Gastric Sleeve Leak (Expert’s Guide)

Gastric Sleeve Surgery, or VSG (Vertical Sleeve Gastrectomy), is the process of surgically altering the stomach size by removing 75% to 85% of it, leaving a sleeve-shaped pouch. This provides less physical holding space for food and restricts how much you can eat in one sitting, resulting in weight loss. After gastric sleeve surgery, the body will reduce the production of Ghrelin, a hunger hormone that communicates to the brain what you need to eat and how often.

Although gastric sleeve surgery helps morbidly obese patients to lose significant expected weight loss, the procedure does carry potential complications. One of the complications that most patients fear is the possibility of gastric sleeve staple line leak.

The published leak rate for sleeve gastrectomy is 2.8% – at Mexico Bariatric Center®, we are significantly lower than average at less than 0.5%. Most leaks can be detected by CT Scan and managed non-operatively. Mexico Bariatric Center surgical teams use staple-line reinforcement, 3 leak tests during and after surgery, and place abdominal drains to detect and prevent gastric leaks.

What is a Gastric Sleeve Leak?

A leak after laparoscopic sleeve gastrectomy is typically a small seam or hole between staples in the newly formed stomach sleeve. The sleeve leak or fistula usually causes digestive fluids to excrete from within the stomach into the abdominal cavity, exposed to internal organs and tissues.

Sometimes, as the gastric contents leak out from the sleeve, a small fluid collection, or abscess, forms next to the sleeve.

Types of Gastric Sleeve Leaks

• Early Leak – 95% of leaks are discovered within three days (the patient would still be in the care of the Mexico Bariatric Center surgeons if gastric sleeve surgery was performed in Tijuana, Mexico).
• Delayed Leak – 99% are identified within 30 days post-op (including the 95% early leaks) – meaning 4%-5% of sleeve leakage is experienced after patients return home.

Treatment of Gastric Sleeve Leaking

Treatment of an early leak, diagnosed within the first 3 days after surgery, is generally easier than a delayed leak, diagnosed more than 8 days after surgery.

• The quickest, best way to treat an early leak is to perform emergency abdominal surgery to wash out the infection, seal the hole in the pouch and put a drain. Another benefit of surgery will typically address any issues that cause concern during surgery.
• A delayed leak is successfully managed with the placement of an Esophageal Stent endoscopically (2 to 6 weeks), abscess drainage, and anantibiotics.
• The patient will be on total parenteral nutrition starting with clear liquid and transitioning to pureed food in 2 months.

Making sure that you are getting help right away could mean the difference between gastric sleeve surgery success and failure. You will want to make sure that you pay close attention to the way that you are feeling in the weeks following the operation.

What Causes Gastric Sleeve Leaks?

Gastric leaks are typically caused by three scenarios:

• Mechanical misfiring of the stapler device.
• Stitches or staples may loosen.
• Damage to the tissue at the staple line.

Symptoms of a Gastric Sleeve Leak

Those that may have a gastric sleeve leak could experience increased heart rate, an overwhelming sense of anxiety, a fever and a consistently worsening shortness of breath. These signs could indicate that you are experiencing a gastrointestinal leak, and it is important that the patient contacts the surgeon immediately if this is the case. Additional symptoms:

• Abdominal pain
• Chest pain
• Shoulder pain
• Dizziness
• A sense of illness

If you experience any of the warning signs listed above, it is recommended that you call your physician. In case you feel dizzy or having difficulty breathing, call 911.

How to Avoid Leaks, Lower Risks?

• Avoid NSAID Usage
• Follow Post-Op Diet
• Rest Following Surgery

Mexico Leakage Prevention Practices

Mexico Bariatric Center Leak Rate: Out of every MBC has 2,000 patients, only 3 or fewer patients may experience a leak. In general, 9 out of 10 of the leaks will be discovered and treated before the patient leaves Mexico. Only one patient with a leak is discovered after they return home.

Sleeve vs. Other Bariatric Surgery Complications

Gastric sleeve is a fast and long-term treatment for obesity for most patients. Sleeve surgery has some significant advantages, such as a lack of Dumping Syndrome, which is common with other types of weight loss surgeries, such as bypass. Compared to other bariatric surgeries, gastric sleeve risks are also likely minimal.

Sleeve weight loss surgery does not require you to have any foreign body, and weight loss is more natural. Your body will stop requiring that you eat more to become full, so you will use only what you have for nutrients and will not store very much.

Contact Our Staff Today

While a gastric sleeve can help those who need to lose weight accomplish their goals, possible complications, like gastric sleeve leaks, can cause problems with the recovery process. These difficulties need to be dealt with immediately to avoid more damage.

Several symptoms can relate to gastric sleeve leaks, and you should talk to your surgeon about them before you agree to the surgery. Contact our helpful patient care coordinators today to learn about potential risks and complications following gastric sleeve surgery.