Consent: Sleeve Gastrectomy - Podcast Version 0:00 / 0:00 1x 0.25x 0.5x 0.75x 1x 1.25x 1.5x 1.75x 2x 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. Adobe Stock, Licensed to TeachMeSeries Ltd Figure 1Illustration 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 Frequent questions What is a sleeve gastrectomy? A sleeve gastrectomy is a surgical procedure that reduces the size of the stomach by removing the greater curvature, resulting in a tube-like structure approximately 4-5 cm wide. This operation primarily functions through a restrictive mechanism to aid weight loss. What complications can occur during sleeve gastrectomy? Intra-operative complications may include significant haemorrhage due to damage to surrounding structures like the bowel, liver, or spleen. Additionally, anaesthetic risks such as injury to the teeth or throat and reactions to medications are also potential concerns. What are the early complications associated with sleeve gastrectomy? Early complications can include infections, leakage from the staple line, and cardiovascular events like DVT or PE. Preventative measures such as intravenous antibiotics, wound irrigation, and careful post-operative care can help mitigate these risks. What are the late complications of sleeve gastrectomy? Late complications may involve metabolic and endocrine disturbances affecting nutrient absorption and gastric secretions. Collaborating with a specialist bariatric dietician is crucial for managing these changes in post-operative patients. What factors can lead to failure in weight loss after sleeve gastrectomy? While sleeve gastrectomy is generally effective for weight loss, some patients may fail to achieve their goals due to various factors, including individual metabolic responses and adherence to post-operative lifestyle changes. Rate This Article