Frequently Asked Questions - Gastric Sleeve Surgery

What bougie size does the doctor use?

Dr. Alvarez uses a 32 Fr bougie for the gastric sleeve procedure. This is the bougie size that has the best results without having complications such as strictures.

Complications?

This is a Table of the possible complications reported in literature and Dr. Alvarez’s complications.
As with any surgery, there can be complications. This list can include:

Complication

Literature

Dr. Alvarez

Deep vein thrombosis

0.5%

0.25%

Pulmonary embolism

0.5%

0%

Pneumonia

0.2%

0.5%

Acute respiratory distress syndrome

0.25%

0%

Spleenectomy

0.5%

0%

Gastric leak and fistula

1.0%

0.32%

Postoperative bleeding

0.5%

0%

Small bowel obstruction

0%

0%

Death

0.25%

0%

Note: These results are based on the first 6,000+ sleeves done by Dr. Alvarez

Maintenance of the VSG?

VSG procedure differs from Lap-band surgery because it is free of “maintenance”. Meaning, you will not need any band adjustments or “fills”, nor will you have any erosions or slippage because you have no band. The VSG does not need regular checking (blood work, vitamin screening, etc.) as with the Roux en Y Gastric bypass or Duodenal switch because you have no mal-absorption

What kind of staples do you use?

Will they sound off the alarm if I cross the metal detector in an Airport?
We use titanium staples made by Autosuture in the United States. We use these because they have 3 rows of staples. That gives the patient an added sense of security. We also over sew the staple line making our leakage rate % very low.

Do you use stitches to close up the incisions?

Dr. Alvarez uses an absorbable suture called Monocryl®. So no stitches need to be removed. Your small wounds will be covered with Steri-strips™. They will stay on for about 7 days. You will be able to shower with regular soap and water. You will be instructed not to apply any ointments or creams on the wounds for 15 days. You will not be able to submerge in a bathtub, hot-tub or a swimming pool for a couple of weeks.

How many incisions are done in the surgery and what size?

VSG Incisions

How much protein per day should I be eating?

Studies show that you should take between 40 to 70 grams of protein daily, especially in the first 6 to 12 months post-op.

What kind of diet will I be on Post-op? Do you send me information?

We take our patients by the hand step by step. We will inform you pre surgery what will be required of you. This includes your post-op diet guide, any special instructions you may need as well as aftercare directions.

Should I be taking a Vitamin everyday?

Although there are no reported vitamin deficiencies, we recommend a multivitamin (chewable) to our patients once daily.

Will I lose my hair?

Hair loss is the result of bad eating habits. You can prevent it by eating enough protein and taking your vitamin supplement.

Will I have nausea?

There are people who are very sensitive to the anesthesia. These people tend do be a bit more nauseated than others. The manipulation of the stomach during surgery may also produce some nausea in some patients. The post-operative VSG patient that does present with nausea, is around 15-20%. Nausea does subside in the next few hours post-op. All of our patients receive medications to prevent nausea in the recovery room.

Will this fix my heartburn?

Probably. Heartburn or acid reflux (GERD) is directly related to being overweight (there are other causes of GERD). Once you start losing those pounds you should notice that the heartburn starts to disappear. We give each patient who undergoes the VSG a treatment to reduce the acid production in the stomach, which also reduces the heartburn.

How easy is it to stretch out my new tummy?

Not easy at all. No such thing has been documented on 5-year studies.

What are the long-term results of VSG?

Since it is a quite new procedure, there are no long-term studies (10 years) yet. But studies have shown that the VSG has similar results to the Lap-Band or Roux en Y but without their complications at 5 years.

Can I drink alcohol?

Yes, but it is not recommended. Alcohol has many calories and will not help on your progress with your weight loss. Alcohol intoxication will also hit you a lot faster with the VSG than other surgeries.

How does Smoking affect my surgery?

It hinders the healing process and if you are looking to get healthy you should quit.

How much time off work?

After a bariatric procedure done through laparoscopy you will be able to do your regular activity once you get home. Drive in 3 to 4 days and return to work in 5 to 7 days. Some people who have desk-jobs return to work immediately. We restrict our patients on “heavy” weight lifting for 30 days.

What kind of staples do you use? Will they sound off the alarm if I cross the metal detector in an Airport?
We use titanium staples made by Autosuture in the United States. We use these because they have 3 rows of staples. That gives the patient an added sense of security. We also over sew the staple line making our leakage rate % very low.

How would I know if I had a leak?

Our leakage rate is at 0.32% with over 6,000+ patients. But say you did have a leak, symptoms would be fever, abdominal pain, tachycardia (elevated heart beat), intolerance to liquids, etc. For this reason, we perform 2 leak tests in the operating room after the sleeve is completed, a blue dye and an air test before you are brought from under anesthesia.

What kind of follow-up do I need with my primary care doctor/lab tests?

We give all our patients the “paperwork” needed for follow-up. You take home your surgery report, lab test, chest X-ray, etc. So if any other doctor in the states is going to be seeing you he will know exactly what was done inside you and what to expect.  VSG patients don’t need to be attended to by doctors as regularly as Lap-Band or Roux en Y patients. Our coordinators keep in touch with all of our patients via email or telephone to ensure you are doing well and to answer any questions you may have post-operatively.

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Contact Dr. Alvarez Today
Dr. Alvarez believes that educating his patient about bariatric surgery is the best way to provide a positive patient experience. During a comprehensive consultation, he helps patients learn more about their weight loss surgery options, including the difference between gastric sleeve and Lap Band or other procedures. Contact his practice today at 1-866-697-5338 to schedule a consultation and decide which procedure is for you.

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