Sleeve Gastrectomy

Illustration en rose et bleu d'une sleeve gastrique : représentation graphique de la procédure chirurgicale de sleeve gastrectomie, avec des tons de rose et de bleu. L'image montre la résection d'une grande partie de l'estomac pour créer un tube étroit, réduisant ainsi sa capacité

Mode of action: Sleeve or vertical gastroplasty.

The Sleeve gastrectomy, or "vertical gastroplasty," is a bariatric surgery procedure performed by Dr. Patrick Noel.

It is a restrictive and non-reversible technique that involves removing a large portion of the stomach while maintaining digestive continuity. The stomach is reduced to a tube that slows down the passage of food, which is then evacuated more quickly into the small intestine.

The Sleeve promotes weight loss by:

Limiting food intake through the reduction of stomach volume. With a smaller stomach, it can no longer accommodate large amounts of food.
Providing a faster feeling of fullness by reducing ghrelin levels (the hunger hormone).

The selection criteria are rigorous, it is not necessary to have a BMI greater than 40 to be operated on in Tunisia. We treat patients with a BMI of 30 .

Result of a Sleeve

With a Sleeve, the expected weight loss is around forty kilos after one year, i.e. 70% excess weight. If it turns out to be insufficient to obtain greater weight loss, it can then be transformed into Bypass under good security conditions.

Currently, the Sleeve is often offered instead of gastroplasty (gastric banding) for the following reasons:

It causes a rapid feeling of satiety, like gastroplasty.
It does not require the placement of a foreign body (gastric band).
Vomiting is less common than with gastroplasty.
It decreases the rate of ghrelin, and therefore the feeling of hunger, as in the Bypass.
It is performed by laparoscopy

Sleeve: The course of the operation

The operation takes place under general anesthesia. It lasts about 2 hours.

The intervention takes place by laparoscopy-laparoscopy. Incisions (generally 3 to 5) are made in the abdomen and trocars are placed. A tube, called a candle, is introduced through the mouth into the stomach. It serves as a calibration for the new stomach. With automatic forceps, the stomach is cut and sutured at the same time with a triple row of staples. The resected part of the stomach is then removed from the abdomen.

The scars are sutured with absorbable thread, more rarely with non-absorbable thread or staples.

Complications and postoperative follow-up of the sleeve

Malnutrition and vitamin deficiencies are rare.
No oral supplementation is necessary.
A biological assessment after a weight loss of 25 to 30 kg is carried out. It sometimes shows small vitamin deficits which are easily compensated orally.
The Sleeve is not reversible. However, in a certain number of cases, the tube risks dilating after 3 to 4 years, and is no longer effective.
Eating habits should be changed, 3 meals and possibly 2 snacks.
Vomiting is quite rare.
Regular monitoring by a multidisciplinary team is mandatory.
2 blood tests are necessary the first year, then 1 blood test per year, to look for a vitamin deficiency.

Learn more about the Sleeve in Tunisia with Dr Patrick Noel

Hospitalisation d’une Sleeve gastrectomie

Hospitalization & price of a sleeve gastrectomy in Tunisia

The duration of hospitalization is 4 to 5 nights for optimal monitoring.

For obvious security reasons, the duration of the stay will be imposed, namely 6 days / 5 nights on Tunisian territory. Essential time to ensure that you can return home safely.

Price of Sleeve gastrectomy in Tunisia with Dr Jabbes: 3800 € (all-inclusive stay).

The Nissen sleeve in Tunisia

The Nissen procedure is a surgical operation indicated in the treatment of gastroesophageal reflux disease, otherwise known as GERD, or for a hiatal hernia.

Sleeve gastrectomy alone can lead to or aggravate postoperative reflux in the patient. Associating the Nissen gesture with a Sleeve within the same intervention makes it possible to avoid this complication.

This operation consists of making a valve with stomach, which will surround the esophagus on its terminal part in order to prevent acid reflux. It is a kind of anti-reflux valve used to prevent the rise of food from the stomach to the esophagus. Once the valve has been made, a calibration tube is positioned in the stomach, and the latter is cut as for a sleeve gastrectomy.

Check out our full article on the Nissen sleeve in Tunisia .

The Nissen Sleeve

The Nissen procedure is a surgical operation indicated for the treatment of gastroesophageal reflux, also known as GERD, or for a hiatal hernia.

Sleeve gastrectomy alone can lead to or worsen reflux in postoperative patients. Combining the Nissen procedure with a Sleeve in the same intervention helps to avoid this complication.

This operation involves creating a valve with part of the stomach, which will wrap around the esophagus at its terminal part to prevent acid reflux. It acts as a kind of anti-reflux valve to prevent the backflow of food from the stomach into the esophagus. Once the valve is created, a calibration tube is placed in the stomach, and the stomach is cut as in a Sleeve gastrectomy.

Please refer to our comprehensive article on the Nissen sleeve.

nissen sleeve dr patrick noel estelle pasquier