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Sleeve Gastrectomy: Procedure, Recovery, Cost, Risk & Complication

What is Sleeve Gastrectomy?

Sleeve gastrectomy is a modern type of weight-loss surgery that involves removing fairly a large portion of the stomach, eventually restricting the amount of food that can be consumed after the surgery. Like every other metabolic surgery, it promotes weight loss by changing the hormonal signals between your stomach, brain and liver.

In this surgery, most of the stomach is removed, leaving a small sleeve-shaped pouch. The patient will not be able to have as much food as he/she was eating previously, so fewer calories will be absorbed in the body, resulting in changes in the hormonal signal that is sent between the brain and the stomach. Therefore, there will be an improvement in the metabolic syndrome, cause weight loss and also maintain overall health and well-being.


Sleeve gastrectomy is recommended in the following conditions:

  • If a person is very obese and unable to lose weight through dieting or exercising
  • A person who has a BMI (Body Mass Index) of 40 or more than that, meaning almost 100 pounds over the recommended weight. A normal BMI lies between 18.5 and 25.
  • A high BMI along with a severe health condition like heart disease, type 2 diabetes or obstructive sleep apnea. These conditions may improve if extra weight is lost.
  • In some cases, it is done on patients who are too heavy to undergo any other surgery for weight-loss safely

What Procedure is followed :

Pre Procedure

There are certain pre-procedure guidelines that you need to follow before undergoing a sleeve gastrectomy:

  • Have a detailed discussion with your doctor regarding the whole procedure; what can you expect post-surgery and the complications that may arise
  • You will have to undergo a complete physical examination and nutritional counselling
  • You also have to go for a blood test, ultrasound test of the gallbladder, along with other tests so that your doctor can ensure that you are healthy enough for undergoing the surgery
  • Inform your doctor regarding any medical conditions that you have, such as diabetes, heart/lung problems or high blood pressure so that they can be kept under control. Also, inform your doctor if you think you are pregnant.
  • Stop smoking.
  • You have to stop eating or drinking anything a few hours before the surgery. Follow the instructions carefully as provided by your doctor.

During Procedure

This surgery is performed by administering general anaesthesia to the patient. A tiny camera will be placed inside the stomach, through one of the small incisions that the surgeon makes on your belly. The camera and the other instruments that are required for performing the surgery are inserted through these tiny incisions. The camera, being connected to a monitor outside, allows the surgeon to have a view of the stomach while he is performing the surgery.

The surgeon will remove most of the stomach, and join the portions that remain with the help of surgical staples. It will change the shape of the stomach like a long, vertical tube, similar to that of a banana. The procedure does not cut or change the sphincter muscles that are responsible for allowing food to enter/leave the stomach. The camera and the other instruments are then removed and the cuts are stitched and bandaged.

Post Procedure

You may have to stay in the hospital for 2-3 days after the surgery. In the first two days, your diet will consist only of clear liquids. After that, you can go on a pureed diet. You will be given medications that will provide you relief from the pain. This surgery will bring about a great change in your lifestyle. Very small amounts of food will fill your stomach quickly. You have to eat healthy foods, control the portion sizes that you eat regularly and exercise on a daily basis. Follow the diet that your surgeon or dietician has recommended.

You will have to visit your doctor 2-3 weeks after the surgery. The wounds will be assessed and if you have any other issues, they will be discussed in this appointment.

Risk & Complication

The possible risks or complications that may be associated with sleeve gastrectomy are:

  • Bleeding or infection from the incision site
  • Formation of blood clots
  • Problems in breathing
  • Injury in the stomach, intestine or other organs in the course of the surgery
  • Inflammation of the stomach lining, stomach ulcer or heartburn
  • Leakage from the area where the parts of the stomach has been stapled together
  • Scarring in the insides of the belly, that could eventually lead to blockage in bowel in the future
  • Vomiting, if you eat more than your reduced stomach can hold
  • Dumping syndrome, when food moves from the stomach to the small bowel at a very fast speed

More Info

It is very important that you monitor your diet eat carefully after undergoing a sleeve gastrectomy. Make sure that you are eating the right foods at the right time, and also prepared in the right way. Foods that can be chewed and swallowed easily must be included in your diet. There are some foods like popcorn, nuts, seeds or hard meat that are not chewed properly before swallowing; hence it is advisable to avoid them. Also, avoid having carbonated beverages that may produce gas due to the digestive enzymes. There is not much room for the expansion of gas in the reduced size of the stomach. Apart from that, exercising is also an important aspect that has to be included in your daily schedule.

