What to Know About Gastric Sleeve Weight Loss Surgery

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Gastric sleeve surgery is almost always done as a minimally invasive procedure using a laparoscope. This means a long, thin tube is inserted into your abdomen through several small incisions. This tube has a light and a tiny camera attached to it as well as various instruments.

Gastric sleeve surgery is done using general anesthesia, which is medicine that puts you into a very deep sleep and requires a ventilator to breathe for you during the surgery.

The surgery entails dividing your stomach into two unequal parts. About 80 percent of the outer curved part of your stomach is cut away and removed.

The edges of the remaining 20 percent are then stapled or sutured together. This creates a banana-shaped stomach that’s only about 25 percent of its original size.

You’ll be in the operating room about an hour. Once the surgery is complete, you’ll be moved to the recovery room for postoperative care. You’ll be in the recovery room for another hour or so while you wake up from the anesthesia.

The small incisions in your abdomen typically heal quickly. The minimally invasive nature of the surgery helps you recover faster than a procedure where your abdomen is opened with a larger incision.

Unless there are complications, you should be able to go home within 2 or 3 days after the surgery.

Gastric sleeve surgery helps you lose weight in two ways:

• Your stomach is significantly smaller so you feel full and stop eating sooner. This means you take in fewer calories.
• The part of your stomach that produces ghrelin — a hormone that’s associated with hunger — has been removed, so you’re not as hungry.

According to the American Society of Metabolic and Bariatric Surgery, you can expect to lose at least 50 percent of your excess weight within the 18 to 24 months following gastric sleeve surgery. Some people lose 60 to 70 percent.

It’s important to remember that this will only happen if you are committed to following the diet and exercise plan recommended by your surgeon. By adopting these lifestyle changes, you’re more likely to keep the weight off long term.

Bariatric surgery of any type, including gastric sleeve surgery, is only considered an option when strong attempts to improve your diet and exercise habits, and the use of weight-loss medications, haven’t worked.

Even then, you must meet certain criteria to be eligible for a bariatric procedure. These criteria are based on your body mass index (BMI) and whether you have any obesity-related health conditions.

Occasionally, gastric sleeve surgery is done if you’re overweight but don’t meet the criteria for obesity, but you have a significant health condition related to your weight.

Gastric sleeve surgery is considered a relatively safe procedure. However, like all major surgeries, there can be risks and complications.

Some complications can occur after almost any surgery. These include:

• Hemorrhage. Bleeding from the surgical wound or inside your body can lead to shock when it’s severe.
• Deep vein thrombosis (DVT). Surgery and the recovery process can increase your risk of a blood clot forming in your vein, usually in a leg vein.
• Pulmonary embolism. A pulmonary embolism can happen when part of a blood clot breaks off and travels to your lungs.
• Irregular heartbeat. Surgery can increase the risk of an irregular heartbeat, especially atrial fibrillation.
• Pneumonia. Pain can cause you to take shallow breaths which can lead to a lung infection, like pneumonia.

Gastric sleeve surgery can have additional complications. Some possible side effects that are specific to this surgery include:

• Gastric leaks. Stomach fluids can leak from the suture line in your stomach where it was sewn back together.
• Stenosis. Part of your gastric sleeve can close, causing an obstruction in your stomach.
• Vitamin deficiencies. The section of your stomach that’s removed is partly responsible for the absorption of vitamins your body needs. Unless you take vitamin supplements, this can lead to deficiencies.
• Heartburn (GERD). Reshaping your stomach can cause or worsen heartburn. This can typically be treated with over-the-counter medication.

It’s important to remember that changing your diet and exercise habits are essential to losing the weight and keeping it off after gastric sleeve surgery. It’s possible to gain the weight back if you:

• eat too much
• eat an unhealthy diet
• exercise too little

Other concerns

Another common concern, especially when you lose a lot of weight quickly, is the large amount of excess skin you may be left with as the pounds fall away. This is a common side effect of gastric sleeve surgery.

This excess skin can be surgically removed if it bothers you. But keep in mind that it can take up to 18 months for your body to stabilize after gastric sleeve surgery. That’s why it’s usually best to wait before considering a skin removal procedure. Until then, you may want to try some techniques for tightening loose skin.

Another thing to consider before deciding to have gastric sleeve surgery is that, unlike some other bariatric surgeries, gastric sleeve surgery is irreversible. If you are not happy with the outcome, your stomach cannot be changed back to the way it was.

Before gastric sleeve surgery is performed, you typically have to agree to specific lifestyle changes recommended by your surgeon. These changes are meant to help you achieve and maintain weight loss.

One of these changes includes eating a healthier diet for the rest of your life.

Your surgeon will recommend the best gastric sleeve diet for you before and after your surgery. The dietary changes your surgeon suggests may be similar to the general dietary guidelines below.

You’ll usually be able to eat regular, healthy food about one month after your surgery. You’ll find that you eat less than before the procedure because you’ll get full quickly and won’t feel as hungry.

Your limited diet and smaller meals may cause some nutritional deficiencies. It’s important to make up for this by taking multivitamins, calcium supplements, a monthly B-12 shot, and others as recommended by your surgeon.

In the United States, most health insurance companies understand that obesity is a risk factor for other health conditions that can lead to serious medical problems. For this reason, many insurance companies pay for gastric sleeve surgery if you have a qualifying condition.

According to the Centers of Medicare & Medicare Services (CMS), Medicare will pay for gastric sleeve surgery if you meet the following conditions:

• your BMI is 35 or higher
• you have one or more obesity-related health conditions
• you were unable to lose the weight by changing your diet and exercise habits or by taking medication

Medicare doesn’t cover gastric sleeve surgery if you’re obese but don’t have an obesity-related health condition.

Without health insurance coverage, the cost of gastric sleeve surgery can vary widely from one region to another, and even from one facility to the next in the same geographic area. On average, the cost could range from $15,000 to more than $25,000.

Given this wide variation, it’s best to research and talk to several surgeons and operative centers to find one you’re comfortable with — and one that fits your budget.

Gastric sleeve surgery is one of several types of bariatric surgery options. It works by making your stomach smaller so you eat less. Because the size of your stomach is reduced, you’ll also find that you’re less hungry.

To qualify for gastric sleeve surgery, you must meet certain criteria. You need to prove that you’ve tried other weight-loss methods — including diet, exercise, and weight loss medications — without success. Other qualifying criteria include your BMI and whether you have any obesity-related health conditions.

If you follow a healthy diet and exercise regimen regularly after gastric sleeve surgery, you may be able to lose more than 50 percent of your excess weight within 24 months.

However, as with most surgical procedures, there is the risk of side effects and complications. If you’re interested in gastric sleeve surgery, talk with your doctor about whether you qualify for this procedure and if it’s a safe option for you.