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Laparoscopic Sleeve Gastrectomy

Very generally speaking, the more obese a person is, the higher the risks of surgery. The gastric bypass is a complex operation. If a patient is super obese ( BMI > 60) or has severe obesity–related conditions, their health makes the operation more complex and more risky. In these patients a sleeve gastrectomy is an alternative.

Sleeve gastrectomy may be a good alternative in patients who would otherwise undergo a gastric bypass operation but who have many adhesions (areas of scar tissue) from previous operations. Patients with inflammatory bowel disease may be better served by the sleeve gastrectomy.

The sleeve gastrectomy is also being used increasingly in patients with BMI in the 40 – 50 range as an alternative to the band and bypass.

The laparoscopic sleeve gastrectomy procedure is a restrictive procedure that involves stapling, cutting, and removing 80% of the stomach. The result is a stomach “tube or sleeve” that is the size and shape of a banana. This procedure is irreversible.

The stomach is divided vertically from top to bottom leaving a tube of stomach and the pyloric valve at the bottom, which regulates the emptying of the stomach into the small intestine, remains intact. This means that although smaller, the stomach function remains unaltered.

Because the patient can only eat a small meal, they will lose weight, especially if they also comply with a low fat, low sugar diet. Because of the reduced stomach size, the patient will also keep the feeling of fullness for longer, helping them to eat just three meals per day. However, they suffer none of the side effects experienced by bypass patients because the digestion is unaltered.

This operation takes about 1- 2 hours, is performed laparoscopically and the hospital stay post–operatively is normally 2-3 days.

Most patients lose 40–60% of their excess weight in the first 18 months after a sleeve gastrectomy operation. The timing of a second operation if required (completion to bypass) ranges from 12–18 months after the first, depending on the degree of weight loss.


Risks of this operation:

The risks of this surgery include staple-line leak, bleeding, and too-narrow gastric tube.

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Other Procedures (click to view):


Laparoscopic Gastric Banding for Obesity

Laparoscopic Gastric Bypass for Obesity

Laparoscopic Anti-reflux Surgery

Laparoscopic Myotomy for Achalasia

Sleeve Gastrectomy
Frequently Asked Questions:

How much weight can I expect to lose?

Most patients lose 40–60% of their excess weight in the first 18 months after a sleeve gastrectomy operation.

Will I need Nutritional Supplements?

Patients may require vitamins, calcium, iron and vitamin B12 supplements after sleeve gastrectomy. Not all patients need supplements though as the procedure is not malabsorptive.

Do I have to avoid salads or bulky foods?

In fact, we recommend a balanced diet that includes salads and fruits. A soft diet is only recommended in the first few weeks after the initial operation. After a sleeve gastrectomy normal food is introduced slowly 4 weeks after surgery.

Can I travel?

There are no restrictions to travelling once fully recovered from the surgery. Patients have taken short haul flights 7 days after discharge. It is better to wait at least 4 weeks before a long haul flight as special arrangements may need to be made and this should be discussed with the team.

Hospital stay

The sleeve gastrectomy operation requires a 2-3 day hospital stay.

Time off work post op?

A minimum of 2 weeks with a possibility of returning part-time for desk-type jobs, after this time. Strenuous activity and heavy exercise should be avoided for about 4 weeks.

Will I have a lot of vomiting?

No. You should not have any vomiting. The commonest reason for vomiting is failure to adjust eating habits. You may be eating too fast, chewing insufficiently or eating too much. Regurgitation in the first few weeks after a sleeve gastrectomy can occur. The “tube or sleeve” in the stomach is deliberately fashioned to be tight. This settles down. Rarely an endoscopy under light sedation may be needed after the first month or so to stretch the outlet by a few mm.

Will I be able to take my normal medication?

In general there should be no problem. It is advisable during the first four weeks after surgery that you should take your medication in liquid form or crush your tablets. You will need to check with your pharmacist or G.P. You should always drink plenty after any medication and avoid lying down afterwards.

Will plastic surgery be required?

About a quarter of our patients require plastic surgery after they lose weight. Generally, it is best to wait until after two years by which time the weight loss should be stabilised.