surgery?
One of the worst complications of obesity operations is the leakage after the gastric sleeve operation, because the patient and his family are exposed to it, and before all of that the treating team suffers from suffering and psychological pressures, the extent of which only God knows.
Although the sleeve gastrectomy process is one of the easiest obesity operations, it may turn into a difficult process, and its end will be tragic, up to death.
As for why the patient and the doctor suffer, this is because the treatment period is long, it may take between two to 6 weeks inside the hospital, and follow-up treatment after that for a period ranging from 3 to 6 months!
This is a general law in surgery, even the appendix operation, with its ease, but it often led to many risks and deaths.
What should you do before the sleeve gastrectomy?
Mental and physical readiness
Starting an integrated sports nutrition program
Change in lifestyle and eating behaviors
Increase your information about the process and everything related to it, both positively and negatively.
Perhaps the best way for those who want to gulp is
Take on the role of the mute before starting the operation
What is the leak?
It is the exit of the contents of the upper digestive system from inside the alimentary canal into the abdominal cavity, often between two to four weeks after the operation, and often at the beginning of the stapling line
There is a theory that (high pressure inside the stomach and esophagus, especially with vomiting, may lead to an explosion of the stapled line)
Its reasons
Technical reasons such as poor surgical tools and poor experience of the surgeon
Pathological causes such as the presence of chronic diseases and stomach infections
Previous stomach surgeries, such as stapling, packing and ballooning
Patient''s lack of adherence to diet and cessation of smoking
Unknown causes, may be immunological or genetic
Clinical signs of leakage
Severe pain in the upper abdomen
An increase in the rate of breathing
Increase in heart rate
high temperature
blood test
High white blood cells
CT scan
The presence of an accumulation inside the abdomen
Diffusion of the dye beyond the bounds of the stomach sleeve
Treatment steps
As soon as these symptoms occur, the patient must communicate with his doctor, and quickly enter the hospital, the sooner the treatment, the better the results
Do not take anything by mouth
Intravenous fluids and rehydration
Intravenous antibiotics and analgesics
Preparing for the operation if necessary
Often there is a gathering inside the abdominal cavity and this needs quick drainage in one of the ways:
External drainage under interventional rays
Laparoscopic surgical drainage with washing and cleaning, and this is the most common
Opening the abdomen with drainage and lavage
and what ?
The patient needs sustainable nutrition for a certain period (6 weeks to 3 months) in one of the ways:
Central intravenous nutrition
Feeding through a tube from the nose to the small intestine
Direct feeding of the intestines through the abdominal wall (this is often done at the time of surgery)
Is the story over? No, not yet!
The patient needs an internal stent to prevent leakage of the contents of the digestive system and to reserve the damaged part of the stomach, for healing and construction again.
And what is the pillar?
It is a flexible metal tube that is ed endoscopically to cover the inner wall of the alimentary canal, starting from the bottom of the esophagus to before the duodenum.
How long does it take for the stent to stay?
From 4 to 10 weeks, depending on the patient''s condition
Many patients, two weeks after installing the stent, can leave the hospital and eat their food through the food tube or orally if the stent is in a good and appropriate position, but they need to visit their doctor frequently to complete the treatment plan.
In the end, the stent is extracted laparoscopically, with some tests done the next day, such as dye rays and some blood tests.
After this long journey, the patient leaves the hospital with an outpatient follow-up, bringing with him memories full of pain and hope.
I do not see God hated.
Written by Dr. Salem Mansour Al-Sawat
