What is Sleeve Gastrectomy? Purpose, Procedure & Results

Sleeve gastrectomy is a weight loss surgery where doctors remove about 80% of your stomach, leaving behind a narrow tube or "sleeve" that's roughly the size of a banana. This procedure helps you lose weight by dramatically reducing how much food you can eat at one time and by changing hormones that control hunger and blood sugar.

This surgery has become one of the most popular weight loss procedures because it's effective, relatively straightforward, and doesn't require rerouting your intestines like some other bariatric surgeries. Many people find it helps them achieve significant, long-term weight loss when other methods haven't worked.

What is sleeve gastrectomy?

Sleeve gastrectomy is a surgical procedure that permanently removes a large portion of your stomach to help with weight loss. During the surgery, your surgeon removes the outer curve of your stomach, which is where most of the stomach's stretchy capacity comes from.

What remains is a narrow, tube-shaped stomach that holds much less food than before. Think of it like turning a large balloon into a thin tube. This smaller stomach fills up quickly, so you feel full after eating just a small amount of food.

The surgery also removes the part of your stomach that produces ghrelin, a hormone that makes you feel hungry. This means you'll likely experience less hunger than you did before the procedure, which can make it easier to stick to smaller portions.

Why is sleeve gastrectomy done?

Doctors recommend sleeve gastrectomy for people with severe obesity who haven't been able to lose weight through diet, exercise, and other non-surgical methods. It's typically considered when your body mass index (BMI) is 40 or higher, or 35 or higher if you have serious health conditions related to your weight.

The surgery can help treat or improve many weight-related health problems. These include type 2 diabetes, high blood pressure, sleep apnea, and joint problems. Many people also see improvements in their cholesterol levels and reduced risk of heart disease.

Beyond the physical benefits, sleeve gastrectomy can significantly improve quality of life. People often report feeling more energetic, confident, and able to participate in activities they couldn't do before. The psychological benefits of achieving sustained weight loss can be just as important as the physical ones.

What is the procedure for sleeve gastrectomy?

Sleeve gastrectomy is typically performed using minimally invasive laparoscopic techniques. Your surgeon makes several small incisions in your abdomen and uses a tiny camera and specialized instruments to perform the surgery.

The procedure usually takes 1 to 2 hours and follows these main steps:

1. You'll receive general anesthesia to ensure you're completely asleep during the surgery
2. Your surgeon makes 4-6 small incisions in your abdomen, each about half an inch long
3. A laparoscope (tiny camera) is inserted to guide the surgery
4. Special stapling devices are used to divide and remove about 80% of your stomach
5. The removed portion is taken out through one of the small incisions
6. The remaining stomach is checked for leaks and the incisions are closed

Most people stay in the hospital for 1-2 days after surgery. The small incisions typically heal faster than traditional open surgery, with less pain and scarring.

How to prepare for your sleeve gastrectomy?

Preparing for sleeve gastrectomy involves several important steps over the weeks and months before your surgery. Your healthcare team will guide you through a comprehensive preparation process to ensure the best possible outcome.

Your preparation journey typically includes these key elements:

• Complete medical evaluation including blood tests, heart function tests, and nutritional assessments
• Meet with a nutritionist to learn about post-surgery eating habits
• Attend psychological counseling to prepare for the lifestyle changes ahead
• Follow a pre-surgery diet for 1-2 weeks to shrink your liver and reduce surgical risks
• Stop smoking at least 6 weeks before surgery if you're a smoker
• Adjust certain medications as directed by your doctor
• Arrange for help at home during your recovery period

Your doctor may also recommend losing some weight before surgery if possible. This can make the procedure safer and may improve your results. The pre-surgery diet is usually low in calories and carbohydrates to help prepare your body for the changes ahead.

How to read your sleeve gastrectomy results?

Success after sleeve gastrectomy is measured in several ways, with weight loss being the most obvious but not the only important factor. Most people lose 50-70% of their excess weight within the first two years after surgery.

