Gastric Sleeve

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Sleeve Gastrectomy (Gastric Sleeve)

Gastric Sleeve Surgery: All the things you need to know

Sleeve Gastrectomy Illustration
Sleeve Gastrectomy Illustration

The Gastric Sleeve Surgery (or Vertical Sleeve Gastrectomy) is a bariatric procedure that removes 75-80% of the stomach. It is now the most commonly performed bariatric procedure in United States and worldwide.

Gastric Sleeve Surgery brings profound changes to life!

  • Overall improved quality of life
  • Excess weight loss of about 60-70% within one year of surgery
  • Remission or improvement of obesity related health conditions such as diabetes mellitus type II, hypertension, sleep apnea, fatty liver disease, joint pain, and hyperlipidemia
  • Desire to eat decreases
  • Reduction in hunger sensation

How Gastric Sleeve surgery is performed

    

Life after sleeve gastrectomy

     

How does the Gastric Sleeve surgery work?

  1. There is a reduction in stomach volume, causing people to feel full much quicker after the surgery
  2. Hormonal changes such as reduced secretion of hunger hormones cause people to feel less hungry
  3. Increased stomach motility, which allows food to pass stomach and intestine quicker after surgery

History and Trend of the Gastric Sleeve

Initially, the Gastric Sleeve was the restrictive part of the biliopancreatic diversion duodenal switch operation. Then, the gastric sleeve became the first stage operation for very obese patients who underwent duodenal switch operation to reduce the perioperative risks. Some patients lost enough weight after the gastric sleeve surgery and did not undergo the planned second stage duodenal switch operation. These findings prompted bariatric surgeons to consider the gastric sleeve surgery as a standalone bariatric procedure. The first laparoscopic Gastric Sleeve was performed in 2000.

Over the past decade, the number of gastric sleeve surgeries continue to increase nearly every year. Now, more than half of all bariatric surgeries performed in US are gastric sleeve procedures.

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How much weight will I lose after the Gastric Sleeve?

  • On average, people lose about 60-70% of their excess weight 
    • The first 2 weeks: 10-20 pounds; most patients lose about one pound a day
    • The first 3 months: 35-45% of excess weight loss
    • The first 6 months: 50-60% of excess weight loss
    • The first year: 60-70% of excess weight loss
  • Most people reach their lowest weight 12-24 months after surgery
  • The Gastric Sleeve success rate is approximately 80-90%

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Improvement of Obesity Related Health Problems

  • Large clinical trials and studies have proven gastric sleeve surgery lead to resolution or improvement of many obesity related health problems such as:
    • Type 2 diabetes: Most studies indicated that 60-80% of patients with type 2 diabetes could achieve disease remission or improvement after gastric sleeve surgery
    • Hypertension
    • Fatty liver disease
    • High cholesterol
    • Sleep apnea
    • Decreased cancer risk
    • PCOS
    • Asthma
    • Migraine
    • Join pain
    • Depression and other psychosocial problems
    • Infertility
    • Low testosterone: Gastric sleeve can naturally lead to increased testosterone level
    • Urinary incontinence
    • Gout

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Eligibility and Insurance Coverage

  • Most insurance companies cover bariatric surgery, when you meet the following criteria:
    • BMI greater than 40, or
    • BMI of 35-39.9 with one of the obesity related health problems such as:
      • Hypertension
      • Type 2 diabetes
      • Sleep Apnea
      • Fatty liver disease, or
      • Hyperlipidemia

For patients who want to have surgery at UCLA, we will verify your insurance coverage.

Please submit an online request of appointment form.

For patients with BMI of 30-34.9, insurance will not cover bariatric surgery procedures. However, we have self-pay options for those individuals who have struggled with obesity for a long time, especially those with obesity related health problems.

