Gastric Sleeve

Surgery

Gastric sleeve surgery, also called sleeve

gastrectomy, is a bariatric surgery procedure.
It removes a large portion of your stomach,
leaving behind a narrow “sleeve.” Reducing
your stomach helps restrict calories and
reduce hunger signals. This surgery is offered
to help people with clinically severe obesity
achieve effective weight loss.

Contents Overview Procedure Details

Risks / BeneEts Recovery and Outlook

Overview

A sleeve gastrectomy divides your stomach to create a

narrow gastric sleeve.

What is gastric sleeve surgery?

The gastric sleeve, also called sleeve
gastrectomy, is a bariatric surgery operation
to induce weight loss. It works by reducing
the size of your stomach. The word
“gastrectomy” means removal of part or all of
your stomach. The gastric sleeve operation
removes about 80% of your stomach, leaving
behind a tubular “sleeve,” about the size and
shape of a banana.

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What does a gastric sleeve do?

Reducing the size of your stomach is a
simple way to restrict the amount of food you
can eat in one sitting, making you feel fuller
faster. But it also serves another purpose: it
reduces the amount of hunger hormones that
your stomach can produce. This helps to
decrease your appetite and cravings and may
help to prevent the impulses that cause
people to regain the weight they've lost.

How common is gastric sleeve

surgery?
The gastric sleeve is the most commonly
performed weight loss surgery in the U.S. and
worldwide. More than half of bariatric
surgeries performed in the U.S. each year are
sleeve gastrectomies. The total number of
gastric sleeve operations performed each
year is about 150,000 in the U.S. and 380,000
worldwide. But, only 1% of people who could
beneEt and would qualify for the surgery
actually get it.

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What medical conditions does

gastric sleeve surgery help treat?
Gastric sleeve surgery is a surgical treatment
for obesity and medical conditions related to
obesity. It’s only offered to qualiEed people
who have serious medical conditions related
to their obesity or are at high risk for
developing them. Gastric sleeve surgery can
improve and sometimes eliminate diseases,
including:

Insulin resistance and Type 2 diabetes.

Hypertension and hypertensive heart

disease.

Hyperlipidemia (high cholesterol) and

arterial disease.

Nonalcoholic fatty liver disease and

steatohepatitis.

Obesity hypoventilation syndrome and

obstructive sleep apnea.

Joint pain and osteoarthritis.

Is the gastric sleeve safe?

The risks of gastric sleeve surgery are far
less than the risks of having obesity and its
related diseases. It also has lower
complication rates than other common
operations, including gallbladder removal and
hip replacement. Most gastric sleeve
procedures are performed by minimally
invasive surgical techniques, which means
less pain from incisions and faster recovery.

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Procedure Details
What quali?es you for gastric
sleeve surgery?
To qualify, the general requirements are:

That you have severe obesity (class III).

This is determined by your BMI (body
mass index), which is calculated by your
weight and height, and your related health
conditions. Class III obesity means a BMI
of 40 or higher, or a BMI of at least 35
with at least one related disease.

That you have tried to but not succeeded

in losing weight prior to surgery. You
may be required to spend three to six
months on a medically supervised weight
loss plan before your insurance company
will approve and cover your surgery.

That you are physically and mentally

prepared for the surgery and recovery
process. Before qualifying for weight loss
surgery, you’ll meet with a team of
dietitians, psychologists and other
medical specialists for counseling and
screening.

What happens before gastric

sleeve surgery?
If you’ve passed your health screening and
qualify for bariatric sleeve surgery, the next
step will be a two-week liquid diet. Your
surgeon will give you speciEc guidelines to
follow. The purpose is to lose some of the fat
in your abdomen and your liver to make the
surgery safer.

You’ll be asked not to eat or drink anything

for 12 hours before your operation. That’s to
make sure your stomach is empty during the
procedure. Having food or liquid left in your
stomach during the surgery could cause
unpleasant or even dangerous side effects.

How is gastric sleeve surgery

performed?
Most of the time, a sleeve gastrectomy is
done by laparoscopic or robotic surgery. That
means that instead of making a large incision
(or cut) to open your abdominal cavity to
access your organs, your surgeon will
perform the operation through small
incisions. This makes for an easier recovery,
but some people may be better served by
open surgery, depending on their conditions.

What happens during gastric

sleeve surgery?
1. Your surgeon will give you general
anesthesia, so you’ll be asleep during the
procedure.

2. Your surgeon will make a small cut in

your abdomen (about 1/2 inch long) and
insert a port. They’ll pump carbon
dioxide gas through the port to expand
your abdomen.

3. Then they’ll place a small lighted video

camera (laparoscope) through the port.
The camera will project your insides onto
a screen.

4. Through one to three additional incisions,

your surgeon will insert additional ports
and complete the procedure using long,
narrow tools.

5. They will measure out the gastric sleeve,

then divide and separate the remainder
of your stomach using a surgical stapler.

