Post op sleeve stretch

Question
I had sleeve surgery on the 31 st   March. My surgeon told me to be careful not to stretch the sleeve in the 2 weeks post surgery, to allow it to harden and not to put ptessure on the stitches. I am on a 10 day liquid diet but for the first two days after surgery I could hardly manage to get down a third of the daily recommended liquids. On day 3 I made a concerted effort and got down about half but felt very uncomfortable.  Day 4 & 5 and I'm  taking large sips with no problem and no discomfort or full feeling. I am worried that I may have stretched my sleeve and wonder if there is anything I can do? I am just managing the daily recommended allowance of liquids and never feel hungry.

Thanking you in anticipation for your answer

Answer
Jerome,
Your description indicates to me that you are healing appropriately, and it seems very unlikely to me that you have stretched or damaged your Sleeve at this point.  I will explain my reasoning, but it may be that I have a slightly different understanding of the Sleeve healing dynamic than your surgeon.  I hope that my information will be useful for you, but I encourage you to look to your surgeon and his/her team as your primary source of information about your Sleeve, your recovery, and the best way to gain optimum health over time.

My understanding is that the body (such as the stomach in this case) reacts to surgical trauma with swelling and stiffness.  For the first couple of weeks after surgery, the walls of the stomach tube are thickened and stiff as a natural result of surgery - this means that the open channel down the center of the tube is very narrow and it likely has been difficult for fluids to go down.  Over several weeks the swelling goes down and fluids go down more easily.  I think this healing explains your recent experience of improved tolerance to liquid swallowing.

All of us who care for bariatric patients do worry about 'stretching' of the Sleeve, but my understanding is that such stretching can only be caused by a patient who shows a willful disregard for the constraints that the surgery provides over a sustained period of time.  As long as you pay attention to your body reasonably well, I would have every expectation of success for you.

In health,
Dr JP

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