medicare. Below is a handy table breaking down the costs.

Pain associated with the gastric sleeve surgery is usually mild to moderate, and only in the short term. In Australia, the procedure is performed under general anesthesia, so there’s no pain during surgery. Most patients will experience a certain level of soreness around the incision site for a few days after. This is easily managed with medication. By the second week, pain is almost always minimal, and almost all usual daily activities can be resumed. Overall, the pain from gastric sleeve is very manageable and can be improved quickly with proper care.

A gastric sleeve weight loss calculator provides an estimate of how much weight you could lose after gastric sleeve surgery. Rates for this are based on your starting weight, BMI and gender. After surgery, on average, 60 to 70% of excess weight is lost within 12 to 18 months. Those who follow a strong diet and exercise regimen following the surgery often see even greater results.

No, it is generally not recommended to take ibuprofen two years post-gastric sleeve surgery. Ibuprofen, especially stronger versions, can irritate the stomach lining and increase the chance of ulcers, bleeding and gastritis. Most medical professionals advise against using ibuprofen, but in certain cases, they may provide a prescription if really necessary. Alongside the prescription, they will provide a stomach-protecting medication such as Nexium. Always consult your GP before taking any new medication after gastric sleeve surgery.

You don’t have to wait long before getting back behind the wheel after gastric sleeve surgery. Most people are back to regular driving within one week, but it all depends on how your recovery is. Some may be ready sooner than others, and it is essential that you don’t rush anything. You must look after yourself.

In Australia, strict medical guidelines ensure that gastric sleeve surgery is a very safe procedure, especially when performed by an experienced bariatric surgeon. It is one of the most commonly performed weight loss surgeries worldwide, with major complications being incredibly rare (only seen in 1 to 2% of cases). While there are a series of long-term risks, these are easily managed through healthy lifestlye habits and general support.

No, gastric sleeve surgery is not reversible. 70 to 80% of your stomach is permanently removed during the surgery. As a result of this surgery’s permanence, it is essential to understand the long-term outcomes and commitments involved before making the decision whether or not gastric sleeve surgery is right for you.

Approximately 60 minutes.

You can definitely overeat, which can lead to feeling overfull or even cause you to vomit. This is not recommended! But in short no, it is not technically possible for you to do something to cause a tear.

Dumping syndrome occurs when simple carbohydrates quickly enter the small bowel, causing fluid to be rapidly drawn into the gut. This can lead to low blood pressure and a sympathetic response. The main symptoms patients complain of are cramping abdominal pain, sweating, diarrhoea and light headedness.

Leak tests are not routinely performed. However if there is concern, we may ask you to drink some contrast and have either an x-ray study (where they follow the contrast as you swallow it) and/or a CT scan.

Leaks can present with symptoms such as fever, raised heart rate, a higher breathing rate, abdominal pain or shoulder tip pain. Some people just feel generally off, especially if they had felt they were improving and things start getting worse again. If you experience any of these symptoms after discharge, please contact your GP or get in contact with us directly as you may need further investigations. In rare circumstances, people may present with sepsis and be extremely unwell. This is far less common.

Leaks can occur early (ie within 7 days), but they can also occur up to a few months post procedure. Although it is an uncommon complication, occurring in <5% of patients, it is one of the main issues that doctors will monitor for. If you experience new fevers, shortness of breath, abdominal pain or can feel your heart racing- we suggest seeing your GP or presenting to the emergency department for review. You should also get in contact with us so we can advise and assist.

After discharge on around day 2 following the procedure, we recommend a week or two of resting at home before getting back into work and regular activities. Walking is excellent for recovery and we recommend building up the distance as tolerated. You should not be performing vigorous exercise, specifically anything that causes you to strain your abdominal muscles or require you to lift more than 10kg until you have been cleared at your post op visit.

We remove approximately two thirds of your stomach so yes it is a major surgery! Having said that, the operating time is minimal and the stay in hospital is usually only a few days.

You are only under anesthetic for a short time before and after the procedure with the surgery time still approximately 60 minutes. The total time of general anesthetic is around 90 minutes.