Gastric sleeve surgery (sleeve gastrectomy)

It’s weight loss surgery to remove part of your stomach, leaving the left side in a long, sleeve-like shape.

This reduces your stomach size, limiting the amount you can eat. It also changes the way your hormones work, so you’ll feel full more quickly than before.

Other benefits are an improvement or a reduced risk of developing weight-related conditions such as type 2 diabetes and heart disease.

Who needs it?

If your body mass index (BMI) is 35 or more and you’ve been struggling to lose weight even while maintaining a healthy lifestyle, this could be an option for you.

Sometimes, gastric sleeve surgery is carried out before you can have gastric bypass surgery. In this case, you’ll need to wait for up to 18 months after your gastric sleeve surgery before being assessed for the second operation. By that time, you should have lost a significant amount of weight.

It’s an operation to remove one side of your stomach to help you lose weight. This works in two ways:

• It reduces your stomach size by around 75%, limiting the amount you can eat
• It removes the portion of your stomach involved in releasing the hunger hormone ghrelin, so you’ll feel full much more quickly

The benefits are:

• You can expect to lose around 30–50% of your excess weight in the first 12 months after your operation
• Improvements in any weight-related conditions that you might have such as, type 2 diabetes, heart disease, osteoarthritis, obstructive sleep apnoea
• You'll be more able to do physical activity which can lead to increased energy, fitness, strength, stamina, bone density, improved mood and self-confidence

Before surgery

You’ll be assessed to check that you’re fit for the operation. This may include blood tests, X-rays and scans, as well as an explanation of the surgery and long-term outlook.

You may also need to follow a calorie-controlled diet to reduce the size of your liver. This will make the operation easier and safer.

During surgery

Gastric sleeve surgery is usually done by laparoscopic (keyhole) surgery. This has a faster recovery time than traditional open surgery. The surgery is carried out under general anaesthetic so you’ll be asleep.

During the operation your surgeon will:

• Make small incisions and insert a telescopic instrument with a camera on the end
• Divide and seal any blood vessels supplying the part of your stomach to be removed
• Surgically remove around 75% of your stomach, leaving the remainder in a sleeve-like shape
• Leave in place the valve that releases food into your small intestine so your digestive system isn’t changed
• Close your incisions

If your surgeon thinks keyhole surgery isn’t suitable for you, they may suggest open surgery, which involves making one single, larger cut.

How long does gastric sleeve surgery take?

Between one and two hours.

Pain after gastric sleeve surgery

It's normal to experience some pain or discomfort after gastric sleeve surgery, but your healthcare team will make sure you have appropriate pain relief medication.

Your hospital stay

You’ll stay in hospital for at least two nights.

Recovery time

You can usually leave hospital two days after your surgery and it’s normal to feel very tired at first.

You should feel comfortable doing most everyday activities within four to six weeks. For three to six months afterwards, you may also get symptoms due to rapid weight loss, such as:

• Aching
• Dry skin
• Feeling cold
• Mood changes
• Thinning hair
• Tiredness

Aftercare and ongoing treatment

Your healthcare team will explain what you need to do during your recovery. This will include:

• Pain relief
• A review of any medicines you’re taking for weight-related conditions, such as diabetes or high blood pressure
• A carefully controlled diet plan for the first four to six weeks, moving from liquids to pureed, soft then solid foods, plus advice on eating and portion sizes
• An exercise plan to help speed up your weight loss and improve your fitness
• Blood tests to check if you need extra vitamin and mineral supplements

Your lifestyle after treatment

Even though you won’t be able to eat as much as before your surgery, it’s important to follow a healthy diet and lifestyle. This way you’ll maximise your weight loss and reduce your risk of weight-related diseases. Our dietitians will help you.

You should avoid getting pregnant for the first 18 months after gastric sleeve surgery so your weight can stabilise.

To maintain the benefits of your weight loss surgery, you’ll need regular check-ups for the rest of your life. These will become less often as time goes on.

Most people have gastric sleeve surgery without complications, but all surgery carries some risks. Your consultant will explain them to you before you go ahead.

Although rare, gastric sleeve surgery complications can include:

• Blood clots
• Infection
• Internal bleeding
• Leaking from where the stomach has been closed
• Acid reflux – when stomach acid leaks back up into your oesophagus (the tube that connects your mouth and stomach)
• Nausea and vomiting, which usually gets better over time
• Nutritional deficiencies
• Folds of skin due to rapid weight loss

Some complications can be treated with medication, but others may need further surgery.

At Spire hospitals, your safety is our top priority. We have high standards of quality control, equipment and cleanliness and an ongoing system of review and training for our medical teams.