Sleeve Tunisia : Sleeve Gastrectomy Surgery for Weight Loss

• The pain is generally not very important. Simple analgesics are enough to calm them.
  Mobilization is usually resumed quickly. Professional activities can be resumed after 3 to 4 weeks, sports activities after 1 month*.
  During the first week following the operation, the food should be liquid (soup, compotes, yogurt, puree…). For the 2nd and 3rd week, the food must be soft (ratatouille, scrambled eggs…). From the 4th week onwards, the food becomes normal again. It should be noted, however, that tolerance to each food is very variable from one person to another.

• On average, about 70% of excess weight is lost during the first 3 years (analysis of 112 studies, nearly 10,000 patients – Parikh et al., Ann Surg 2013); 5 years after surgery, the average loss is about 58% of excess weight (Juodeikis and Brimas, Surg Obes Relat Dis 2017).
• Weight loss is fastest in the first weeks, then slows down; most people reach their lowest weight 12 to 24 months after surgery.
• Results vary from one person to another and depend strongly on nutritional follow-up and physical activity after surgery.

Bariatric surgery of any type, including sleeve surgery in Tunisia, is only considered an option when attempts at diet and your exercise habits, as well as the use of weight loss medications, have not worked.

Even then, you must meet certain criteria to be considered for bariatric surgery. These criteria are based on your body mass index (BMI) and whether or not you have an obesity-related health problem.

Eligibility Requirements:

Extreme (morbid) obesity (BMI of 40 or higher).
Obesity (BMI of 35 to 39) with at least one significant obesity-related condition
Sometimes, gastric sleeve surgery in Tunisia is performed if you are overweight but do not meet the criteria for obesity, but have a significant health problem related to your weight.

With weight loss, many obesity-related health problems can improve or resolve, for example:

Type 2 diabetes: five years after a sleeve, remission or improvement was observed in 77.8% of diabetic patients (review of 20 studies – Juodeikis and Brimas, Surg Obes Relat Dis 2017)
High blood pressure
Fatty liver disease
High cholesterol
Sleep apnea
Risk of some obesity-related cancers
Polycystic ovary syndrome
Asthma
Migraine
Joint pain
Depression and other psychosocial problems
Infertility
Low testosterone levels
Urinary incontinence

With improved surgical techniques and surgeons’ experience, the sleeve has become a common and generally safe bariatric operation. Complications can nevertheless occur during and after surgery; the surgeon explains them to you during the consultation. The main ones are:

• Leak (fistula) at the staple line: a rare but serious complication, seen in 2.2% of patients in an analysis of 112 studies (Parikh et al., Ann Surg 2013). Fever, abdominal pain, shortness of breath or a racing heart after surgery require immediate medical attention.
• Functional stenosis (narrowing of the gastric tube without anatomical narrowing): a rare complication caused by a twist of the staple line.
• Bleeding.
• Blood clot (phlebitis, pulmonary embolism): early walking, compression stockings and anticoagulant treatment, if prescribed, help prevent it.
• Reflux (heartburn): it may improve with weight loss in some patients, but appear or worsen in others; it is usually treated with medication prescribed by the doctor. Revision surgery for reflux was needed in 2.9% of patients followed for 7 years or more (Clapp et al., Surg Obes Relat Dis 2018).
• Nutrient or vitamin deficiency: supplements and regular blood tests are needed in the long term.
• Weight regain: slight regain after 1 to 2 years is common; among patients followed for 7 years or more, significant weight regain was observed in 27.8% (Clapp et al., 2018). Nutritional follow-up and physical activity remain essential.
• Excess skin: after major weight loss, surgery to remove excess skin may be considered once weight has stabilised.

Day 1 to 3: fasting with an infusion. Some surgeons allow patients to drink water a few hours after the sleeve operation in Tunisia

Day 3-14: Full liquid diet including protein shakes, yogurt, broth, milk and juice

Weeks 3 to 5: Gentle diet

Patients can begin to introduce a regular diet 5 weeks after surgery. They are encouraged to eat a small amount of food each time and to eat more frequent meals.

All patients should change their eating habits and take multivitamins and B vitamins after surgery

A sleeve may be preferred, for example, when a gastric bypass would carry particular risks for you; conversely, significant reflux may make a bypass the better option.

You should discuss all available surgical procedures with your surgeon, get his or her opinion about sleeve surgery in Tunisia and determine which one is best for you.