Sleeve gastrectomy

Dealing with obesity and its complications can be overwhelming. At Atrium Health Floyd and Harbin Clinic, you have a trusted partner to help you lose weight and improve your quality of life. Our bariatric surgeons offer a personalized approach to weight loss so you experience optimal results, long-term.

What is a sleeve gastrectomy?

A sleeve gastrectomy is a weight loss surgery. During the procedure, a bariatric surgeon removes a portion of your stomach. Then they use staples to shape your remaining stomach into a thin, vertical sleeve. After surgery, you feel fuller sooner and get hungry less quickly.

Some of the main benefits of a sleeve gastrectomy include:

• Reduced risks: A sleeve gastrectomy doesn’t reroute your intestines, and your stomach still operates normally. This contrasts with the other main type of bariatric surgery, gastric bypass. A sleeve gastrectomy may lead to less weight loss, but there’s no risk of the kinds of complications associated with gastric bypass, such as dumping syndrome. Dumping syndrome causes diarrhea, nausea and lightheadedness.
• Safe for high-risk patients: Sleeve gastrectomy may be a solution for patients who have conditions that make other bariatric surgeries risky.
• Significant weight loss: People who have a sleeve gastrectomy lose 50–83% of their excess weight in the 12–24 months after surgery.

Conditions a sleeve gastrectomy treats

Weight loss surgery may be an option for you if you have obesity and haven’t been able to lose weight with diet and exercise. Your doctor may recommend a sleeve gastrectomy if you have:

• Body mass index (BMI) of 40 or above. People with a BMI of 40 or higher are at least 100 pounds over their recommended weight.
• BMI of 35 or higher, along with a serious medical condition that might improve with weight loss. Some of these conditions include type 2 diabetes, obstructive sleep apnea and heart disease.

It’s important to understand that a sleeve gastrectomy is not a quick fix. After surgery, you must eat healthy foods, control your portion sizes and exercise. If you don’t follow this guidance, you may have poor results and complications such as digestive problems or stomach stretching.

What happens during a sleeve gastrectomy?

You receive general anesthesia to remain asleep and pain-free during the operation. Usually, a sleeve gastrectomy is a laparoscopic surgery. Laparoscopic procedures use smaller incisions and a tiny camera called a laparoscope. The camera connects to a video monitor in the operating room so your surgeon can see inside your body.

During a sleeve gastrectomy, your surgeon:

• Makes two to five small incisions (cuts) in your belly.
• Inserts the laparoscope through these incisions.
• Uses surgical tools to remove about 75% of your stomach.
• Joins the remaining 25% of your stomach with staples to create a long, banana-shaped, tube-like stomach.
• Removes the laparoscope and surgical tools and closes the incisions with stitches.

The procedure usually takes around 60–90 minutes.

What to expect after a sleeve gastrectomy

After a sleeve gastrectomy, the food you swallow still passes through your stomach and into the small intestine. However, removing a large portion of your stomach helps you feel fuller sooner. It also decreases the release of hormones that drive appetite, so you feel less hungry.

You’ll need to follow a strict diet after surgery:

• First 4 weeks: You need to eat foods in liquid or pureed states. Eating solid foods too soon puts pressure on your staple line and may cause serious complications such as leaking. You need to eat five to six times a day, and meals should be about ¼–½ cup of food (2–4 ounces).
• 4–12 weeks: With your doctor’s approval, you can advance to semi-solid or soft foods. You need to eat four to six times a day, and meals should be ½–¾ cup of food (4–6 ounces).
• 12 weeks: When your doctor approves it, you can graduate to tougher meats and raw vegetables. You need to introduce these foods slowly to test your tolerance. Most people experience some problems, such as nausea, especially with dry meats and breads. These problems usually resolve over time.

Weight tends to come off slowly after a sleeve gastrectomy. Full weight loss can take up to three years.

Sleeve gastrectomy side effects

Like all surgeries, a sleeve gastrectomy carries some risks, including:

• Gastritis (inflamed stomach lining)
• Heartburn
• Leaking from the area where your stomach has been stapled
• Scarring inside the belly that could cause a bowel blockage
• Stomach ulcers
• Vomiting from eating more than your stomach pouch can hold

It’s also important to understand that a sleeve gastrectomy is not reversible. Part of your stomach is permanently removed.