Common Questions on Gastric Sleeve in Singapore with Dr Ganesh Ramalingam

Dr Ganesh Ramalingam

Obesity and weight problems have been considered an epidemic for many years now. Countries like Singapore do not escape the problem. In the past years, the continuously growing number of obesity rates in the nation, across all age groups, can be deemed concerning. These large numbers speak to the struggle Singaporeans have regarding losing weight.

It is also unfair to conclude that most overweight or obese people do not try or are too lazy to do so. There are various weight loss regimens available in Singapore, whether it is diet plans or workout programs. Most of these solutions focus on your daily consumption of calories. The logic is simple, to lose weight is to burn more calories than you eat. Sounds simple, right?

However, a lot of people still struggle to accomplish this ‘simple’ rule. They are not to blame if they cannot accomplish such an order. Losing weight is more complex than one would think. It may be, due to the lack of professional assistance, they might be doing their weight loss diets and exercises incorrectly, not targeting the aspects they need to hit.

On the other hand, their body might be immune from these types of weight loss solutions, thus they are not yielding their desired results. In this case, people start to seek alternative solutions, including medically assisted weight loss such as a gastric sleeve.

Medical-Assisted Weight Loss in Singapore

As mentioned earlier, many people in Singapore have a hard time losing weight through traditional means such as diet and exercise. Sure, it might give them good results in the beginning, but they are unable to sustain their weight loss and, worse, end up gaining back more weight.

This is usually the case for people who have been overweight or obese for a long time. As their body is already used to excessive weight, they find it hard to shed it off just by mere diet and exercise. Furthermore, they already established unhealthy eating habits that are hard to turn away from. That’s why many of them turn to medical-assisted weight loss solutions such as bariatric surgery.

Bariatric surgery is commonly referred to as weight loss surgery. It creates changes to your digestive system, limiting the amount of food you can eat and assisting your weight loss. It also helps your body to absorb fewer calories from what you eat, avoiding any more excess weight.

In terms of bariatric surgery, you might have heard about gastric bypass. With that said, there’s another less complicated procedure called gastric sleeve that also helps in losing weight.

We teamed up with Dr Ganesh Ramalingam, a surgeon from G&L Surgical, to answer some of the common questions Singaporeans have regarding a gastric sleeve procedure. Dr Ganesh Ramalingam specializes in gastrointestinal, bariatric advanced laparoscopy and endoscopic surgery.

Common Questions on Gastric Sleeve in Singapore

Gastric Sleeve

Q: What is the Gastric Sleeve procedure?

A: Gastric Sleeve or Sleeve Gastrectomy is a bariatric surgery targeted at helping a patient achieve weight loss.

This option is usually recommended for patients who may be required to achieve substantial weight loss due to health reasons but have not been able to, despite making changes to their dietary and lifestyle habits such as exercising.

During laparoscopic sleeve gastrectomy, the stomach is stapled and divided vertically. This procedure requires specially designed surgical staplers, using the keyhole or laparoscopic method. By doing this, about 2/3 or 60% of the stomach will be removed. The remaining stomach is now in the shape of a long narrow tube resembling a shirt sleeve.

The reduced size of the stomach restricts the amount of food the stomach can hold at a time and thus reduces the appetite of the patient, helping them reduce the calorie intake and achieve long term weight loss.

BMI

Q: Who is eligible and what are the criteria?

A: Not all patients can qualify for sleeve gastrectomy. This procedure is only an option if:

  • The individual’s BMI (Body Mass Index) is 40 or above.
  • The individual’s BMI is between 35 and 39.9, and they display signs of serious weight-related health problems such as type 2 diabetes, high blood pressure or severe sleep apnea.

The individual’s BMI is between 30 and 34, however, they have serious weight-related health problems that can be life-threatening and your doctor advises immediate attention.

The patient must also be prepared to make permanent changes to their lifestyle to ensure sustainable weight loss can be achieved. Such lifestyle changes may include:

  • Long-term follow-up sessions with your doctor
  • Following a nutrition plan
  • Adopting an active lifestyle such as regular exercises
  • Monitoring of medical condition progress
Bariatric Surgery

Q: What are the results of this procedure?

A: The result of Sleeve Gastrectomy is very good. About 60% of excess weight will be lost over one or two years. More importantly, this can be maintained for at least five to ten years with close follow-up with the doctor. Complications from the surgery are also considerably lower if you opt for Laparoscopic Sleeve Gastrectomy compared to traditional open Sleeve Gastrectomy surgeries.

Endoscopy

Q: Does this procedure require an endoscopy?

A: Prior to doing a sleeve gastrectomy, you will be required to undergo an endoscopy to check on the size of your stomach. Patients with prior stomach surgery will not be able to proceed with Sleeve gastrectomy. However, during the procedure, endoscopy will not be required. The incisions are made along the abdomen to carry out the procedure.