The cost of sleeve gastrectomy could be around Rs. 2,50,000 – Rs. 5,00,000.

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Popular Health Tips

Sleeve Gastrectomy - 10 Ways It Is Beneficial For You!

MBBS, MS - General Surgery, M.Mas, Diploma In Minimal Access Surgery, Fellowship In Minimal Access Surgery, Fellowship In Robotic Surgery, FICS, F.I.A.G.E.S, FAMASI
Surgical Gastroenterologist, Chennai
Sleeve Gastrectomy -  10 Ways It Is Beneficial For You!

Some people find it harder to lose weight as compared to others. Gastric sleeve surgery is a viable option for such people. This surgery involves reducing the size of the stomach to control the intake of food.

Here are 10 ways this surgery will affect you.

  1. You’ll need a special diet for the first few days: You will need to follow a special diet for 8 weeks after the surgery. This gives your stomach the time to heal properly. Normal food will have to be reintroduced slowly. However, alter, you can eat anything you like.
  2. You can eat lesser: You’ll find yourself taking smaller servings at all meals as your stomach is much smaller than it was. This does not mean that you’ll be able to eat more frequently. It simply means that you will eat a lot lesser. A smaller stomach also means that you will feel less hungry.
  3. Weight Loss: After a gastric sleeve surgery, patients typically lose up to 75% of their excess weight. In the first three months itself, you should see yourself lose up to 33% of excess body weight. Thus, it can help cure obesity and reduce your BMI.
  4. Resolution of obesity-related health issues: As your weight reduces, so does the impact of other diseases. Patients suffering from diabetes, high cholesterol, high blood pressure and sleep apnea report a large amount of improvement in their conditions after this surgery.
  5. Stronger joints: Excess weight puts additional pressure on your joints. This can cause joint pain and increase the wear and tear of joint cartilage. By reducing your weight, there is less pressure on your joints. Improved mobility and lesser knee pain are commonly experienced benefits.
  6. Lowered cancer risk: The risk of some types of cancer is associated with the patient’s weight. As a result of this surgery, the risk of colon cancer, pancreatic cancer, breast cancer and endometrial cancer reduces by up to 33%.
  7. Improved fertility: Women with obesity of overweight issues typically find it difficult to conceive. A gastric sleeve surgery can improve these fertility rates. Studies have shown that more than 50% of the women who underwent this procedure could conceive a child successfully within the next year.
  8. Improved mental health: Your weight also affects your self-confidence. In many cases being overweight or obese contributes to depression. Undergoing this surgery can improve a patients’ self-image and relieve symptoms of depression, anxiety etc.
  9. Better sleep: Losing body fat makes it more comfortable to get a good night’s sleep. Weight loss also helps treat conditions such as sleep apnea that can keep you from sleeping restfully.
  10. Your weight loss will plateau after 2 years: As time passes, your stomach will begin to expand. Hence you may not see yourself losing too much weight after the first year. If you are not careful, you may begin to put on weight again after the 2nd or 3rd year.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3698 people found this helpful

Gastric Sleeve Surgery - Understanding The Process!

MBBS, MS - General Surgery
Bariatrician, Delhi
Gastric Sleeve Surgery - Understanding The Process!

When dieting and exercising fail to help an obese person manage their weight, bariatric surgery may be suggested. One of the most popular types of bariatric surgery is a gastric sleeve surgery or sleeve gastrectomy. The main aim of this surgery is to reduce the amount of food that can be consumed in one sitting. It does not affect the amount of nutrients and fats absorbed from the food that has been eaten. A majority of the weight loss resulting from this surgery happens within 18 months.

