GASTRIC SLEEVE SURGERY (STOMACH REDUCTION)
Sleeve gastrectomy, an effective surgical solution in the fight against obesity, is a method that allows the removal of approximately 80% of the stomach, reducing its volume and reducing the production of the hunger hormone (ghrelin). This surgery, which is especially recommended for people who cannot achieve permanent results with diet and exercise, have a BMI of over 35-40, or have diseases such as diabetes and hypertension due to obesity, offers significant improvements in metabolic health as well as weight loss.
What is stomach reduction (gastric sleeve) surgery?
Stomach reduction surgery, also known as a gastric sleeve or sleeve gastrectomy, is one of the most common types of bariatric surgery. It involves removing a large portion of the stomach for weight loss purposes. After the surgery, you will feel full after eating a small amount of food.
The surgery also makes you feel less hungry because a smaller stomach produces lower levels of the hormone ghrelin, which is responsible for feeling hungry.
What are the benefits of stomach reduction surgery?
Sleeve gastrectomy has a lower risk of complications than another type of bariatric surgery, gastric bypass. The type of bariatric surgery recommended for you depends on your health and how much weight you are aiming to lose. You should talk to your doctor about what is best for you. Losing weight after gastric sleeve surgery can help:
- Control type 2 diabetes
- Lower blood pressure
- Improve heart health
- Improve your quality of life
When might you consider gastric sleeve surgery?
If you have tried to lose weight by dieting and exercising and have not reached a healthy weight, you may consider stomach reduction surgery. Bariatric surgery is usually recommended if other weight loss options are not successful. Your doctor may recommend stomach reduction surgery to help you lose weight in the following cases:
- If your body mass index is over 40
- If you have other serious health problems such as diabetes or heart disease and your body mass index is over 35
Since the surgeries are performed with a closed (laparoscopic) method, the pain is much less compared to open surgeries. Liquid nutrition is started on the same day.
Following a diet program after the surgery will ensure that the process is healthier.
It is necessary to eat mostly liquids, especially in the first week. Afterwards, it is appropriate to eat pureed foods for 1 month. Afterwards, it is important not to eat heavy foods and to stay away from fatty and sugary foods. It would be good to stay away from foods such as rice, pasta and bread for up to 6 months.
Vitamin and protein support is usually required for up to 3 months, after which progress will be made depending on the evaluation.
How do you prepare for gastric sleeve surgery?
If you are considering surgery, your doctor will refer you for tests to make sure that gastric sleeve surgery is right for you. You may be asked to attend an information session to learn more about the surgery and what to expect afterward.
Smoking can affect your recovery from surgery and increase your risk of complications. If you smoke, it is strongly recommended that you quit smoking at least 6 weeks before gastric sleeve surgery.
To reduce your risk of complications, it is recommended that you follow a very restricted diet for several weeks before surgery. Your doctor will give you more information about any changes you need to make to your medications and diet in the weeks or days leading up to surgery.
How is gastric sleeve surgery performed?
Gastric sleeve surgery is performed under general anesthesia. It is usually performed laparoscopically (closed) and takes 60 to 90 minutes.
The surgeon will use a stapler to create a small tube (‘sleeve’) in the stomach and then remove the rest of the stomach. During gastric sleeve surgery, most of the stomach is removed.
What is the recovery like after the operation?
Most people stay in hospital for 2 to 3 days after gastric sleeve surgery. You may need to take painkillers for a short while after the operation and it is advised that you do not drive.
After gastric sleeve surgery, you will initially start with a liquid diet. You will then gradually move on to pureed foods and then solid foods after a few weeks. Your meals will be much smaller and you may need to stop drinking with your meals because of your small stomach.
Our dietician will advise you on how to change your eating habits after gastric sleeve surgery to stay healthy while you lose weight. Physical activity is also important after gastric sleeve surgery. Our physiotherapists can guide you on how to gradually increase your exercise levels if necessary.
You may find that you lose weight initially, but your body will then get used to the changes made during the surgery. It is important to follow the advice of your healthcare professionals and discuss any concerns you may have to maintain your weight loss in the long term.
You will need regular check-ups and blood tests after your surgery. You will also need to take vitamin and mineral supplements for the rest of your life.
If you are on medication, these may need to be adjusted after surgery, so make sure you see your doctor regularly.
What are the risks of sleeve gastrectomy?
As with any surgical intervention, sleeve gastrectomy also has some risks and possible complications. These include bleeding, infection, heart problems, lung problems, pain and blood clots in the legs. In addition, respiratory problems or other reactions due to anesthesia may also occur. In the post-operative period, complications such as stomach leaks, nutritional deficiencies and narrowing of the stomach tube (stricture) may occur. Some patients may experience heartburn or reflux after surgery. Therefore, it is very important to follow your doctor’s recommendations before and after surgery.
What should the diet be like after surgery?
A liquid diet is applied for the first week or two. Then, pureed foods, soft foods and eventually normal foods are switched to. Each meal should be very small and the food should be consumed slowly, each bite should be chewed thoroughly. In the post-operative period, patients are advised to eat smaller portions more frequently and follow a balanced diet. High-fat, sugary and carbohydrate foods should be avoided, and protein-rich and nutritious foods should be preferred. In addition, daily multivitamins, calcium-vitamin D supplements and, if necessary, vitamin B-12 or iron supplements should be taken to prevent vitamin and mineral deficiencies. In the first year after surgery, regular blood tests should be performed to check for iron deficiency anemia, high blood sugar or low calcium or vitamin D levels.
What are the long-term results and lifestyle changes in sleeve gastrectomy?
While sleeve gastrectomy helps patients lose weight, long-term success depends on the patient’s adaptation to lifestyle changes. A balanced diet, regular physical activity and continuing doctor check-ups are essential for a successful weight loss process. In the post-operative period, some patients may lose weight while others may gain weight. Therefore, it is important to stick to a healthy diet and regular exercise program. Also, joining a weight loss surgery support group can be helpful in adjusting to new eating habits.
How much weight loss is expected after surgery?
The expectation in the first year is to lose 60-70% of the excess weight (average 25-35 kg). Long-term success should be supported by diet and exercise.How soon after surgery can you get pregnant?
Pregnancy is not recommended for at least 12-18 months after surgery. Vitamin deficiencies can pose a risk during pregnancy.Do smoking and alcohol consumption affect healing?
Smoking delays healing and increases the risk of ulcers. It should be stopped 6 weeks before surgery. The risk of alcohol dependence increases due to rapid absorption in the small stomach. Consumption should be limited.Can the stomach be returned to its original state after gastric sleeve surgery?
No, the removed stomach tissue cannot be brought back. However, in case of weight gain, additional surgeries such as bypass can be performed.What is the difference between gastric reduction surgery and other bariatric surgeries?
Gastric bypass involves both stomach reduction and changing the intestinal tract. It provides faster weight loss but has a higher risk of complications. Gastric Banding is a reversible method but its effectiveness is low.When to see a doctor?
You should definitely see your doctor if you experience the following:- Fever, severe abdominal pain, shortness of breath
- Vomiting, difficulty swallowing
- Yellowing of the skin or extreme weakness (signs of vitamin deficiency)
Sources:
- Mayo Clinic
- American Society for Metabolic and Bariatric Surgery (ASMBS)
- National Institutes of Health (NIH)
- WebMD
- Cleveland Clinic
- Johns Hopkins Medicine
Last Update Date: 19/03/2025