Sleeve gastrectomy or gastric sleeve surgery is a type of weight-loss surgery where the size of your stomach is reduced by removing the lateral 2/3rds of the stomach (approx. 75-85%) with a stapling device, shaping the remaining stomach into a tube or ‘sleeve’ so that you can only eat small meals.
The gastric sleeve procedure takes one to two hours. The surgeon will usually be able to work laparoscopically, which means that you will only need small, keyhole incisions. You will need to have a general anaesthetic.
Surgery should only be used for weight loss after you have tried losing weight by dieting and exercising. Your doctor might also recommend trying certain medicines before considering surgery. If you are sure about bariatric surgery, you have a few alternative procedures to consider. In addition to sleeve gastrectomy, it is possible to have a stomach band fitted or to undergo a gastric bypass operation.
Gastric sleeve surgery involves the removal of a large section of your stomach. Reducing the size of your stomach will restrict the amount you can eat. It will also reduce your appetite by decreasing the production of appetite stimulating hormones in your stomach.
The sleeve gastrectomy is usually performed as a laparoscopic procedure, through four or five keyhole incisions. The operation will take one to two hours and requires a general anaesthetic. A large part of your stomach will be removed. The remaining section will be shaped into a sleeve or tube about the size of a banana and sealed using staples. You will need to stay in hospital for two to three nights after the procedure and it will be two or three weeks before you are fully recovered.
A sleeve gastrectomy can help you to lose weight by restricting the amount you can eat and reducing your appetite. Like a gastric bypass or band, gastric sleeve surgery restricts the amount of food that you can eat by reducing the size of your stomach so that you feel full faster. However, the removal of a large part of your stomach also reduces the amount of appetite stimulating hormones it is producing, which can help you to feel less hungry. Most people who follow the recommended diet will lose 50-60% of their excess weight after the gastric sleeve procedure.
Gastric sleeve surgery does not alter the route that food takes through your digestive system and the remaining part of the stomach retains its ability to start the digestive process, so you will still be able to digest and absorb food normally. Dumping syndrome is less common than with a gastric bypass, but there is still a chance that it could happen as the food will be passing through your small stomach sleeve faster than usual.
– During the laparoscopic sleeve gastrectomy the nerves of the stomach and pylorus are not altered, preserving the function of the stomach.
– The rest of the gastrointestinal tract anatomy is not altered, so the food ingested follows the normal course. This results in less chance of developing lack of vitamins and minerals and dumping syndrome.
– The procedure decreases significantly the hunger by removing the part of the stomach that produces the main stimulating hormones.
– Fewer clinic follow-ups than the laparoscopic stomach band, since there is no need for band size adjustments.
Gastric sleeve surgery is generally safe, but there are always risks when you are having an operation. You will need to discuss these risks with your doctor before deciding if the procedure is right for you.
Certain side effects can happen after gastric sleeve surgery. Side effects will usually only be temporary and they are generally mild. The most frequent effects are soreness or some slight swelling round the incisions. Some people experience discomfort after eating in the first days after the operation. This feeling should go away once you heal, as long as you don’t overeat.
More serious complications can also happen when you have gastric sleeve surgery. This is when problems occur during or after the operation. Such problems are much less common than the milder side effects. Most people will not experience any serious complications from this surgery.
One potential risk of having the procedure is that you will need to be put under a general anaesthetic. Some people can have a bad reaction to the anaesthetic. Other potential complications associated with surgery include heavy bleeding and blood clots. The chance of surgical complications is low, but they are increased by conditions such as high blood pressure.
There is a chance your surgeon may need to convert your keyhole procedure to open surgery. This means making a bigger cut on your abdomen. This is only done if it’s impossible to complete the operation safely using the keyhole technique.
The chance of complications during or after the procedure will vary between individuals. Your surgeon will be able to provide personalised advice on the risks of weight loss surgery. In general, about 5% of people will experience some complications when having a sleeve gastrectomy. The chance of experiencing fatal complications during surgery is 0.2%.
A healthy diet and lifestyle will be essential for weight loss after surgery. Starting to make these changes before the operation can make recovery easier. Eating a calorie controlled diet is especially important in the last few weeks as it can reduce the size of your liver and lower the risk of surgical complications. If you smoke, you should try to give up before the procedure as it could affect your healing.
As it gets closer to the day of your operation, you should:
On the night before surgery, you will need to stop eating and drinking to prevent complications during the procedure.
You will need plenty of rest when you get home, but you should gradually be able to return to your normal routine over the next 2-3 weeks. However, you should avoid any heavy lifting or very strenuous activities for a couple of months.
The surgical wounds should heal in about a week. The dressings can then come off. You should look out for any signs of complications, such as swelling, pus or inflammation. About 5% of patients will experience some kind of problem after gastric sleeve surgery, but serious complications are rare.
You will have follow up appointments to check on your recovery, but you should contact your doctor if you notice anything unusual or you are experiencing severe discomfort.
When you wake up in the recovery room after gastric sleeve surgery, you will probably feel a bit sore and drowsy. Your memory may be a hazy for a while. You will have dressings over the surgical wounds in your abdomen and there may be tubes draining away excess fluid. You might also have a catheter.
The nurses will offer you something to drink and monitor your condition as you recover. You should soon be able to get out of bed and move around a little. You will usually need to spend 2-3 days in hospital for gastric sleeve surgery. You should arrange for someone to pick you up from the hospital as you won’t be able to drive until your surgical wounds have healed.
Your doctor will ensure that you have a personalised diet after gastric sleeve surgery. You will be on a liquid-only diet for the first few weeks. You can then begin to introduce some soft, moist foods that will be easy to digest. It will be about 4-6 weeks before you can start eating solids. Certain foods, such as white bread, rice, high fibre vegetables and chewy meat may need to be reintroduced more slowly as they are more difficult to digest.
The sleeve gastrectomy should help you to stick to your diet by restricting the amount you can eat and reducing your appetite. However, you may experience some acid reflux, nausea or vomiting as your body adjusts to the sleeve gastrectomy. You should soon begin to lose weight and notice an improvement in your health, as long as you follow your diet.
All medical procedures come with a small risk of complications. Approximately 5% of people who have gastric sleeve surgery will have complications of some kind. Although these are usually relatively mild and easy to treat, they can sometimes be more serious. The complications are fatal in 0.2% of people.
Potential risks of sleeve gastrectomy include:
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