Gastric Sleeve Surgery in St. Louis, MO

Gastric Sleeve is done for weight loss as well as to improve one’s quality of life and improve health by preventing or treating common medical conditions such as:

• Hypertension
• Sleep Apnea
• High Cholesterol
• Heart Disease
• Type 2 Diabetes
• Stroke
• Cancer
• Infertility
  
  

It is a life saving intervention.

• If your BMI is over 40
• Anyone with a BMI of 35-39 and with associated comorbidities such as Hypertension, Diabetes etc is a good candidate for Gastric Sleeve.
• Select patients with Class I obesity ( BMI 30 to 35) with co morbid conditions have been shown to benefit from gastric sleeve surgery.

There is no specific wait period for gastric sleeve surgery at Arch Bariatrics. Most times the “wait period” is dictated by the type of medical insurance or your payment and financing options

At Arch Bariatrics every patient needing weight loss surgery is needed to complete the following

•       A consultation and discussion with Dr. Kumaran Chinnappan
•       Medical clearance from your Primary Care Physician
•       Psychological clearance from a licensed professional
•       Arrangement of finances or approval from your insurance
•       Dietary evaluation and follow pre op diet as advised.

We have a Self Pay price of $11,111- all inclusive with no additional cost. This cost includes surgeon fee, facility charges, anaesthesia charges and hospital stay. 

Many health insurances do cover gastric sleeve surgery for patients who qualify. There may be patient responsibility in terms of copay, coinsurance or deductibles. Please refer to your insurance contract for further information.

• You will be on diet as advised.
• You will do preoperative lab work as advised.
• Avoid anxiety and maintain a positive mindset.
• Prepare yourself for a one night stay in the hospital
• Arrange for someone to drop off and pick up from the hospital

Yes. You may be placed on a special pre-operative liquid diet for 1-2 weeks. This diet helps to shrink the liver and to reduce the fat inside the abdomen. This reduces the risk during the procedure.

In addition, some insurance companies might require you to participate in a physician monitored diet program for 3 to 6 months prior to them approving your surgery. This program is more about diet education and demonstrating behavioral changes and willingness to be compliant to the program.

• Arrange to arrive at the time as advised
• You will be received in a pre procedure room and change into hospital attire.
• Dr. Chinnappan and an anaesthesiologist will meet you and go over the procedure again and answer any questions you may have.
• An IV line will be started in your arm and fluids and medications will be administered.
• Your family member or friend can stay with you until you are taken to the operating room.

 Usually the surgery takes about an hour to complete. This could be variable depending on an individual patient’s body habitus or scarring from previous surgery etc.

Since the procedure is done by laparoscopic (Key hole) method, the pain is not severe and typically well controlled by regular pain medications. In addition you may have a pain medication delivered through a pain pump placed during surgery.

There are two kinds of pain due to gas after the surgery. 

We use carbon dioxide (CO2) to inflate the abdominal cavity to perform laparoscopic sleeve gastrectomy. Usually all the CO2 is evacuated completely at the completion of the procedure. Occasionally some CO2 may be trapped and cause abdominal discomfort or shoulder pain. This is rare and resolves in 24- 48 hours after surgery and the pain medication can be effective in giving relief.

Another kind of “Gas Pain” is when some air is trapped in the lumen of the stomach. Intake of carbonated beverages (soda), using straw or chewing gum can precipitate this kind of pain and should be avoided. This is self limiting and resolves on its own. Improving ambulation or simethicone drops can provide relief.

After the surgery you will be moved to the Post Anesthesia Care Unit (PACU) for observation. When awake you will be shifted to your room on the hospital floor. You will be strongly encouraged to walk in the room as well as the corridor on the floor. Regular use of an incentive spirometer (provided) is also encouraged. You might feel very sleepy on the day of surgery and that is to be expected.

You will be started on a clear liquid diet next morning. It is normal to expect some nausea, vomiting or acid reflux during this time. As the day goes by your oral intake typically improves and you can expect to be released home after noon.

It is extremely important to maintain adequate intake of fluids and protein to prevent dehydration and weakness.

It is not advisable to drive within 24 hrs of general anaesthesia and when you are taking strong pain medications. Please arrange for someone to pick you from the hospital upon discharge. You may be able to start driving 3-4 days after the surgery.

Most patients can expect to return to work in 1 week after surgery. People working from home may be able to return sooner.

In the initial phase immediately after the gastric sleeve surgery, you might experience pain in the lower chest while swallowing. This is due to the narrowed food passage as well as some air trapped in the pathway. Drink/eat slowly, small amounts at a time and walk and try to be in an erect posture while swallowing. Do not drink while lying in bed. Do not stop trying!

  Week 1-    Clear liquid diet. We advise Protein water as a source of protein.

  Week 2 –   Full liquid diet. You may start taking Protein shakes.

  Week 3-    Soft diet.

  Week 4 –  Regular diet.

You will regain a normal diet gradually but will consume lesser quantities. You can expect to have weakened appetite and craving. Healthier food choices are very important for the rest of your life. 

At Arch Bariatrics, we recommend you crush your pills for the 1st month after surgery if the size of your pill is bigger than an M&M.

The day of surgery! You will be encouraged to walk on the same day of surgery. We advise you to continue short walks and low impact exercise in the initial days after surgery. It is a good idea to avoid lifting heavy objects in the initial 4 weeks after surgery. After this time there are no restrictions to physical activity or limitations on exercise.

In the long term behavioral change to accommodate a regular exercise regimen is strongly advised. Regular exercise helps to burn calories as well as control appetite and stress. The exercise need not be intense and painful.