Gastric Sleeve Surgery: How It Works and What to Expect

Gastric sleeve surgery, also known as sleeve gastrectomy, is one of the most popular weight loss surgeries worldwide. This minimally invasive procedure helps individuals lose significant weight by reducing the size of their stomach, thus limiting food intake. Unlike other weight loss surgeries, gastric sleeve surgery permanently alters the stomach's size and shape, making it an irreversible procedure.

This article provides a comprehensive overview of how gastric sleeve surgery works, the benefits, potential risks, and what patients can expect before, during, and after the surgery.

How Gastric Sleeve Surgery Works

Gastric sleeve surgery involves the removal of about 80% of the stomach, leaving behind a tube-like structure, often referred to as a “sleeve.” This smaller stomach can hold significantly less food, allowing patients to feel full sooner and consume fewer calories.

Step-by-Step Procedure:

1. Pre-Operative Preparations: Patients undergo a thorough evaluation that includes medical history reviews, blood tests, and imaging studies. These help ensure that the patient is a suitable candidate for the procedure.
2. Anesthesia: The surgery is performed under general anesthesia, meaning the patient will be asleep during the procedure.
3. Laparoscopic Surgery: The surgeon makes small incisions in the abdomen to insert a camera and surgical instruments. This method is minimally invasive and reduces recovery time.
4. Stomach Removal: The surgeon removes approximately 80% of the stomach, including the section that produces ghrelin, the hormone responsible for hunger.
5. Stapling the Stomach: The remaining portion of the stomach is stapled and sealed into a narrow sleeve shape. The stapling is carefully done to ensure there are no leaks.
6. Post-Operative Recovery: After surgery, patients are monitored in the hospital before being discharged, typically within 1-2 days.

The surgery usually lasts 1-2 hours and requires a hospital stay of a day or two for post-surgical monitoring.

What to Expect Before Surgery

Pre-Surgical Consultations:Before undergoing gastric sleeve surgery, patients will meet with a bariatric surgeon for a comprehensive evaluation. This includes medical tests, a nutritional assessment, and psychological evaluations to determine the patient’s readiness for surgery. Patients are often required to follow a pre-surgery diet, which helps reduce the size of the liver and makes the surgery safer.

Pre-Surgery Diet:A liquid or low-calorie diet is typically recommended for 1-2 weeks before surgery. This diet reduces fat around the liver and makes the procedure easier for the surgeon to perform.

Clear Expectations:Patients should be prepared for a lifelong commitment to diet changes, exercise, and regular follow-up care. The surgery is a tool that requires continued effort and adherence to lifestyle changes to maintain long-term weight loss.

What to Expect After Surgery

Immediate Post-Surgery:After gastric sleeve surgery, patients will spend time in recovery to be monitored for complications. Once stabilized, they can expect to experience the following in the days following surgery:

• Pain and Discomfort: Some pain at the incision sites is normal, but it is usually manageable with prescribed pain medications.
• Restricted Diet: Patients will be placed on a liquid diet immediately after surgery. Over time, they will gradually transition to pureed foods, then soft foods, and finally solid foods over a period of weeks.

Hospital Stay and Recovery Time:Most patients stay in the hospital for 1-2 days following surgery. The laparoscopic approach means a quicker recovery time, with many returning to normal activities within 2-4 weeks. Heavy lifting and strenuous activities should be avoided for at least a month.

Long-Term Diet:Patients must adopt a new eating pattern that focuses on small, protein-rich meals. Because the stomach is significantly smaller, overeating can cause discomfort or complications such as nausea or vomiting. Hydration and vitamin supplementation are also critical due to reduced stomach capacity and altered nutrient absorption.

Benefits of Gastric Sleeve Surgery

1. Significant Weight Loss: On average, patients lose around 60-70% of their excess body weight within the first 12-18 months after surgery.
2. Improved Health Conditions: Gastric sleeve surgery can lead to improvements or complete remission of obesity-related health conditions, including type 2 diabetes, hypertension, sleep apnea, and high cholesterol.
3. Reduced Hunger: Because the part of the stomach that produces hunger hormones is removed, many patients report a decreased appetite post-surgery.
4. Fewer Dietary Restrictions: Unlike gastric bypass, patients can still absorb nutrients normally, which means fewer restrictions on the type of foods they can eat.

Risks and Considerations

While gastric sleeve surgery is generally safe, it is important to be aware of the potential risks and complications associated with the procedure.

Short-Term Risks:

• Infection: As with any surgery, there is a risk of infection at the incision sites.
• Bleeding: Internal bleeding can occur, although it is rare.
• Blood Clots: There is a risk of blood clots, especially if patients are immobile for too long after surgery.

Long-Term Risks:

• Nutritional Deficiencies: Although patients do not typically suffer from malabsorption, there can still be nutrient deficiencies, particularly in vitamins B12, D, and calcium. Regular supplementation is essential.
• Acid Reflux: Some patients may develop or experience worsening acid reflux after surgery.
• Weight Regain: While most patients maintain significant weight loss, it’s important to continue healthy lifestyle choices to prevent regaining lost weight over time.

Psychological Considerations:Adjusting to a new relationship with food can be challenging. Many patients benefit from psychological support or counseling to help with the emotional and mental aspects of this major life change.

Is Gastric Sleeve Surgery Right for You?

Gastric sleeve surgery is not for everyone. It is typically recommended for individuals who:

• Have a BMI (Body Mass Index) of 40 or higher.
• Have a BMI of 35 or higher with obesity-related health issues, such as diabetes or high blood pressure.
• Have tried and failed to lose weight through diet and exercise alone.

Patients considering this surgery should also be prepared for the lifelong commitment to diet, exercise, and regular medical follow-ups.

We highly recommend Dr. Jalil Illan Fraijo, MD. Dr. Illan is a Tijuana bariatric surgeon and one of Mexico's top-ranked, board-certified weight loss surgeons. Dr. Jalil Illan is a recognized expert in laparoscopic surgery who has performed over 16,500 metabolic and bariatric surgeries; 6,000 revision surgeries, and helped more than 22,000 patients.

During this time, he distinguished himself by publishing research articles in Obesity and General Surgery. Afterward, Dr. Illan completed an intensive four-year fellowship program in Laparoscopic Bariatric Surgery with world-renowned surgeon, Dr. Juan Lopez Corvalá. Dr. Jalil Illan completed advanced courses in both Laparoscopic Surgical Techniques and Laparoscopic Gastric Bypass at the prestigious Hospital Oswaldo Cruz Sao Paulo, Brazil – which holds a position as one of the most recognized healthcare institutions in Brazil. He has become one of the few Master Surgeons in Tijuana, Mexico. A distinguished accreditation by the Surgical Review Corporation in Mexico. Dr. Illan has always strived for a better education and overall practice in his medical career.

To learn more about Dr. Illan or to contact him, please visit www.drjalil.com.