Calculate your BMI

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Recovery after Surgery

  • The surgery takes approximately 40-70 minutes
  • Discharge from hospital typically occurs after 1-2 nights
  • All patients are encouraged to walk as early as 3-4 hours after surgery
  • In general, the pain is easily manageable after surgery. Most patients take less than the recommended pain medication
  • Most patients go back to work and/or school after 2-4 weeks. Fatigue is common the first 2 weeks due to low calorie intake from liquid diet. However, the majority of patients do not feel hungry during this stage of the diet. The energy level improves quickly after the introduction of the soft diet, which is approximately 2 weeks after surgery. On occasion, we allow patients to work from home 2-3 days per week after surgery.
  • Patients can begin exercising 4 weeks after surgery

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Complications and Risks

  • Over the past decade, with the improvement of surgical techniques and surgeons’ experience, the gastric sleeve has become an overall safe bariatric surgical procedure. However, complications can still occur during and after surgery. Below are the main complications and risks of the gastric sleeve surgery:
    • Leakage from the staple line – this is a rate complication of the gastric sleeve surgery. The stable line opens after surgery. Most leaks can be treated with endoscopic procedure.
    • Stricture/stenosis – another rare complication with narrowing of the stomach after sleeve gastrectomy. Most stricture/stenosis can be treated with endoscopic dilation.
    • Bleeding
    • Blood Clot
    • Heart Burn – This is a very controversial topic in bariatric surgery and the data from different centers is inconsistent. In our experience, most patients with heartburn before surgery see improvement of symptoms after surgery due to weight loss. Some patients may develop new heartburn, which is treatable with over-the-counter anti-acid medications, in most cases.
    • Nutrient or vitamin deficiency
    • Weight Regain – After 1-2 years, slight weight regain is common among all bariatric procedures and about 10-20% of patients can have significant weight regain after gastric sleeve surgery. After 5 years of follow up, many centers collected data to show that the majority of patients can maintain their weight loss after the Gastric Sleeve Surgery.  
    • Excess skin, in some cases, insurance will cover excess skin removal

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Diet after Gastric Sleeve Surgery

  • Day 1: Clear liquid diet. Some surgeons allow patients to drink water a few hours after surgery
  • Day 2-14: Full liquid diet including protein shakes, yogurt, broth, milk, and juice
  • Weeks 3-5: Soft food diet
  • Patients can begin introducing regular food 5 weeks after surgery. They are encouraged to eat a small amount of food each time and have meals that are more frequent.
  • All patients must take multi-vitamin and B complex after surgery

Comparison of Gastric Sleeve to other Types of Bariatric Procedures

  • Laparoscopic gastric banding (Lap-band) was once very popular. However, due to its high rate of long term complications and inferior weight loss, the number of Lap-band surgeries went down every year in the US and worldwide. Most of the US large academic Bariatric Surgery Centers rarely perform the Lap-band procedure at this time.
  • Laparoscopic Roux-en-Y Gastric Bypass Surgery is the gold standard of bariatric surgery. However, Gastric Sleeve has replaced the Gastric Bypass Surgery as the most popular bariatric surgery in recent years due to its technical simplicity and fewer long-term complication rates.

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Advantage of Gastric Sleeve versus Gastric Bypass Surgery

  • Technically, the Gastric Sleeve is a much simpler surgery. The operating time for gastric sleeve is usually 40-70 minutes, while gastric bypass surgery takes approximately 2-3 hours to complete.
  • There is a much lower chance for nutrient or vitamin deficiency with the Gastric Sleeve procedure. In addition, there is no mal-absorption for Gastric Sleeve patients.
  • Some long-term complications could occur with the Gastric Bypass patients including bowel obstruction, marginal ulcer, and internal hernias. The chance of Gastric Sleeve patients developing these complications is exceedingly rare.

     

Gastric Sleeve Surgery Success Stories

Kallista's Story - Weight Loss Surgery: Gastric Sleeve*

Gastric Sleeve
I am forever grateful for my experience at UCLA. 
View Kallista's Story >

Sheena's Story - Weight Loss Surgery: Gastric Sleeve*

Gastric Sleeve
If I had to do it all over again, I would do it in a heartbeat.
View Sheena's Story >

Sarah's Story - Weight Loss Surgery: Gastric Sleeve*

Gastric Sleeve
I truly feel like I got another chance at life!
View Sarah's Story >

     

Contact Us

To schedule a consultation with UCLA Bariatric Surgery in Los Angeles, California, call us at (310) 825-7163 or fill out our online form >

For a physician referral, please call (800) UCLA-MD1 (825-2631).

*Weight loss results can vary depending on the individual. There is no guarantee of specific results. Read full disclaimer.