Gastric Sleeve Surgery or Vertical Sleeve Gastrectomy (VSG) is the process of surgically altering the size of the stomach by removing 85% of it which leaves by a sleeve-shaped stomach.
This provides less physical holding space for food and restricts how much you can at one time 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 (VSG) 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% (0.5% at Mexico Bariatric Center). 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 prevent gastric leak.
What is a Gastric Sleeve Leak?
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 will usually cause 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
- 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.
Measures taken by MBC surgical teams to prevent leak:
1. Reinforcing Staple Line – Mexico Bariatric Center’s top surgeons’ dedication to patient care means we take every precaution with our patients. Reinforced Staple Line With Sutures, done after three lines of staples.
2. Leak Tests – Gastrointestinal leak test has shown to avert complications in the future. To detect any leaks after surgery, our top Mexico weight loss surgeons typically perform two leaks tests for all gastric sleeve patients. If a leak is detected, the doctor will treat the leak BEFORE a patient is sent home.
- During Surgery: The new stomach pouch is filled with methyl blue dye, and the surgeons observe the stomach from the abdominal cavity to ensure no blue color is seen.
- After Surgery: The day after surgery, patients will be asked to drink a hydrosoluble contrast solution. Then the stomach will be viewed via radiology to ensure the solution does not escape the stomach into the abdominal cavity. Patients are sent home with a copy of these results.
Gastric Sleeve vs. Other Bariatric Surgery Complications
Gastric sleeve is a fast and long-term treatment of obesity for most patients. Sleeve has some significant advantages such as a lack of Dumping Syndrome that is common with other types of weight loss surgeries, such as bypass. Compared to other bariatric surgeries, gastric sleeve potential risks are also minimal.
Sleeve weight loss surgery does not require that you 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 in need of weight loss to accomplish their goals, there are some potential complications such as a gastric sleeve leak that can cause problems with the recovery process. These difficulties need to be dealt with immediately to avoid more damage.
There are several symptoms that you can relate to gastric sleeve leaks, and you will want to make sure that you talk to your surgeon about them before you agree to the surgery.
Contact our helpful, patient care coordinators today to learn more about the potential risks and complications following gastric sleeve surgery.