H. Your surgeon will remove the remainder

of the stomach, then close your
incisions.

How long does gastric sleeve

surgery take?
Compared to other weight loss surgery
procedures, a sleeve gastrectomy is a
relatively short and simple operation. It takes
about 60 to 90 minutes. Your surgeon may
still want you to stay in the hospital for one to
two days afterward. This way, they can help
manage your pain and any temporary side
effects of surgery, such as nausea.

What happens after gastric sleeve

surgery?
You’ll have frequent check-ups with your
healthcare provider in the following weeks
and months. They’ll monitor your weight loss
progress, your related health conditions and
any side effects of the surgery. They’ll also
want to know if you’re taking good care of
yourself and following the necessary lifestyle
guidelines to maintain your health and weight
loss.

Will I have to follow a diet after

gastric sleeve surgery?
In the short term, you will have to follow strict
dietary guidelines to make sure your stomach
heals well. After a few months, you may
begin to eat a more normal diet, but you’ll still
have to choose your foods wisely. Because
you won’t be able to eat as much as before,
you’ll have to make sure that what you do eat
is nutritious enough to sustain your energy
needs. You’ll begin taking vitamins shortly
after surgery and will need to continue taking
them permanently.

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Risks / Bene?ts
What are the advantages of this
procedure?
Compared to other bariatric surgery
operations, the gastric sleeve is simpler,
quicker and safer. People with health
conditions that might not be suited for a
longer procedure can often tolerate a sleeve
gastrectomy. Because the surgery doesn’t
rearrange your intestines, it’s also much less
likely to cause long-term complications
related to nutrition.

While the average weight loss with gastric

sleeve is slightly less than with more
complex weight loss surgeries, it still offers
excellent weight loss and health beneEts.
This operation began as the Erst step in a
two-step bariatric surgery called the
duodenal switch. Surgeons started offering it
as a standalone procedure after many people
found that they didn’t need to complete the
second part.

What are the possible risks or

complications of gastric sleeve
surgery?
All surgeries have some risk of
complications. With sleeve gastrectomy, they
occur in less than 1% of operations. Surgical
complications include:

Bleeding.

Infection.

Reactions to anesthesia.

Leaking from the staple line.

After recovering, some people develop long-

term complications from the surgery. These
are usually easy to treat when they occur.
They can include:

Scar tissue after the operation can cause

your stomach to be narrow, which can
slow or block food from moving through
your stomach causing nausea, vomiting,
and digculty eating.

Nutritional de?ciencies. It’s harder to get

enough nutrients when you’re eating
much less. People who have bariatric
surgery are usually prescribed daily
nutritional supplements for life.

Gastroesophageal rehux. Some people

who had acid rehux before the operation
feel that it gets worse afterward, and
some people who didn’t have it before
seem to get it. This can often be treated
with medication.

Gallstones. Rapid weight loss can make

gallstones more likely. It causes more fat
to process through your liver, which can
then build up in your gallbladder as
cholesterol stones and cause pain after
eating. You may need another surgery to
remove your gallbladder called a
cholecystectomy.

Recovery and Outlook

What is the recovery time from
gastric sleeve surgery?
You should give yourself a good month
before you expect to feel quite like yourself or
return to work at full capacity. During this
time, many people feel fatigued or tired as
their bodies work to recover while adjusting
to limited calories. In the early weeks, you’ll
only be able to tolerate a liquid diet. Over
time, you’ll gradually progress to a soft diet,
and Enally, solid foods.

How much weight will you lose

with the gastric sleeve?
The average weight loss is 25% to 30 % of
your body weight in the Erst one to two years.
That means if you weighed 300 lbs before
surgery, you’d lose 100 lbs. You might lose
more or less, depending on the lifestyle
habits you adopt after surgery. Some people
also regain some weight, but the overall
average weight loss of 25% to 30% of your
body weight is consistent over Eve years.

What if it doesn’t work?

While it isn’t common, some people do regain
the weight they lose. They might go back to
old habits, or their stomach may stretch out
again over time. If this happens to you, you
might consider gastric sleeve revision
surgery. Your surgeon may repair the original
gastric sleeve or convert it to another type of
weight loss operation with stronger results,
such as a gastric bypass or duodenal switch.

A note from Cleveland Clinic

A sleeve gastrectomy is a simple and safe

procedure that can produce great weight loss
results. It’s also an irreversible change to your
stomach that will require lifelong changes
from you. You’ll have to be very intentional
about what and how you eat after surgery,
and for the rest of your life, to protect your
stomach and meet your nutritional needs.

But if you’re committed to change and weight

loss, surgery can help you be healthier. It
doesn’t just limit what you can eat, but it also
helps reduce hunger and regulate your blood
sugar, so fewer calories feel more natural.
Many obesity-related health conditions can
improve and even resolve after gastric sleeve
surgery.

Medically Reviewed

Last reviewed by a Cleveland Clinic medical

professional on 04/29/2022.
Learn more about our editorial process.

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