Q: Does this procedure require general anaesthesia?

A: Patients undergoing sleeve gastrectomy will be required to be placed on general anaesthesia and remain fully sedated throughout the procedure.

Sleeve Gastrectomy procedure,

Q: What is the whole process of a patient undergoing this procedure?

A: Step 1: Two weeks before the Sleeve Gastrectomy procedure, patients will be required to start on a liquid diet to prepare their stomach for the procedure.

Step 2: The day before the procedure, patients have to fast for 8 hours before the surgery with no intake of food and water.

Step 3: After being wheeled into the OT, the patient will be placed under General Anaesthesia for 2 hrs (a typical procedure time).

Step 4: Once the patient is under General Anaesthesia, the doctor will proceed to make an incision or incisions along the stomach depending on whether you are undergoing an open surgery or laparoscopic surgery.

Step 5: In laparoscopic surgery, A few small incisions, ranging from 0.5 to 1.5cm will be made in your abdomen. A telescopic camera, instruments and staple devices are inserted through these incisions into your stomach.

Step 6: The surgeon will then remove the curved part of your stomach, known as the fundus and will staple the remaining part of the stomach together around the lower oesophagus to create a tube that resembles a sleeve.

Step 7: The incisions will be sealed up and you will be brought to the recovery room to awake from your surgery.

On Complications of Gastric Sleeve in Singapore

Complication

Q: What are the possible complications of this procedure?

A: Complications from sleeve gastrectomy are rare and usually not life-threatening.

Severe complications from a sleeve gastrectomy may lead to the following conditions such as:

  • Nausea and vomiting
  • Hypoglycemia (Low blood sugar)
  • Gastrointestinal obstruction
  • Hernia
  • Gastroesophageal reflux disease (GERD) and
  • Malnutrition

When conducted laparoscopically, the risk of complication from sleeve gastrectomy is also reduced as the surgery adopts a less invasive method and allows faster recovery time.

Side Effects

Q: What are the side effects of this procedure?

A: Sleeve gastrectomy like any other surgeries carry some level of risks that can be both short and long term.

Some side effects associated with a sleeve gastrectomy can include bleeding from the surgical site, allergic reaction to the anaesthesia, leakage from the stomach and infection from the wound.

Medisave

Questions on Medisave Claimable in Singapore

Q: Is this procedure claimable?

A: Yes, a portion of the procedure is Medisave Claimable, depending on the choice of hospital and the number of days that you are warded.

Q: What is the estimated percentage of claimable Medisave for this procedure?

A: As individuals' claimable amount may vary, around 10-15% of the total bills for Sleeve Gastrectomy is claimable by Medisave.

Q: Which part of the procedure is claimable?

A: The claimable fees will cover a portion of the surgical fees, medical consumables, doctors’ fees and hospitalisation. This amount will vary based on your insurance policy and coverage.

In Conclusion

Gastric Sleeve

The gastric sleeve procedure is a great way to kickstart your weight loss journey. However, you should not rely on the effects of the surgery alone. Do not think that just because your stomach is smaller that you can consume as much as you want like in the past. Again, it only serves as a catalyst to start losing weight. Dropping unhealthy habits and leaning towards healthier lifestyle choices is the prime solution in keeping the weight off.

Also, undergoing gastric sleeve surgery can be a cost-effective intervention. You only need to undergo it one time for results that last a lifetime. Rather, than spending money every month on fad diets and workout plans, why not consider undergoing bariatric surgery.

With that said, if you are not too keen on undergoing gastric sleeve procedure, there are other types of bariatric surgeries that you can look into like gastric bypass. If you are not ready to commit to such a permanent change, there are other non-invasive weight loss solutions like gastric balloons. Gastric balloons usually only take four to six months inside the stomach to assist in losing weight. But then again, pair these medical-assisted weight solutions with healthy lifestyle choices to enjoy your results for longer.

Regardless of how you choose to approach it, it is important to think about your weight loss journey as soon as possible. When left untreated, overweight or obesity can lead to more serious health problems such as cardiovascular diseases, diabetes, cancer, and more.

If you are already from the aftermath of gaining excessive weight, the more you should start now. Even if you haven’t been diagnosed with any comorbidity, losing weight can decrease the risk of developing any unwanted health conditions. It can improve your blood pressure, blood cholesterol & blood sugar.

As long as you fall into an overweight or obese category, motivate yourself to start losing weight. It frees you of any worries that may affect your way of living now and in the future. Also, do not be afraid to ask for assistance through the whole process, whether it is medically or emotionally. Weight loss is a hard path to go through, but always remember that you are not alone. You can do it!

Please seek advice from a qualified doctor to assess eligibility for this program.