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Medically Reviewed April 2023, by Mr. Bryan Mayou (GMC: 1414396) - founder of the Cadogan Clinic and one of the world's leading plastic surgeons
Gastric sleeve surgery, also known as sleeve gastrectomy, is a surgical procedure to reduce the size of the stomach, therefore reducing the amount of food that can be consumed.
There are two types of gastric sleeve surgery: a total gastrectomy, which sees the whole stomach removed leaving behind a ‘sleeve’, and a partial gastrectomy, where just the lower half of the stomach is removed. Sleeve gastrectomy will reduce the stomach to around a tenth of its size. Both methods will remove the area of the stomach that produces an appetite-increasing hormone.
Gastric sleeve surgery will help you to lose weight if other weight-loss methods have failed. It is a highly effective way to lose excess weight. It is popular too, with sleeve gastrectomy being the second most performed weight-loss surgery in the UK.
Unlike gastric band surgery, gastric sleeve surgery is not reversible.
Your surgeon will discuss all the risks and benefits of gastric sleeve surgery at your initial consultation at the Cadogan Clinic.Get in touch
The primary goal of a sleeve gastrectomy is to lose weight and reduce your risk of serious, potentially life-threatening, conditions. These include cancer, heart disease, stroke, high cholesterol, high blood pressure, Type 2 diabetes, obstructive sleep apnoea and infertility. Carrying excess weight can also cause joint pain and joint damage, so by losing weight with a gastric sleeve you will reduce the risk of joint problems.
People who are overweight or obese feel self-concious about their weight which triggers anxiety and depression. It also means they are likely to avoid certain social situations. Losing weight via gastric sleeve surgery usually results in a marked improvement in a person’s mental health.
You would be considered a suitable candidate for a sleeve gastrectomy if you have a body mass index (BMI) of 40 or more, or a BMI of between 35 and 40 with an obesity-related health condition, such as severe sleep apnoea, high blood pressure or Type 2 diabetes. You must be fit enough to have a general anaesthetic and for the surgery to go ahead.
Gastric sleeve surgery should only be considered if all other weight loss methods, such as dieting and changing your exercise habits, have failed. You must be willing to commit to long-term lifestyle changes following your gastric sleeve surgery.
Your surgeon must be satisfied that you are in good mental health ahead of surgery.
Words from our clients:
"I was extremely satisfied with the care and treatment I received at the Cadogan Clinic. My surgeon was friendly and informative and explained the procedure fully. My procedure went very well and with the excellent care of the nursing staff, I made a speedy and full recovery. Would recommend to anyone."Eva Berry
"At the beginning before the operation the nurse taking care of me made me feel so comfortable. The surgeon and anesthetist helped me feel so calm. Fantastic before and after treatment"Scarlett Elliott
"The girls on the reception at the clinic were very pleasant and professional. The nurse who took out my stitches after my surgery was just lovely and took me through step by step what she was doing and she also recommended a great cream to use to help with healing."Georgina Nolan
“I was treated with care and provided with thorough knowledge about the procedure I was undertaking. My surgeon was very methodical (a perfectionist) and I felt I received A class treatment."Courtney O'Sullivan
"Outstanding experience from the first appointment to being discharged. Very professional, friendly and a fantastic outcome."Gemma Stevenson
"Reception staff very welcoming and efficient. Both nurses who I dealt with were fantastic, and the whole team (anaesthetist, surgeon etc) were friendly but professional, and really put my mind at ease. That I was able to stay later than I perhaps needed after my surgery to fit in with my husbands schedule was greatly appreciated."Emma Davies
Included in this treatment
Up to two 60 minute consultations with a leading specialist plastic surgeon at our award-winning premises in Chelsea
Your procedure carried out at London’s leading specialist cosmetic surgery centre of excellence
24/7 on call nurse assistance
Dedicated Patient Co-ordinator, as a personal point of contact through your journey with Cadogan
A pre-operative medical assessment to ensure you are fit for surgery
Comprehensive post-operative aftercare courtesy of our specialist cosmetic nurses
The premise behind gastric sleeve surgery is simple: reduce the size of the stomach and reduce the hormone which causes you to feel hungry in order to lose weight.
Gastric sleeve surgery is carried out under a general anaesthetic using keyhole (laparoscopic) surgery. Around 80 to 90 percent of the stomach is removed, leaving behind a tube-shaped stomach, known as a gastric sleeve. This sleeve is similar in size and shape to a banana. By reducing the size of the stomach, this restricts the amount of food you can physically consume. The surgery also reduces the amount of hormone produced which makes you feel hungry. As a result, you will lose weight.
