Gastric sleeve surgery (sleeve gastrectomy)

What is gastric sleeve surgery?

Gastric sleeve (also called sleeve gastrectomy, vertical sleeve gastrectomy, or VSG) is a common minimally invasive, laparoscopic, or robotic-assisted bariatric surgery procedure. During the procedure, a surgeon uses small incisions and instruments to remove about 85 percent of your stomach. The remaining 15 percent resembles a narrow tube or sleeve.

Unlike other weight loss procedures, VSG does not change the anatomy of the stomach and intestines. It is a clinically proven, safer procedure with lower risk of malabsorption (difficulty absorbing nutrients from food), intestinal blockage, and ulcer. There is no risk of dumping syndrome, when food moves too quickly through the stomach, following a bariatric procedure.

Our surgeons perform hundreds of sleeve gastrectomy procedures each year with very low complication rates.

Who is a candidate for gastric sleeve surgery?

Sleeve gastrectomy is the most common bariatric procedure performed today, with excellent outcomes when supported by dedicated lifestyle changes. At Penn Medicine, candidates for any bariatric surgery must meet specific criteria established by the National Institutes of Health (NIH). Many insurance providers require these criteria for approval:

  • A body mass index (BMI) greater than 40, or greater than 35 with medical conditions related to obesity, such as high blood pressure, Type 2 diabetes, high cholesterol, and sleep apnea
  • No active drug or alcohol abuse or major psychiatric disorder

Surgery candidates must also complete a series of screenings and medical tests to ensure their eligibility for bariatric surgery. We submit test results and documentation to your insurance provider. Our team ensures you meet all insurance requirements throughout the surgery process.

How does gastric sleeve surgery work for weight loss?

After surgery, your stomach holds only three to four ounces of food. This limits the amount of calories you take in. In addition, the portion of the stomach removed in gastric sleeve surgery is responsible for producing ghrelin, the hormone that makes you feel hunger. As a result, you produce less ghrelin, and your appetite is reduced.

After sleeve gastrectomy, people lose an average of 25 percent of their total body weight (and up to 70 percent of their excess body weight).

What to expect during gastric sleeve surgery

On the day of your procedure, you’ll arrive at the hospital at a pre-scheduled time. Your bariatric surgeon will discuss details of your surgery and answer your questions about bariatric surgery.

Sleeve gastrectomy requires general anesthesia. This means you’ll be asleep and comfortable throughout the procedure. During the procedure, your surgeon will make four to five small incisions (usually about the width of your fingertip). They’ll insert small tools into the incisions to reduce the size of your stomach.

As a minimally invasive procedure often performed robotically, gastric sleeve surgery usually takes one to two hours. Most people spend one to two days recovering from gastric sleeve surgery in the hospital. You’ll need someone to drive you home after your discharge.

Recovery and follow-up after sleeve gastrectomy

Most people don’t require special care when they return home from gastric sleeve surgery. However, you can’t drive until you stop taking medications associated with surgery and can move quickly. People usually return to work within one to two weeks. If you perform physically demanding work, it may take up to six weeks before you can return.

Follow-up visits with your bariatric surgery team begin ten days after your procedure. You’ll continue follow-up visits at six weeks, three months, six months, and then every 12 months. Like other types of weight loss surgery, sleeve gastrectomy requires lifelong lifestyle changes to help you sustain your weight loss.

Working with our registered dietitian is an important part of your ongoing care. Shortly after surgery, you’ll begin a phased approach to eating. You’ll start with a clear liquid diet within 24 hours of your surgery, followed by a full liquid diet, a soft food diet, and your regular diet in the weeks ahead.

We invite you to attend our support groups for bariatric surgery patients. No one understands your journey like others who are also going through it. Connecting with peers can be a source of support that helps you stay committed to your weight loss goals

Advanced bariatric surgery procedures from experienced surgeons

The board-certified bariatric surgeons at Penn Medicine have expertise in the latest surgical weight loss procedures. Our team performs hundreds of robotic and laparoscopic gastric sleeve surgeries every year, with excellent results and low complication rates. These precise minimally invasive techniques require smaller incisions and result in faster recovery. We’re proud to be accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) in recognition of our safe, high-quality care.

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