A gastric sleeve surgery is a relatively safe, straightforward and short surgery. Prior to the day of the surgery, you would have been given a special diet to be followed for two weeks. It is essential to follow this diet strictly. This surgery may be performed laparoscopically or via a large incision made in the abdomen. More than half the outer side of the stomach is removed. The remaining part of the stomach takes the form of a tube. This surgery is not reversible.

Recovery from a gastric sleeve surgery varies from person to person. A certain amount of pain and discomfort is normal for the first week following the surgery. Soft foods may be introduced in week 4 and you can get back to small amounts of your normal food in week 5. You will notice that you feel fuller much faster and are able to consume a very limited portion of your normal food intake. In some cases, your food may also be emptied into the small intestines at a very fast rate. This is known as dumping syndrome. This may cause diarrhea and nausea and leave you feeling weak. It is essential to drink plenty of water to allow for smooth bowel movements and to prevent constipation.

On an average, this surgery can help people lose up to 60% of their excess body weight. However, this depends largely on your control over your diet and the amount of exercise you do. At some point in time, your weight loss may plateau. This is normal to overcome this, you must make a change to your diet or exercise schedule. A dietician can also help you address the right number of meals needed by your body. A gastric sleeve surgery does not require any maintenance post the surgery but it is important not to fall back to your earlier unhealthy lifestyle and to maintain a positive attitude. If you wish to discuss about any specific problem, you can ask a free question.

2429 people found this helpful

Body Weight Management

MS - General Surgery, MBBS Bachelor of Medicine and Bachelor of Surgery
General Surgeon, Bangalore
Body Weight  Management

Body weight control management to stay fit, healthy and desired shape. Body weight management 90% from diet, exercise. Few obese people requires assist through drugs like orlistat, less than 1% requires non operative endoscopic gastric balloon placement for four to six months for effective weight control. Few extreme obese people require surgeries like sleeve gastrectomy, and metabolic surgery.

1 person found this helpful

Does Bariatric Surgery Reduces The Risk Of Cancer?

Fellowship in Minimal Access Surgery, Fellowship in Bariatric Surgery, M.S.
Bariatrician, Lucknow
Does Bariatric Surgery Reduces The Risk Of Cancer?

Obesity can make life miserable. From unhealthy eating habits to unhealthy lifestyles and medical conditions, obesity can be an amalgamation of many factors. Obese people are a greater risk of suffering from many serious health complications like type 2 diabetes, mood swings, and depression, cardiac problems, high blood pressure and high cholesterol, to name a few. It does not stop there. More alarming is the fact that obese people are an increased risk of suffering from different types of cancer.

Bariatric surgery comes as a saviour for highly obese people (with a BMI over 40), who have tried every possible treatment under the sun to lose weight without any success. Bariatric surgery has helped many severely obese people attain a healthy weight. Bariatric surgery can be of three types;

  1. Gastric bypass surgery (Roux-en-Y): This is one of the most common types of weight-loss surgery practised worldwide. The procedure involves rearranging (dividing) the stomach into a smaller upper pouch and a larger lower part. The smaller pouch is then connected to the small intestine. The food consumed will pass into the small intestine through the pouch. The idea is to rearrange the stomach in such a way that a person consumes a lesser quantity of food.
  2. Gastric banding (Laparoscopic Adjustable Gastric Band): In this procedure, the surgeon creates a small pouch at the upper part of the stomach by placing a band (lap band or A-band) around it. The pouch, true to its name, is used to hold the food consumed. The purpose of placing a band around the stomach (upper part) is to reduce the intake of food.
  3. Sleeve Gastrectomy (Gastric Sleeve surgery): In Sleeve Gastrectomy, surgeons remove a large portion of the stomach, leaving behind only a small sleeve-like pouch (hence the name). Like the other two surgeries, sleeve gastrectomy also aids in limiting the consumption of food.
  4. Duodenal switch: The fourth type of bariatric surgery, Duodenal switch with biliopancreatic diversion, is not very commonly used. Bariatric surgery has several health benefits. In addition to the weight loss, it plays a pivotal role in lowering the incidences of Type-2 Diabetes, depression, anxiety, coronary artery problems, sleep apnea cardiovascular diseases.

