What is gastric sleeve surgery?

Gastric sleeve surgery, also called sleeve gastrectomy or VSG, is a type of weight loss surgery that removes a large portion of the stomach. It is the most commonly performed weight loss procedure not only in the United States but globally.

Gastric sleeve surgery removes about 80% of your stomach. After surgery, the stomach will be able to hold only 3-7 ounces of liquid. Reducing the size of the stomach limits the amount of food you need to eat to feel full, allowing you to lose weight over time. Because the stomach is smaller after surgery, it has an impact on the hormones in your gut, also known as hunger hormones.

A gastric sleeve procedure may be recommended for those who have obesity and who have been unable to lose weight or sustain weight loss through diet and exercise alone.

Gastric sleeve surgery vs. gastric bypass surgery

Gastric sleeve surgery and gastric bypass surgery are types of weight loss surgeries, but they work in different ways.

Gastric bypass is a complex procedure that revises the size and function of the stomach and the small intestine. A surgeon separates a portion of the stomach to make a small pouch and connects the pouch directly to one part of the small intestine. Food bypasses the larger part of the stomach and part of the small intestine.

Gastric sleeve also involves creating a small stomach pouch. However, a surgeon removes up to 80% of the stomach to create the pouch, but the stomach connects to the small intestine in the same way it did before surgery. Vertical gastric sleeve surgery (VSG) is less complex than gastric bypass, and recovery is usually quicker.

Am I a good candidate for gastric sleeve surgery?

Doctors use many factors to determine whether you’re a good candidate for gastric sleeve or other types of weight loss surgery. Generally, candidates for gastric sleeve have tried unsuccessfully to lose weight using other weight loss methods, including diet, exercise and medication.

Gastric sleeve is often an option for people who are ineligible for other weight loss procedures, including gastric bypass. Your doctor may recommend it as a standalone treatment or as an initial treatment followed by another weight loss surgery once you lose some weight.

Most often, doctors consider the following gastric sleeve requirements to determine if it’s right for you:

  • A body mass index of at least 40
  • A body mass index of at least 35 with at least one obesity-related condition, such as high cholesterol, high blood pressure, diabetes or obstructive sleep apnea

The gastric sleeve procedure

Gastric sleeve is the most common type of weight loss surgery, but it is only the first step in your weight loss journey. To gain the most from your procedure, you’ll need to commit to healthy lifestyle habits before surgery that will help you achieve and sustain weight loss afterward.

Before the procedure

Before having a gastric sleeve procedure, you’ll attend classes to learn about the procedure itself and the lifestyle changes you’ll need to make before and after surgery. You’ll also receive other educational materials to help you understand your post-surgery lifestyle, including the diet you’ll need to follow after you have a gastric sleeve. You’ll also have presurgical testing to make sure you’re healthy enough for surgery. Once you’re cleared for surgery, you’ll receive instructions to prepare you for the day of surgery. You’ll learn when to stop eating and drinking and whether you need to stop taking any medications in the days and hours before surgery.

Gastric sleeve surgery risks

While gastric sleeve surgery (VSG) is typically safe and effective, any surgery can cause complications. Complications that can develop in the days and weeks after your procedure include excessive bleeding, reactions to anesthesia, leaks along the staple line, blood clots and infection.

Gastric sleeve surgery side effects

In addition to the potential post-surgery complications of gastric sleeve surgery, it’s also possible to develop long-term side effects. Some of these side effects are caused by the surgical procedure itself, while others are associated with the weight loss that occurs after surgery.

Side effects include:

  • Acid reflux: A smaller stomach increases pressure on the lower esophageal sphincter, which typically prevents stomach acid from entering your esophagus. Acid reflux is a common side effect of gastric sleeve surgery.
  • Gallstones: Rapid weight loss may increase your risk for gallstones.
  • Low blood sugar: Also called post-bariatric surgery hypoglycemia, low blood sugar can develop due to changes in hormones and how quickly food moves through your smaller stomach.
  • Vitamin deficiencies: People having gastric sleeve surgery may have lower rates of nutrient deficiencies than other weight loss surgeries, but you may become deficient in B vitamins, iron, calcium and vitamins A and K.

Gastric sleeve surgery recovery time

Recovery after gastric sleeve surgery typically takes several weeks to a month. Your recovery time may vary depending on several factors, including whether you experience any complications and your overall health. Your surgeon can offer guidance about when it’s safe to resume specific activities and work.

During your recovery, you’ll gradually progress from eating a liquid diet to eating small amounts of solid food. Your gastric sleeve diet will depend on your surgeon’s instructions, but it’s important to focus on getting enough protein and staying well-hydrated. 

Frequently asked questions