Gastric Sleeve Surgery

This is a major surgical procedure that requires a general anaesthetic. The operation is virtually always done laparoscopically, using keyhole surgery and you will normally need to stay in hospital for two days. Recovery time is a little longer than that after a gastric band but most patients resume normal activities in two weeks.

The main advantage of a sleeve gastrectomy is that it does not change the way your body digests food, so there is less chance of you becoming deficient in key vitamins, minerals or protein with time, though you need to take supplements in the first two years as your food intake will be severely reduced.

Patients who have had this type of weight loss surgery feel fuller sooner, even though they can eat normally. In the first 6-12 months, there is no appetite because of a lack of the appetite-causing hormone. Weight loss is comparable with a gastric bypass in the first 24 months.

When we treat patients who are morbidly obese, with a BMI of 60 or higher, we use the sleeve gastrectomy as the first stage in a potentially two-stage weight loss treatment. The sleeve gastrectomy is the less risky of the two operations and can be done safely in people who are so obese.

In such patients, the tendency to over-eat is strong and the stomach is liable to expand after one to two years. However, the sleeve gastrectomy is able to bring about enough weight loss to bring their BMI down to around 50, which then makes it possible to perform a duodenal switch. This more complex surgery cannot be attempted in someone with a higher BMI.

Most patients lose 60–70 % of their excess weight in the first 12 months after a sleeve gastrectomy operation. If it is done as a two stage operation, you may lose 30-50% of your excess weight. The timing of the second stage operation, the duodenal switch, ranges from 12–24 months after the first, depending on the lack of further weight loss or even the tendency to gain weight.

Not all patients who start off with a very high BMI will need the second stage operation; if motivation is high and patients continue to lose weight 2-3 years after a sleeve gastrectomy, they can opt to defer the second operation indefinitely.

The most serious complications include rupture of the stomach along the line at which the stomach has been stapled. Bleeding and leakage can occur within 24-48 hours after surgery. Data shows that this occurs in fewer than one in 100 patients. However, the skill of the bariatric surgeon is crucial; the very experienced surgeons at The London Clinic rarely see such complications.

Although many patients do lose weight after a sleeve gastrectomy, the impact of the surgery can diminish over time. If you eat larger meals, this will stretch the remaining stomach pouch and a ‘pyramidal’ stomach expands more easily compared to a ‘banana’ stomach.