Here's what healthy progress typically looks like:

• Steady weight loss of 1-2 pounds per week in the first few months
• Improvement in weight-related health conditions like diabetes or high blood pressure
• Increased energy and ability to be more physically active
• Better sleep quality and reduced sleep apnea symptoms
• Improved mobility and reduced joint pain
• Better laboratory values including blood sugar, cholesterol, and inflammation markers

Your healthcare team will monitor your progress through regular follow-up appointments. They'll track not just your weight loss but also your nutritional status, vitamin levels, and overall health improvements. Remember that everyone's journey is different, and comparing yourself to others isn't helpful.

How to optimize your sleeve gastrectomy results?

Getting the best results from your sleeve gastrectomy requires commitment to long-term lifestyle changes. The surgery is a powerful tool, but your daily choices determine how successful you'll be in the long run.

Following these guidelines can help you achieve and maintain your weight loss goals:

• Eat protein first at every meal to preserve muscle mass and promote healing
• Take small bites and chew thoroughly to prevent discomfort
• Stop eating when you feel full, even if food remains on your plate
• Drink water between meals, not during meals, to avoid filling up your small stomach
• Take prescribed vitamin supplements daily to prevent nutritional deficiencies
• Exercise regularly, starting with walking and gradually increasing intensity
• Attend all follow-up appointments with your healthcare team

Building healthy habits takes time, so be patient with yourself as you adjust. Many people find that working with a registered dietitian and joining support groups helps them stay on track with their new lifestyle.

What are the risk factors for sleeve gastrectomy complications?

Like any major surgery, sleeve gastrectomy carries some risks, though serious complications are relatively uncommon when performed by experienced surgeons. Understanding these risks helps you make an informed decision about whether the surgery is right for you.

Several factors can increase your risk of complications:

• Very high BMI (over 50) or super obesity
• Previous abdominal surgeries that may have caused scar tissue
• Smoking, which impairs healing and increases infection risk
• Diabetes or other chronic medical conditions
• Sleep apnea or other breathing problems
• Heart disease or blood clotting disorders
• Age over 65, though surgery can still be safe with proper evaluation

Your surgical team will carefully evaluate these factors during your pre-surgery assessment. They may recommend addressing certain issues, like quitting smoking or optimizing diabetes control, before proceeding with surgery.

What are the possible complications of sleeve gastrectomy?

While sleeve gastrectomy is generally safe, it's important to understand the potential complications so you can recognize warning signs and seek help if needed. Most people experience no serious complications, but being informed helps you make the best decisions about your care.

Early complications that can occur within the first few weeks include:

• Bleeding from the surgical site, which may require additional treatment
• Infection at the incision sites or inside the abdomen
• Leaks from the staple line where your stomach was cut and sealed
• Blood clots in the legs or lungs, which is why early movement is encouraged
• Adverse reactions to anesthesia, though these are rare

Long-term complications are less common but can include:

• Strictures or narrowing of the stomach sleeve that may require stretching procedures
• Gastroesophageal reflux disease (GERD) or worsening of existing reflux
• Nutritional deficiencies if you don't take supplements consistently
• Gallstones due to rapid weight loss
• Loose skin that may require plastic surgery

Most complications can be successfully treated when caught early. This is why following up with your healthcare team regularly is so important for your long-term success and health.

When should I see a doctor after sleeve gastrectomy?

Regular follow-up care is essential after sleeve gastrectomy, but you should also know when to seek immediate medical attention. Your healthcare team will schedule routine appointments, but certain symptoms require urgent evaluation.

Contact your doctor immediately if you experience:

• Severe abdominal pain that doesn't improve with rest
• Persistent vomiting that prevents you from keeping fluids down
• Signs of infection like fever, chills, or redness around incisions
• Chest pain or difficulty breathing
• Leg swelling or pain that could indicate blood clots
• Inability to eat or drink anything for more than 24 hours

You should also reach out to your healthcare team if you notice signs of nutritional problems. These might include unusual fatigue, hair loss, brittle nails, or changes in your mood or memory. Regular blood tests can catch these issues early, but your own observations are important too.

Don't hesitate to contact your medical team with concerns, even if they seem minor. Early intervention can prevent small problems from becoming bigger ones.