Sleeve gastrectomy, also known as gastric sleeve surgery, is a weight-loss procedure that involves the removal of a large portion of the stomach, leaving a smaller, banana-shaped “sleeve.”
This surgery helps individuals with severe obesity lose weight by reducing the stomach’s capacity, leading to decreased food intake.
Learn more about sleeve gastrectomy, including how it works, candidate criteria, types of surgery, expected weight loss, post-surgery diet and lifestyle, and potential risks and complications.
Bariatric surgeons at WashU Medicine
Our bariatric surgeons are part of a weight loss team committed to helping people take charge of their health. We see patients at convenient locations in St. Louis, and we work with nutritionists, psychologists, and others to provide the care you need in a nationally accredited program.
What is sleeve gastrectomy?
Sleeve gastrectomy involves surgically removing about 75-80% of the stomach, leaving a narrow, tube-like structure that holds significantly less food. The procedure also removes the part of the stomach that produces the hunger hormone ghrelin, which helps reduce appetite.
Types of sleeve gastrectomy surgery
Open surgery
- Procedure: A large incision is made in the abdomen to access and remove part of the stomach.
- Recovery: Longer recovery time, more pain, and a higher risk of complications compared to minimally invasive methods.
Laparoscopic surgery
- Procedure: Several small incisions are made, and a laparoscope (a small camera) is used to guide the surgery.
- Benefits: Less postoperative pain, shorter hospital stay, quicker recovery, and lower risk of infection.
Robotic surgery
- Procedure: Similar to laparoscopic surgery but performed with robotic arms controlled by the surgeon, who sits at a console in the operating room with the patient. The surgical robot can offer higher precision than laparoscopic surgery in many cases.
- Benefits: Greater precision and flexibility, potentially enhanced recovery times, and reduced risk of complications.
Who is a candidate for sleeve gastrectomy?
Body mass index (BMI)
- Severe obesity: Ideal candidates generally have a BMI of 40 or higher.
- Obesity-related health conditions: Candidates may also qualify with a BMI of 35 or higher if they have obesity-related health conditions such as type 2 diabetes, hypertension, or sleep apnea.
Learn more about obesity>>
Additional criteria
- Failed weight loss efforts: Individuals who have tried and failed to lose weight through diet, exercise, and possibly medications.
- Commitment: Candidates must be committed to making significant lifestyle changes, including dietary adjustments and regular follow-ups.
- Overall health: Suitable candidates should be in generally good health to withstand surgery and recovery.
- Age considerations: Typically, adults are considered, though the procedure may be considered for younger patients under specific circumstances.
Expected weight loss
Patients can expect to lose about 50-70% of their excess body weight within the first 18-24 months after surgery. Weight loss continues as patients adhere to dietary guidelines and incorporate regular physical activity.
Post-surgery diet and lifestyle
After surgery, you will have to make adjustments to your eating habits and lifestyle. Some changes are for a short time right after surgery, while others are lifestyle changes that you will need to continue for the rest of your life after surgery. Below are some common recommendations your doctor might provide. Be sure to follow any instructions as provided by your health care team.
Immediate post-surgery diet
- Phase 1: Clear liquids for the first few days to prevent dehydration and facilitate healing.
- Phase 2: Gradual introduction of pureed foods, protein shakes, and specific nutrient supplements.
- Phase 3: Soft foods after about 3-4 weeks as the stomach begins to tolerate more textures.
- Phase 4: Introduction of solid foods, usually after around 2 months, in smaller portions to match the smaller stomach size.
Dietary guidelines
- High-protein diet: Emphasize protein to aid healing and maintain muscle mass.
- Hydration: Drink plenty of fluids but avoid drinking 30 minutes before and after meals to prevent overfilling the stomach sleeve.
- Vitamins and supplements: Regular intake of vitamins and minerals such as Vitamin B12, iron, calcium, and a daily multivitamin to prevent deficiencies.
- Eating habits: Smaller, frequent meals, chewing food thoroughly, and avoiding high-sugar, high-fat foods to prevent discomfort and slow digestion.
Long-term dietary and lifestyle changes
Incorporate regular exercise into daily routines to maintain weight loss and overall health.
Continue focusing on a balanced and healthy diet, emphasizing nutrient-rich foods.
Avoid high-calorie, high-fat, and high-sugar foods and beverages.
Read more: What does a day of eating look like after bariatric surgery?
Follow-up care
- Regular check-ups: Scheduled follow-up visits to monitor progress, nutritional status, and address potential complications.
- Support groups: Participation in support groups for emotional support and practical advice.
Potential risks and complications
Common risks
- Infection: Risk of infection at the surgical site.
- Bleeding: Minimal bleeding at the incision sites.
Specific complications
- Nutritional deficiencies: Risk of deficiencies requiring supplementation.
- Gastroesophageal reflux disease (GERD): Increased risk of developing GERD due to reduced stomach capacity.
- Stomach leakage: Rare but serious risk of leakage from the staple line in the stomach.
Rare complications
- Blood clots: Risk of developing blood clots in the legs or lungs.
- Adverse reactions to anesthesia: Rare complications related to anesthesia.
Sleeve gastrectomy is an effective procedure for significant weight loss and improved health for individuals with severe obesity. Understanding the criteria for candidacy, expected outcomes, dietary guidelines, and the importance of post-surgery care is crucial for long-term success. If you are considering sleeve gastrectomy, consult with a health care professional to explore this option and determine the best approach for your specific situation.
