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What Is a Sleeve Gastrectomy?

An illustration of the sleeve gastrectomy procedure

A sleeve gastrectomy, also called gastric sleeve surgery or vertical sleeve gastrectomy, is a weight loss (bariatric) surgery. This a gastric restrictive procedure, which is a type of weight loss surgery that makes your stomach smaller. After surgery, you will feel full more quickly. This will mean you eat fewer calories, leading to weight loss. 

Your surgeon will use staples to divide your stomach vertically. They will remove a large portion of your stomach so the remaining part is a long, narrow tube (sleeve). 

The gastric sleeve is a newer procedure compared to other types of weight loss surgery. That means bariatric surgeons [SS1] have less data about its long-term outcomes. Unlike other weight loss procedures, sleeve gastrectomy only changes your stomach size and doesn’t reroute your intestines.

Sleeve Gastrectomy vs. Gastric Bypass 

Both sleeve gastrectomy and gastric bypass are bariatric surgeries that change the size of your stomach. But in a gastric bypass, your surgeon also connects the middle of your small intestine to your stomach. This makes food bypass the first part of your small intestine and can affect how you absorb calories and digest food. 

All weight loss surgeries have pros and cons. Your surgeon will help you decide which procedure is right for you based on your health risks, history, and preferences. Find out more about Roux-en-Y gastric bypass. 

Average Weight Loss for Sleeve Gastrectomy

We don’t have a lot of information about the long-term outcomes of sleeve gastrectomy. But we know it leads to significant weight loss. Most patients lose about 50% of their excess body weight in the 12–24 months after surgery. Excess body weight refers to the weight you carry above your ideal body weight. Ideal body weight is a standard medical measurement of health. 

You will see the fastest weight loss in the first six months after your surgery. Your weight loss will slow over time. You will succeed to keep your weight off long-term if you commit to healthy diet and exercise habits.

Sleeve Gastrectomy Requirements for Surgery

Your body mass index (BMI) and overall health determine whether you qualify for bariatric surgery. You may qualify for these procedures if you have a high BMI with or without weight-related health conditions. 

Please note that some insurance plans may require a BMI of 40 or a BMI of 35 with a related health condition. Check with your insurance provider to learn whether you qualify for surgery. 

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Sleeve Gastrectomy Surgery: What to Expect

Our team will evaluate you thoroughly before sleeve gastrectomy surgery. You will also work with a trained nutritionist for at least three months. A psychologist and exercise physiologist will meet with you to ensure you’re ready for surgery.

Our surgeons use minimally invasive (laparoscopic or robotic) techniques to perform sleeve gastrectomy surgery. This means your surgeon will operate through small incisions (cuts) instead of making one large incision.

There are several steps to gastric sleeve surgeries: 

  1. We give you anesthesia so you remain asleep during the procedure. 

  2. Your surgeon makes several small cuts in your abdomen where they will insert surgical tools. 

  3. Your surgeon divides your stomach vertically using surgical stapling technology. They then remove the larger portion of your stomach.

  4. Your remaining stomach is a long, sleeve-like shape about the size of a banana.

Gastric sleeve surgery usually takes about 1–2 hours. You will stay in the hospital overnight and return home the next day. 

Sleeve Gastrectomy Recovery

Initial recovery time after a sleeve gastrectomy surgery is about two weeks. Your overall recovery will take several months:

  • Week 1: You’ll have some postsurgical pain for about 5–7 days. 

  • Week 1–4: You’ll need to follow a liquid diet for four weeks. 

  • Week 5–6: You’ll follow a soft solid diet (foods like cooked sweet potatoes, bananas, or canned vegetables) until six weeks after surgery. 

  • Week 6: You can eat a general bariatric diet including whole cuts of meat and raw vegetables.

  • 12 weeks: Most people will feel more fatigue than usual for up to three months after surgery. It may take several weeks for you to return to work, depending on the type of job you have. 

You will see your surgeon for follow-up appointments at specific intervals after surgery: 

  • Two weeks

  • Six weeks 

  • Three months 

  • Six months 

  • One year, then annually 

We will perform nutritional evaluations and blood tests at your three-month, six-month, and annual appointments. These tests help ensure you’re staying healthy after surgery. 

Pregnancy After Sleeve Gastrectomy

Research shows that sleeve gastrectomy usually increases fertility for men and women. But, specialists recommend that women avoid pregnancy for 1–2 years after a sleeve gastrectomy. These two years are a period of rapid weight loss. You have a higher risk of nutritional deficiencies in this period. Those deficiencies could affect your baby.

Sleeve Gastrectomy Diet

Weight loss educator presents dietary information to a class
U of U Heath weight loss patients discuss post-surgery diet with our registered dietician.

You will need to make long-term diet changes for optimal results after a sleeve gastrectomy. Your surgical team will advise you to make several changes: 

  • Fiber: Most people need 25–30 grams of fiber daily. You should aim for 15 grams of fiber per 1,000 calories. 

  • Meal times: You will need to eat three times daily and consume small snacks between meals. 

  • Portion sizes: You will need to limit your portions to about one cup. 

  • Protein: You will need to aim for at least 60 grams of protein daily.  

  • Water: You will need to drink at least 64 ounces of water daily.

Sleeve Gastrectomy Complications and Side Effects

The most common complication of a sleeve gastrectomy is new or worsening heartburn. About 70% of candidates for bariatric surgery already deal with heartburn. You may not want to choose gastric sleeve surgery if you don’t want to make your heartburn worse.

Sleeve Gastrectomy Cost

The cost of a sleeve gastrectomy depends on your insurance. Different insurance plans have different requirements to qualify for bariatric surgery. Our team has a full-time insurance specialist who will help you. They will work with you to understand all the requirements and costs of your surgery. 

You may pay for bariatric surgery out-of-pocket if your insurance plan doesn’t cover it or you don’t have insurance. Please contact our program with questions. 

Why Choose University of Utah Health?

An bariatric specialist chats with a patient in the clinic
Ellen Morrow, MD, discusses bariatric surgery with a patient.

The bariatric surgery program at U of U Health is a comprehensive obesity treatment program. We work with a diverse team of experts so we can fully support every part of your weight loss journey. We are also the only program in the Mountain West region where you have access to every specialist in one location. Our team includes multiple experts: 

We also work closely with liver and heart specialists to coordinate every evaluation you need. Our bariatric surgery team uses only evidence-based treatments with a record of successful outcomes. We commit to find the best way for you to lose weight long-term. 

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You must attend one of our free bariatric surgery seminars before scheduling an appointment with our bariatric surgeons.

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Do I Qualify for Bariatric Surgery?

Bariatric surgery isn't for people who are mildly overweight. Instead, it's for severely obese people who are 100 pounds or more overweight and their health is at risk.

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What Weight Loss Surgery Is Best For Me?

There are several types of bariatric surgery. Choosing the best surgery for you will depend on your weight loss goals and preferences.

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If you're thinking about weight loss surgery, it can be overwhelming to know where to start. We help make the process as easy as possible.

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If your insurance doesn't cover bariatric surgery, you can pay for it using our self-pay option.

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