Consent: Sleeve Gastrectomy

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Last updated: March 2, 2022
Revisions: 8

Last updated: March 2, 2022
Revisions: 8

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This article is for educational purposes only. It should not be used as a template for consenting patients. The person obtaining consent should have clear knowledge of the procedure and the potential risks and complications. Always refer to your local or national guidelines, and the applicable and appropriate law in your jurisdiction governing patient consent.

Overview of Procedure

A sleeve gastrectomy procedure primarily works via a restrictive mechanism, whereby the greater curve of the stomach is removed, leaving only a tube ~4-5cm wide.

Figure 1 – Illustration showing the anatomy following a sleeve gastrectomy procedure

 

Complications

Intra-Operative

Complication Description of Complication Potential Ways to Reduce Risk
Haemorrhage Damage to any of the surrounding structures can cause significant haemorrhage
Injury to surrounding structures including bowel, liver, and spleen Damage can occur to any surrounding organ during the surgery
Anaesthetic risks Includes damage to the teeth, throat and larynx, reaction to medications, nausea and vomiting, cardiovascular and respiratory complications Forms a part of the anaesthetist assessment before the operation

 

Early

Complication Description of Complication Potential Ways to Reduce Risk
Infection Includes both wound infections and intra-abdominal collections, as well as respiratory or urinary tract infections post-operatively Intravenous antibiotics at induction, wound irrigation at closure, and early mobilisation
Leak from the Staple Line Leakage from the staple line may occur and can be potentially serious and frequently requires further surgery
DVT or PE, MI, Stroke, or Mortality As with any major surgery, whilst these events are uncommon, important to be aware of; the mortality risk is over 1 in 200 Adequate pre-optimisation and anaesthetic assessment, peri-operative prophylactic LMWH, high-dependency level care post-operatively

 

Late

Complication Description of Complication Potential Ways to Reduce Risk
Metabolic and endocrine disturbances Changes to absorption and gastric secretions of the alimentary canal can affect nutrition considerably post-operatively The involvement of a specialist bariatric dietician in the management of bariatric patients is essential
Failure to lose weight A sleeve gastrectomy is highly effective, but inevitably a minority of patients ultimately fail to lose weight