Research also suggest that bariatric surgery has been instrumental in reducing the chances of cancer (especially colon and breast cancer) by as much as 60%. The correlation between weight loss and reduced cancer instances is still a debatable topic. Some researchers and oncologists believe that the weight loss (bariatric surgery) brings about a hormonal modification which prevents the growth of tumour cells. Another study links obesity with an increased inflammation. In many cases, inflammation acts as a catalyst, accelerating the growth of cancer cells. Research is still going on to understand this correlation (obesity and reduced cancer rates) better.

Bariatric surgery has its share of risks and demerits. Consult your physician and get yourself thoroughly examined before opting for the surgery. If you wish to discuss any specific problem, you can consult a bariatrician.

1817 people found this helpful

6 Types Of Bariatric Surgery You Can Think of!

MBBS, MS - General Surgery, FRCS - General Surgery , Fellowship in Minimal Access Surgery
General Surgeon, Delhi
6 Types Of Bariatric Surgery You Can Think of!

Obesity can shorten your lifespan by decades and also limit and reduce the quality of your life. Obesity cannot always be controlled by dieting and exercise and thus more complicated means such as bariatric surgery has to be employed.

Types of bariatric surgery
Most bariatric surgeries either limit your ability to consume food and thus make you feel fuller quickly or limit the absorption of nutrients from the food you eat. Certain surgeries use a combination of the two in varying degrees. Mentioned below are the most commonly employed forms of bariatric surgery –

  1. Gastric Balloon – This is a form of surgery wherein a specially made balloon is inserted into the stomach. In certain cases even two balloons are inserted into the stomach to reduce the room left for food. This causes you to have less food resulting in weight loss over a period of time.
  2. Gastric Sleeve – This is a form of surgery wherein a major portion of the stomach is removed through the procedure. Also known as Vertical Sleeve Gastrectomy, the surgeon creates a pouch within the stomach which essentially becomes a connecting tube between the esophagus and the large intestine. The reduced stomach size causes fewer hunger related enzymes and hormones to be secreted, causing less hunger and also reducing your food intake capability. This results in weight loss over a period of time.
  3. Gastric Bypass – Gastric bypass uses the combination of two techniques, lesser absorption of minerals as well as reduced intake capacity. In this method, a part of the stomach is rearranged akin to the gastric sleeve. However the leftover portion of the stomach is not removed as it can continue to secrete stomach acids. Because of the reduced size of the stomach, you would eat less and if you happen to over eat, it would cause dumping syndrome (quick and repeated bowel evacuation) which would deter you from eating more.
  4. Lap band surgery – This is one form of surgery where the stomach is not reduced or cut but rather limited by a band that is put around it. This band constricts the stomach and causes the upper part to become smaller. Hence you would feel fuller from eating less, thus resulting in weight loss.
  5. V-bloc therapy – This is a very modern approach to bariatric procedures which works in a very similar way to a pacemaker. A device is placed just under your skin and two leads or wires are connected to the vagal nerve. This nerve is responsible for sending the hunger signals to the brain from the stomach. This device acts as a block to the nerve signals and thus ensures you eat less.
  6. Duodenal switch – This surgery is also known as a Biliopancreatic Diversion wherein the surgeons cut out the part of the stomach similar to a gastric sleeve surgery but also make adjustments to the pancreatic chain and the small intestine to reduce the absorption of minerals.

In case you have a concern or query you can always consult an expert & get answers to your questions!

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Popular Questions & Answers

i am 31 years old I want to undergo bariatric surgery. I.e lap sleeve gastrectomy. Please tell me approximate cost for surgery.

MS - General Surgery, FMAS.Laparoscopy
General Surgeon, Gandhinagar
Hello dear lybrate-user, Warm welcome to I have evaluated your query thoroughly.* Routinely it varies from center to center, surgeon,other considerations.* But on average it will be around Rs. 2 - 2.5 Lakhs. Hope this clears your query. Wishing you fine recovery. Welcome for any further assistance. Regards take care.
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Table of Content

What is Sleeve Gastrectomy?


