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Sleeve gastrectomy is one of the most popular bariatric surgeries, designed to reduce the stomach's size, decrease appetite, and promote significant weight loss. During the procedure, approximately 80% of the stomach is removed, leaving a narrow, tube-like stomach resembling a banana.
Globally, hundreds of thousands of patients undergo sleeve gastrectomy each year. Studies show that this surgery can help patients lose 60–70% of their excess weight within 1–2 years post-operation.
History of Sleeve Gastrectomy
Sleeve gastrectomy was first introduced in the early 2000s as part of a two-stage surgical approach for patients with severe obesity and extremely high BMI.
- Stage One: Severely obese patients would undergo sleeve gastrectomy to reduce initial weight.
- Stage Two: After initial weight loss, a second surgery such as gastric bypass could be performed if needed.
Over time, surgeons discovered that sleeve gastrectomy alone could provide long-term and effective weight loss, eliminating the need for a second procedure for many patients. Today, it is among the most commonly performed bariatric surgeries worldwide.
Why Sleeve Gastrectomy? Benefits Explained
The primary goal of sleeve gastrectomy is reducing stomach volume and controlling appetite:
- Stomach Size Reduction:
Removing 80% of the stomach restricts food intake and allows patients to feel full faster. - Hormonal Changes:
The removed portion produces the hunger hormone ghrelin. Reducing ghrelin levels helps curb appetite. - Lower Risk of Obesity-Related Diseases:
Effective weight loss improves type 2 diabetes, high blood pressure, sleep apnea, and cardiovascular health. - Simple and Safe Procedure:
Compared to gastric bypass, sleeve gastrectomy is less complex, typically performed via laparoscopy, and associated with fewer complications.
Who Is a Candidate for Sleeve Gastrectomy?
Sleeve gastrectomy is not suitable for everyone. Ideal candidates include:
- Individuals with BMI ≥40 (severe obesity).
- Individuals with BMI ≥35 plus obesity-related conditions (diabetes, hypertension, sleep apnea).
- Those who have tried diet and exercise without achieving weight loss.
- Patients motivated to maintain lifestyle changes and adhere to post-op nutrition guidelines.
Pre-Operative Care
To minimize complications and ensure safety, patients should follow:
- Light diet and exercise for 1 month prior.
- Stop smoking and alcohol at least 1 month before surgery.
- High-protein diet starting a few weeks before surgery.
- Discontinue medications like aspirin, herbal supplements, Omega-3, and blood thinners 2–3 weeks prior.
- 3 days before surgery: liquid-only diet.
- 12 hours before surgery: no food or drink, including water.
Surgical Steps
Sleeve gastrectomy is almost always performed laparoscopically:
- Patient is placed under general anesthesia.
- Several small incisions are made in the abdomen.
- Carbon dioxide gas is introduced to expand the abdomen for visibility.
- A laparoscope (tiny camera) is inserted.
- About 80% of the stomach is removed.
- The remaining stomach is stapled and secured.
- Incisions are closed with sutures.
Post-Operative Care
Following doctor’s instructions is critical:
- Week 1: clear liquids only.
- Week 2: soft, pureed foods.
- Week 4: gradual return to solid foods.
- Avoid caffeinated and carbonated drinks.
- Take daily vitamins, iron, and B12.
- Regular follow-up appointments.
- Maintain a healthy lifestyle with balanced diet and exercise.
Potential Risks
While complications are uncommon, they may include:
- Bleeding (1–2%)
- Gastric leak (1–3%)
- Surgical site infection
- Acid reflux (up to 30%)
- Vitamin deficiencies or malnutrition if supplements are neglected
- Gallstone formation
Comparing Sleeve Gastrectomy, Gastric Bypass, and Mini Gastric Bypass
| Feature | Sleeve Gastrectomy | Gastric Bypass | Mini Gastric Bypass |
|---|---|---|---|
| Portion of stomach removed | ✅ Yes (80%) | ❌ No | ❌ No (stomach reduced but not removed) |
| Small intestine rerouted | ❌ No | ✅ Yes (two anastomoses) | ✅ Yes (one anastomosis) |
| Surgery duration | ~1 hour | 1.5–2 hours | 1–1.5 hours |
| Weight loss | 60–70% excess weight | 70–80% excess weight | 70–80% excess weight |
| Weight regain risk | Medium | Low | Low–Medium |
| Acid reflux | High (up to 30%) | Lower | May worsen |
| Vitamin/mineral deficiencies | Medium | High | High (sometimes higher than bypass) |
| Risk of serious complications | Low–Medium | Medium | Medium |
| Endoscopic access to stomach | Difficult | Very difficult | Difficult, easier than classic bypass |
| Hospital stay | 1–2 days | 2–3 days | 2 days |
Procedure Summary
- Sleeve Gastrectomy: Ideal for those wanting weight loss without intestinal rerouting; simpler but higher risk of reflux.
- Gastric Bypass: Most effective for weight loss and type 2 diabetes; more complex with higher risk of nutrient deficiencies.
- Mini Gastric Bypass: Combines benefits of sleeve and bypass; simpler surgery but may lead to nutrient deficiencies and bile reflux.
✅ Best procedure should be chosen by a bariatric surgeon based on BMI, comorbidities, lifestyle, and stomach/esophagus condition.
Cost of Sleeve Gastrectomy
For pricing at Dr. Akbari Health & Beauty Clinic, patients must first be consulted by Dr. Mohammad Ali Pekneh, after which the final cost will be provided.
Quick Overview Table: Sleeve Gastrectomy
| Category | Key Points |
|---|---|
| 🎯 Goal | Reduce stomach size, control appetite, weight loss |
| 🌟 Benefits | Lose 60–70% excess weight, improve diabetes & BP, feel full faster |
| 👩⚕️ Suitable Candidates | BMI ≥40 or BMI ≥35 with related conditions |
| 🚫 Unsuitable Candidates | Under 18, severe cardiac/pulmonary issues, unmotivated for lifestyle change |
| 🏥 Procedure Steps | Laparoscopic incision, remove 80% stomach, staple remaining part |
| 🛌 Post-Op Care | Liquid & soft foods, vitamins & iron, medical follow-up |
| ⚠️ Possible Risks | Bleeding, leak, reflux, malnutrition |
| 🍏 Non-Surgical Alternative | Diet & exercise |
| 💰 Cost | Depends on surgeon and facility |
| 🔬 2025 Advanced Techniques | Advanced laparoscopy, smaller scars, shorter hospital stay |
