Sleeve gastrectomy, also called vertical sleeve gastrectomy, is a surgical weight loss procedure. This procedure is typically performed laparoscopically; this involves inserting small instruments through multiple small incisions in the upper abdomen. During sleeve gastrectomy, about 80 percent of the stomach is removed and a stomach is the size and shape of a banana.

Limiting the size of your stomach limits the amount of food you can consume. In addition, the procedure activates hormonal changes that aid weight loss. The same hormonal changes also help alleviate conditions associated with being overweight, such as high blood pressure or heart disease. Tube stomach surgery is done to help you lose excess weight and reduce your risk of potentially life-threatening weight-related health problems.

Gastroesophageal reflux disease

Heart disease

Hypertension

High cholesterol

Obstructive sleep apnea

2 types of diabetes

Stroke

Infertility

Gastric sleeve surgery is usually done after you try to lose weight by improving your diet and exercise habits.

In general, gastric sleeve surgery may be an option for you if:

  • Your body mass index (BMI) is 40 or higher (extreme obesity).
  • Your BMI is between 35 and 39.9 (obesity) and you have a serious weight-related health problem such as type 2 diabetes, high blood pressure or severe sleep apnea. In some cases, if your BMI is 30 to 34 and you have serious weight-related health issues, you may be eligible for certain types of weight loss surgery.
  • You must also be willing to make permanent changes to maintain a healthier lifestyle. Participation in long-term follow-up plans that include monitoring your diet, lifestyle and behavior, and medical condition.

 

Risks

As with any major surgery, sleeve gastrectomy poses potential health risks in both the short and long term.

Risks associated with sleeve gastrectomy can include:

  • Excessive bleeding
  • Infection
  • Adverse reactions to anesthesia
  • Blood clots
  • Lung or breathing problems
  • Leakage from the cut edge of the stomach

Longer-term risks and complications of sleeve gastrectomy may include:

  • Gastrointestinal obstruction
  • Hernias
  • Gastroesophageal reflux
  • Low blood sugar (hypoglycemia)
  • Not enought feeding
  • Vomiting
  • Very rarely, the complications of sleeve gastrectomy can be fatal.

 

How do you prepare

If you qualify for sleeve gastrectomy, your healthcare team will give you instructions on how to prepare for the surgery. You may need to have various laboratory tests and examinations before surgery.

 

Food and medicines

Before your surgery, give your doctor a list of all medications, vitamins, minerals, and herbal or dietary supplements you take. You may have restrictions on eating, drinking, and what medications you can take.

If you are taking blood thinning medications, talk to your doctor before surgery. Because these medications affect coagulation and bleeding, your blood-thinning medication routine may need to be changed.

If you have diabetes, talk to the doctor who manages your insulin or other diabetes medications for specific instructions on taking or adjusting them after surgery.

 

Other measures

You will need to start a physical activity program.

You will need to quit any tobacco use 12 weeks before surgery, and a nicotine test may be performed before surgery.

You may also need to be prepared by planning ahead for your recovery after surgery. For example, get help at home if you think you will need it. People who have had sleeve gastrectomy are typically unemployed for four weeks.

 

What can you expect

Sleeve gastrectomy is done in the hospital. Depending on your recovery, your hospital stay may take one to two nights.

 

Before the procedure

Before going to the operating room, you will be put on a gown and asked a few questions by both doctors and nurses. Before your surgery starts in the operating room, you will be given general anesthesia. Anesthetic is the medicine that keeps you asleep and comfortable during surgery.

 

During the procedure

The specifics of your surgery depend on your personal situation and the practices of the hospital or doctor. Some gastric sleeve surgeries are performed through traditional large (open) incisions in the abdomen. However, sleeve gastrectomy is typically performed laparoscopically; this involves the insertion of small instruments through multiple small incisions in the upper abdomen.

The surgeon then creates a narrow sheath by stapling the stomach vertically and removing the larger, curved portion of the stomach.

The surgery usually takes one to two hours. After surgery, you wake up in a recovery room where medical staff will watch you for any complications.

 

After the procedure

After sleeve gastrectomy, your diet starts with sugar-free, non-carbonated liquids for the first seven days, then progresses to pureed foods for three weeks and finally to normal foods about four weeks after your surgery. You will need to take a lifetime multivitamin twice a day, a calcium supplement once a day, and a vitamin B-12 injection per month.

In the first few months after weight loss surgery, you will have frequent medical check-ups to monitor your health. You may need lab tests, blood tests, and various exams.

In the first three to six months after sleeve gastrectomy as your body reacts to rapid weight loss, you may experience changes including:

  • Body aches
  • Feeling tired like you have the flu
  • Feeling cold
  • Dry skin
  • Hair thinning and hair loss
  • Mood changes

 

Results

Gastric sleeve surgery can provide long-term weight loss. The amount of weight you lose depends on your change in lifestyle habits. It is possible to lose about 60 percent or more of your excess weight within two years.

In addition to weight loss, sleeve gastrectomy can improve or resolve conditions related to being overweight:

  • Heart disease
  • Hypertension
  • High cholesterol
  • Obstructive sleep apnea
  • 2 types of diabetes
  • Stroke
  • Infertility

Gastric sleeve surgery can also improve your ability to perform daily routine activities and help improve your quality of life.

 

When weight loss surgery doesn’t work

It is possible not to lose enough weight or gain weight after weight loss surgery. This weight gain can happen if you don’t follow the recommended lifestyle changes. For example, if you frequently beat high-calorie foods, you may have insufficient weight loss. You should make permanent healthy changes to your diet and do regular physical activity and exercise to help you avoid gaining weight again. It is important to keep all of your follow-up appointments scheduled after weight loss surgery so your doctor can monitor your progress. If you notice that you are not losing weight or developing complications.