What is a tube stomach?
In addition, the sleeve gastrectomy also seems to set hormonal processes in motion that curb appetite. There is evidence that after sleeve gastrectomy, the stomach produces lower amounts of the so-called hunger hormone “ghrelin”, which additionally reduces appetite. At the same time, appetite-suppressing messenger substances are released. These include, for example, “GLP-1” and “peptide YY”.
Sleeve gastrectomy is performed worldwide with a strongly increasing tendency. In Germany, sleeve gastrectomy is the most frequently performed bariatric surgery procedure.
Preparation for the sleeve stomach surgery
Procedure of the tube stomach surgery
In a sleeve stomach, most of the stomach is removed. What is left is a two to three centimeter narrow tube (sleeve stomach) with a capacity of about 80 to 120 milliliters.
- After the surgical instruments and camera are inserted, the abdominal cavity is filled with a gas (usually carbon dioxide) to provide better access and visibility of the abdominal organs.
- The separated part of the stomach is pulled out of the abdominal cavity through one of the working channels using a so-called plastic mountain bag. Dye is then introduced into the stomach via a stomach tube. This is done to check the tightness of the staple suture along the edge of the incision. If no dye leaks out, the operation can be completed.
For whom a tube stomach is suitable
The prerequisite is that the patient has already made several unsuccessful attempts to lose weight (with changes in diet and lifestyle) under medical supervision. Patients should be at least 18 and no more than 65 years old.
Tube stomach as an interim goal
For whom a tube stomach is not suitable
A tube stomach is unsuitable for people whose excess weight results primarily from the consumption of soft, high-calorie foods or liquids, i.e. who consume a lot of sweets, sweet drinks (“sweet-eater”) or alcoholic beverages, for example. This is because such calorie carriers pass through the stomach tube almost directly anyway (they pass through) without filling it and triggering a feeling of satiety
Effectiveness of tube stomach surgery
The chances of success with regard to weight loss are very high with tube stomach surgery: Initial studies show that, on average, patients succeed in losing between 33 and 83 percent of their excess body weight. Since tube stomach surgery is a relatively new surgical technique, no long-term results are yet available on the success of the method.
Advantages of a tubular stomach over other procedures
In contrast to other surgical procedures, the function of the stomach remains basically intact with a tubular stomach. The closure of the stomach inlet and outlet is also preserved. Therefore, after a postoperative, gradual diet build-up, patients can eat almost normally again – just in smaller quantities.
Side effects
After the operation, patients must take vitamin B12 artificially for the rest of their lives via injections (intramuscularly or as a short infusion). This is because the vitamin can no longer be absorbed in sufficient quantities via the intestines. The reason for this is that because a large part of the stomach is removed, it no longer produces sufficient “intrinsic factor” – a protein that is required for the absorption of vitamin B12 from the intestine.
Risks and complications
As with any surgery, problems or complications can occur during or as a result of tube stomach surgery. In addition to the typical risks of general anesthesia, these include:
- Injury to blood vessels with bleeding or postoperative bleeding
- Injuries to other organs
- Disorders of wound healing or wound infections
- Leakage of the gastric suture (suture insufficiency) with spillage of gastric contents into the abdominal cavity and the risk of peritonitis
- Adhesions of the abdominal organs
Compared with other bariatric surgery procedures, sleeve gastrectomy has a lower complication rate. The individual risk depends largely on the patient’s health status.
Diet after surgery
In principle, all foods are allowed again a few weeks after the tube stomach surgery, provided they are well tolerated. However, for effective weight loss, dietary and lifestyle habits must be fundamentally and permanently changed. The stomach tube is only one – albeit effective – component of obesity therapy.
