Gastric sleeve surgery

A sleeve gastrectomy is performed as laparoscopic (keyhole) surgery and works by removing a large portion of the stomach. Unlike gastric band surgery, it is a non-reversible procedure.

This option offers a permanent solution with positive lifestyle improvements in health and quality of life. As with all weight loss surgery, it requires a lifelong commitment to a healthy diet and exercise plan. As the surgery is a minimally invasive laparoscopic procedure, this greatly helps to reduce recovery time and generally results in less pain than open surgical procedures.

Nutritional deficiencies are less likely to occur following gastric sleeve surgery, as food absorption is not affected. In addition, levels of the appetite stimulant ghrelin fall after gastric sleeve surgery, which may be a reason why patients experience a marked loss of appetite.

The amount of weight loss varies from patient to patient, but the overall reduction in quantity of food that can enter the stomach, will lead to a noticeable loss of weight.

You may be overweight or struggling to lose weight and this may be affecting your general health.

It is important that you are fully aware of the implications before committing to gastric sleeve surgery as it requires a change to the way you think about food, eating and drinking, and exercise. Losing weight before surgery will help with your recovery, increase your rate of weight loss and help with the transition to a post-operative diet.

Once surgery is agreed, you will need to follow a strict diet in the two weeks prior to the operation in order to prepare your body for the surgery. A pre-operative diet will help shrink your liver and also reduce fat in your abdomen, allowing the surgeon to operate more easily and safely.

You will also be advised to stop smoking as this will increase your risk of getting an infection after surgery, which can slow down your recovery. It can also make your surgery less effective and can lead to complications.

A general anaesthetic will be administered and using laparoscopic keyhole surgery, a sleeve gastrectomy is performed, removing up to 75% of the stomach. This procedure leaves behind a smaller 'sleeve' of stomach that holds less and therefore restricts the amount of food you can eat before feeling full. This procedure is considered to be halfway between a gastric band and gastric bypass.

The sleeve is accurately sized by a tube, which is passed down through the mouth and has a similar effect to a gastric band. It is a permanent and restrictive procedure that takes around 60-90 minutes to perform and does not require long-term follow up or adjustment.

It may take you a week or two to recover from gastric band surgery however, this can vary from person to person, so it is important to follow your surgeon's advice.

You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs.

In most cases patients can leave hospital after two days and would be advised to be off work for two weeks. You will have access to a dietitian for nutritional advice, including diet sheets if you wish and you will have face to face follow up appointments for several months afterwards to monitor your progress. 

In the two week post-operative period you will be permitted to only take liquids, before easing yourself into more solid foods. Whilst you are off you will be advised to avoid sleeping or sitting for long periods, and to push yourself to be generally mobile, as this will help you avoid blood clots forming. You should also avoid lifting heavy objects and you should not drive.

Following surgery you will need to change your eating patterns and your diet, cutting out certain foods that may cause you problems in your changed gastro-intestinal situation. Eating smaller amounts and choosing carefully which foods you eat should help to reduce any nausea as well as helping with weight loss.

Your dietitian may suggest dietary supplements to ensure you get the nutrients you need for energy and good health. You will need to eat smaller portions and will also have to chew your food thoroughly or you may experience discomfort.