What Procedure is followed :

Risk & Complication

More Info

Play video
Weight Loss Surgery or Bariatric Surgery
Here are cause, type and method of Weight Loss Surgery (Bariatric Surgery)

Hi, I am doctor Aloy Mukherjee. I am a senior consultant in advanced laparoscopic surgical gastroenterology and Pediatrics surgery. I'm associated with Indraprastha Apollo Hospital for the last 15 years as a senior consultant. We at Apollo hospital have a dedicated team of doctors who address our patients. Our team encompasses three consultants, a nutritionist, resident doctors, physicians and medical gastroenterologist. Today I'm going to speak to about weight loss surgery, our Pediatric surgery.

As we know that basically is a common problem which is plagued the world over the last several decades. In India, this is a common problem going to the entry of several food chains from the West, but there by increasing our junk food intake. What is Pediatric surgery? Pediatric surgery aims to tackle the problem of obesity, by medical or surgical means, mostly surgical. There are 3 or 4 different types of procedures which are commonly performed in this. The commonest of which is a Laparoscopic gastric band. The other procedures include a gastric bypass, sleeve gastrectomy or VSG and sleeve gastrectomy and in many bypass. Who are the candidates would be enrolled into our program? Patients who are obese or morbidly obese, with comorbidities like diabetes, hypertension, heart disease, obstructive sleep apnea, disc problems, mostly arthritis in the knees, gastro phological reflux, secondary to obesity or any other life style disorders, secondary to obesity are enrolled in our program.

How do we calculate the body mass index? It s a very simple calculation which is available in the most then all over the internet. It is the weight in the kilogram divided by the height and meters square a BMI of a 25 is considered normal. 25-30 is overweight. 30 to 35 is Class-I obesity or mild obesity. 35-40 is severe obesity and more than 40 is morbid obesity. Our patients are mostly in the category of 32 and above. It is not a cosmetic surgery. There by we are not attempting to make the patients lose weight for cosmetic reasons. They come here to be physically fit and mentally fit. They gain about 8-10 years of life after this surgery, which is a very important parameter. All the ancillary problems, the metabolic problems like diabetes, hypertension, requirement for antihypertensive drugs, requirements for oral hypoglycemic insulins are reversed almost completely after the surgery. Now that s the significant gain.

Now to talk in detail about three or four forms of surgery. The commonest like I said is a gastric band in which a band is placed on the stomach. It is about very easy, very easy to perform and the filling port is usually done, is usually filled without patient s department but it does not give us expected weight loss as we would have achieved in the other forms. Thereby it is not performed routinely across the world. The three other main procedures which are performed including, includes the laparoscopic gastric bypass which attains, which helps us attains a significant weight loss. Thereby we make a small out about the size of half a cup in that part of abdomen and bring up in the intestine to join it with this cup. We are bypassing a large segment of the stomach and the smaller. That is what's called a gastric bypass.

The weight loss primary due to a small gastric pouch and secondary to the man's option of this. The third procedure is a vertical sleeve gastrectomy in which the stomach is divided and meet into the 50 ml small pouch the rest of the stomach is taken out of the communicating body. This decreases the hormone ghrelin, which is required for the appetite and also makes it in our pouch. So these two procedures help us to attain significant weight loss. Other procedure is a mini gastric bypass which is also equally effective. How would a patient choose one procedure over the other? The patients talk to us come to us and decides one procedure to other after they have understood the advantages and disadvantages of a particular procedures and talk to a patient. And which is the right center of such a surgery is the right center is the center of excellence whereby which has a dedicated team of surgeons, medical gastroenterologist, physicians, clinical nutritionists and dietitians and a team of doctors and physicians who can actually explain them the procedure.

I would advise that you should meet your local surgeon, local physician for this procedure if you are interested for it. You can contact us at Indraprastha Apollo hospital if you wish to do for your condition of obesity or you can contact us at in the form of texts, in the form of questions, in the form of telephone queries and we would be happy to address you. Thank you.
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