What Is Gastric Sleeve Surgery?

Weight-loss surgery reduces stomach size, limits food intake

A young, heavyset woman researches gastric sleeve surgery.

Weight-loss surgery reduces stomach size, limits food intake

Gastric sleeve surgery is the most common weight-loss surgery today, making up over 60 percent of bariatric surgeries.


Also called sleeve gastrectomy, it is a minimally invasive surgical procedure that can lead to significant weight loss. It works by reducing how much food the stomach can hold.


“Gastric sleeve surgery can especially help people who are very overweight and have health issues from obesity,” says William Fuller, MD, a bariatric surgeon at Scripps Clinic. “The procedure makes the stomach smaller and helps reduce appetite. This helps people lose weight. It also helps with obesity-related issues, including type 2 diabetes, high blood pressure and sleep apnea.”

How does gastric sleeve work?

Gastric sleeve surgery, like other weight-loss surgeries, may be an option when diet and weight medications do not work.


The surgery removes a large part of the stomach, up to 80 percent. The remaining stomach becomes a smaller, sleeve-shaped pouch.


This smaller stomach limits how much food you can eat. It can hold about two ounces of food at a time. An average stomach can hold up to two quarts.


By making the stomach smaller, the procedure affects hunger hormones. “After the surgery, patients tend to feel full or less hungry between meals,” Dr. Fuller says.


Generally, in the first six months to one year after surgery, patients can lose about two-thirds of their excess weight.

How is surgery performed?

Patients first have a complete pre-operative assessment to see if they are suitable candidates. Before the operation, patients are given general anesthesia to ensure their comfort and safety during the procedure.


The surgeon begins by making a few small incisions in the abdomen and uses special instruments to remove about 75-80% of the stomach. The remaining part is reshaped and becomes the new stomach.


Small staples are used to close the stomach and reduce its size. This is done carefully and precisely to avoid leaks and other problems.


A typical gastric sleeve procedure lasts about one hour. Patients usually stay in the hospital for one day for observation. 


Gastric sleeve differs significantly from other weight-loss surgeries like gastric bypass or gastric banding because it does not involve any changes to the intestines or implantation of a device. This makes it a popular choice for patients seeking simple and effective weight loss. Nevertheless, success with sleeve surgery requires a lifelong commitment to healthy dietary and exercise habits.

Benefits of gastric sleeve surgery

Beyond losing weight, gastric sleeve surgery offers many health benefits. Many patients see improvements in obesity-related conditions like type 2 diabetes, high blood pressure and sleep apnea.


Gastric sleeve surgery significantly impacts hunger hormones like ghrelin by reducing their production. This change means patients feel less hungry throughout the day.


“Many patients see better health and quality of life after surgery,” Dr. Fuller said. “They can do physical activities that were hard for them before. Lower hunger hormones can help people eat healthier. This makes it easier to keep off weight and enjoy a more active life.”

Is gastric sleeve surgery safe?

Like any surgery, gastric sleeve surgery carries some potential risks and complications.


One main concern about gastric sleeve is leakage along the staple line. This can cause infection or other issues. Although this risk is low, it needs quick medical attention if symptoms like severe abdominal pain or fever appear. Additionally, patients may face nutritional deficiencies if they do not follow dietary guidelines after surgery.


“If you’ve been approved for gastric sleeve surgery, you’ll work closely with your care team to make sure you’re healthy enough for surgery and develop a plan for reaching your goal weight and maintaining it,” Dr. Fuller says.


Also, unlike other bariatric surgeries, gastric sleeve is not reversible.

Who’s a candidate for gastric sleeve?

To qualify for gastric sleeve surgery, candidates must meet certain medical requirements. Typically, this includes:


  • Body Mass Index (BMI) above 40 (100 pounds or more over your ideal weight)
  • BMI between 35 and 39.9 and a serious obesity-related health problem, (type 2 diabetes, coronary heart disease, severe sleep apnea)
  • Have been unable to sustain weight loss by changing diet and exercise habits or taking medication


The best candidates are motivated and stay informed. They are ready to participate in long-term care. They are willing to make big lifestyle changes. They want to improve their eating and exercise habits for lasting success.


“Gastric sleeve surgery is not a magic solution,” Dr. Fuller says. “People who have received the procedure still have to exercise and eat correctly. Ultimately, the reward for losing weight is improved overall health.”

Gastric sleeve recovery

Recovery after gastric sleeve surgery involves healing and making significant lifestyle changes. A key part is following specific dietary rules.


At first, a liquid diet is recommended to help the stomach heal. Over several weeks, patients can slowly add solid foods back into their diet. Sticking to these rules helps the stomach and staple line heal without problems.


Lifestyle changes are vital for long-term success. Patients must change their eating habits and add regular exercise to their daily routine to help with weight loss and improve overall health and well-being.


If you are considering gastric sleeve surgery, talk to your doctor and ask all the necessary questions to see if the procedure is right and safe for you.