Guide to Sleeve Gastrectomy
Reviewed by weight loss surgeon Francisco Guzman, MD, January 2025
A sleeve gastrectomy is a surgical procedure that induces weight loss by reducing the size of the stomach.
Key Facts
- The surgery removes approximately 75% of the stomach.
- Patients can expect to lose 60% or more of their excess weight in two to three years.
- A sleeve gastrectomy is a permanent procedure that cannot be reversed.
What is a Sleeve Gastrectomy?
Sleeve gastrectomy is a surgical procedure that induces weight loss by restricting food intake. This results in the stomach taking on the shape of a tube or "sleeve" that holds much less food.
Why Have a Sleeve Gastrectomy?
Sleeve gastrectomy induces rapid and effective weight loss that is comparable to a gastric bypass operation. It is an option for obese patients who have struggled to lose weight using diet and exercise.
By losing excess weight, other illnesses associated with obesity can greatly improve. Results have shown a significant reduction in conditions like diabetes and sleep apnea.
You should discuss how weight loss can improve your health with your physician.
Am I a Candidate for Sleeve Gastrectomy Surgery?
Any patient who is a candidate for bariatric surgery is potentially a candidate for this operation.
The typical criteria eligible for weight loss surgery include the following:
- Persons with a BMI of 40 or over (about 100 pounds or more above ideal body weight).
- Persons with a BMI of 35 or above (at least 80 pounds above ideal body weight) and who have life-threatening obesity-related problems such as diabetes, hypertension, and sleep apnea.
- Having mild or no gastroesophageal reflux disease (GERD) symptoms
How is a Sleeve Gastrectomy Performed?
This surgery is performed using a minimally invasive approach, either laparoscopically or robotically, using narrow small incisions in the abdomen. During the procedure, the surgeon removes approximately 75 percent of the stomach, which is then closed to resemble a tube or "sleeve."
How Does the Procedure Cause Weight Loss?
When the smaller stomach fills with food, a feeling of fullness or satiety occurs. Patients simply can't eat as much as they did before surgery because this smaller stomach can only accommodate a few ounces of food at a time.
Removing a portion of the stomach reduces the body's level of ghrelin, commonly referred to as the "hunger hormone." Many people find that they are much less hungry after the sleeve gastrectomy.
Ghrelin also plays a role in blood sugar metabolism. People with type II diabetes often see an immediate decrease in their need for diabetes medications (especially oral medications) after the procedure.
Stories & Perspectives
In Their Own Words: Patients Describe Their Transformations
What Kind of Anesthesia is Used for a Sleeve Gastrectomy?
A sleeve gastrectomy is performed under general anesthesia, so you will not be awake during the procedure.
How Do I Prepare for My Sleeve Gastrectomy Surgery?
Your surgeon will give you specific instructions to help make your procedure more successful. These include adhering to a special diet and discontinuing smoking and certain medications prior to your surgery.
What are the Risks of a Sleeve Gastrectomy?
Like any surgery, a sleeve gastrectomy carries some risk for complications; the risk for these complications is higher for obese patients. Some potential risks that are specific to the procedure include:
- Gastroesophageal Reflux (GERD) – Because the procedure reduces the size of the stomach, it may also increase pressure on the esophagus. This pressure can cause reflux.
- Dumping Syndrome – Food moving quickly from the stomach into the small intestine can cause uncomfortable symptoms, including nausea, vomiting, diarrhea, cramping, and fatigue.
- Stomach Leakage – The seam where the stomach has been stapled back together may leak.
- Long-term Nutrient Deficiencies – Changes in how your body digests food can lead to deficiencies in certain nutrients, especially if the post-surgical diet plan isn't adhered to.
It's also important to remember that a sleeve gastrectomy is non-reversible and may not provide the desired weight loss results.
A detailed discussion of the risks of surgery should be a part of your pre-operative discussion with your surgeon.
What is Recovery Like After a Sleeve Gastrectomy?
For the first few weeks after surgery, you will need to follow a carefully monitored diet, starting with a liquid diet and slowly reintroducing specific types of food. Most patients find that after a reasonable recovery, they are able to comfortably eat a wide variety of foods, including meats and fibrous vegetables.
It is important that patients who have a sleeve gastrectomy procedure make a lifelong commitment to making the necessary changes in their diet. This includes eating enough protein, taking vitamin and mineral supplements, and avoiding sweets and fatty foods.
How Much Weight Will I Lose?
The reported weight loss for this procedure averages about 60% of the excess weight over two to three years. That means that if you're 100 lbs overweight, you will lose, on average, about 60 lbs. Better results can be obtained by sticking to your dietary and behavioral guidelines.
How Long Will the Benefits of a Sleeve Gastrectomy Last?
How well you comply with diet recommendations and exercise will greatly contribute to your final weight. With smart food choices, regular exercise, and good eating habits, patients who have had a sleeve gastrectomy have maintained their weight loss for 10 years or more.
Next Steps
If you'd like to learn more about having sleeve gastrectomy surgery or other weight-loss procedures, our team at Columbia is here to help. Call us at (212) 305-4000 or request an appointment online. We accept a number of insurance plans, and our team can help confirm your coverage.