Surgery Overview

Sleeve gastrectomy (also called gastric sleeve surgery) is surgery to remove part of the stomach. It helps with weight loss. The surgery limits the amount of food your stomach can hold. This can help you eat less and feel full sooner.

The surgery is usually done through several small cuts in the belly. These cuts are called incisions. The doctor will place small surgical tools and a camera, called a laparoscope, through the incisions.

The doctor will separate the upper part of your stomach from the rest of your stomach. This forms a small pouch. The pouch will hold the food you eat.

The doctor will close the cuts in your belly with stitches or surgical staples.

What To Expect

You will have some belly pain and may need pain medicine for the first week or so after surgery. The cut that the doctor made (incision) may be tender and sore.

Most people need 2 to 4 weeks before they are ready to get back to their usual routine.

Because the surgery makes your stomach smaller, you will get full sooner when you eat. Food also may empty into the small intestine too quickly. This is called dumping syndrome. It can cause diarrhea and make you feel faint, shaky, and nauseated. It also can make it hard for your body to get enough nutrition.

Your doctor will give you specific instructions about what to eat after the surgery. You'll start with only small amounts of soft foods and liquids. Bit by bit, you will be able to add solid foods back into your diet. If you drink a lot of high-calorie liquid such as soda or fruit juice, you may not lose weight. Even with a healthy diet, you probably will need to take vitamin and mineral supplements from now on.

Depending on how the surgery was done (open or laparoscopic) you'll have to watch your activity during recovery. If you had open surgery, it's important to avoid heavy lifting or strenuous exercise while you recover so that your belly can heal. In this case, you will probably be able to return to work or your normal routine in 4 to 6 weeks. But the surgery is most often done as a laparoscopic procedure, which means the recovery time is faster.

Weight loss

You probably will lose weight very quickly in the first few months after surgery. As time goes on, your weight loss will slow down. You will have regular doctor visits to check how you are doing.

Emotions

It's common to have many emotions after this surgery. You may feel happy or excited as you start to lose weight. But you may also feel overwhelmed or frustrated by the changes that you have to make in your diet, activity, and lifestyle. Talk with your doctor if you have concerns or questions.

Think of bariatric surgery as a tool to help you lose weight. It isn't an instant fix. You will still need to eat a healthy diet and get regular exercise. This will help you reach your weight goal and avoid regaining the weight you lose.

What you can eat

Your doctor will give you specific instructions about what to eat after the surgery. For about the first month after surgery, your stomach can only handle small amounts of soft foods and liquids while you are healing. It's important to try to sip water all day long to avoid becoming dehydrated. You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements.

Bit by bit, you will be able to add solid foods back into your diet. You must be careful to chew food well and to stop eating when you feel full. This can take some getting used to. That's because you'll feel full after eating much less food than you are used to eating. If you don't chew your food well or don't stop eating soon enough, you may feel discomfort or nausea. You may even vomit. If you drink a lot of high-calorie liquid such as soda or fruit juice, you may not lose weight. If you continually overeat, the stomach may stretch. If your stomach stretches, you will not benefit from your surgery.

Your doctor will probably recommend that you work with a dietitian to plan healthy meals that give you enough protein, vitamins, and minerals while you are losing weight. Even with a healthy diet, you probably will need to take vitamin and mineral supplements from now on.

Why It Is Done

Weight-loss surgery is suitable for people who are severely overweight and who have not been able to lose weight with diet, exercise, or medicine.

Surgery is generally considered when your body mass index (BMI) is 40 or higher. Surgery may also be an option when your BMI is 35 or higher and you have a life-threatening or disabling problem that is related to your weight.

It is important to think of this surgery as a tool to help you lose weight. It is not an instant fix. You will still need to eat a healthy diet and get regular exercise. This will help you reach your weight goal and avoid regaining the weight you lose.

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How Well It Works

Research has shown that people who have either gastric sleeve or gastric bypass surgery have similar weight loss and improvements in other health conditions, such as diabetes. Both gastric sleeve and gastric bypass have better results than gastric band surgery.^{footnote 1} Success is higher for people who are realistic about how much weight they'll lose and who go to appointments with the medical team, follow the recommended eating plan, and are physically active.^{footnote 2}

Risks

Here are some risks common to all surgeries for weight loss:

• You could get an infection in the incision.
• You could get a blood clot in your legs (deep vein thrombosis, or DVT) or lung (pulmonary embolism).
• You may not get enough of certain vitamins and minerals. This can lead to problems such as anemia and osteoporosis.
• Some people get gallstones.
• Some people get kidney stones.
• You could get a leak from the stomach into the abdominal cavity or where the intestine is connected. (This can cause an infection called peritonitis.)
• You may gain the weight back if you don't follow your eating and lifestyle plan.

Another risk is dumping syndrome. It causes nausea, weakness, sweating, faintness, and possibly diarrhea soon after eating. These symptoms get worse if you eat highly refined, high-calorie foods (like sweets). Sometimes you may feel so weak that you have to lie down until the symptoms pass.