You usually lose weight more quickly after a sleeve gastrectomy than after gastric banding. People who have undergone gastric sleeve surgery tend to find they achieve more significant weight loss than with gastric band surgery.
Following your sleeve gastrectomy, you will need to follow a special diet and once you have recovered from the operation, you must commit to eating healthily and exercising more in order to get the very best results from your gastric sleeve surgery. Our expert team here at the Cadogan Clinic will be able to provide you with a dietary plan to follow and offer you the support and guidance you need in order to make a meaningful change to your lifestyle.
Below you will find some key information to help you prepare for surgery and make necessary arrangements to ensure you have the support you need and that everything runs smoothly on the day.
The first step for all of our patients is to meet with the surgeon we feel is best placed to perform your procedure for a consultation.
At the consultation you will be able to discuss with your surgeon what your hope to achieve from the procedure, as well as discuss in detail what may or may not be possible.
Finally a comprehensive discussion regarding risks and complications will take place, alongside a discussion regarding the post procedure and recovery phase. Your previous medical history will also be recorded (including previous surgery, medications, allergies etc.) and an assessment of your fitness for surgery.
If your surgeon feels you are a good candidate for surgery, you are then invited to consider whether you would like to proceed for surgery or otherwise following a two week 'cooling off' period.
Within this period you are welcome to come in and discuss your potential surgery with your surgeon as many times as you like.
02.Leading up to procedure
If you choose to proceed with surgery, the next time you come into the Clinic after your final consultation will be the day of your procedure.
Before admission the following behavioural changes are recommended / required:
03.On the day
Gastric sleeve surgery is carried out under a general anaesthetic and is done via minimally invasive keyhole surgery. Once you are unconscious, the surgeon will make a series of small cuts in your abdomen and a telescopic camera and surgical instruments will be inserted into these incisions. If you are having a total gastrectomy, the surgeon will remove a large portion of your stomach before stapling the remaining part into the ‘sleeve’ shape. The blood vessels that are connected to the part of the stomach being removed are surgically sealed. The incisions in the abdomen are closed using dissolvable stitches. The whole procedure should take one or two hours.
After the procedure is complete, you will need to rest and wait for the effects of the anaesthetic to wear off. You may need pain relief.
You should expect to stay overnight for a night or two. When you do leave the clinic, you must leave accompanied by a responsible friend or family member.
After having a gastric sleeve, it will take a while for you to be able to eat solid foods again.
In the first few days after surgery you will be eating liquid foods, such as thin soup, progressing to pureed foods for the next three weeks. You should return to eating normally around five weeks after your surgery. You should avoid drinking alcohol for four weeks following your gastric sleeve surgery. You should be able to return to work within a few weeks of your surgery.
You will need frequent medical check-ups in the months following your sleeve gastrectomy and will need to take vitamin supplements for the rest of your life in order to avoid complications such as malnutrition.
As part of your treatment with the Cadogan Clinic, you will have access to 24/7 on-call nurse assistance for the duration of your recovery.
You will experience rapid weight-loss in the first three to six months following a sleeve gastrectomy which may result in other changes in your body. You may notice that you also experience some or all of the following: fatigue, mood changes, aches, hair thinning or hair loss, dry skin or feeling cold.
The Patient Journey. A breakdown of what you can expect on your journey with us
We are deeply invested in ensuring that every step of your surgical journey with us is as informative and reassuring to you as it can be. This article outlines what you can expect at each stage of the journeyThe Patient Journey
What are the benefits of a gastric sleeve?
The benefits of a gastric sleeve are substantial and rapid weight loss and the improvement of physical and mental health and wellbeing.
A sleeve gastrectomy helps to improve cardiovascular health, dramatically reducing the risk of heart disease and stroke. Losing weight via gastric sleeve surgery can also cut the risk of cancer.
Sleeve gastrectomy can prompt obesity-related illness and disease to go into remission, including type 2 diabetes, obstructive sleep apnoea and non-alcoholic fatty liver disease. Losing excess weight can also help to alleviate other health conditions including gout and urinary incontinence.
Losing weight can also help with musculoskeletal problems. Shedding the pounds reduces the pressure on the bones lessening the risk of fractures and osteoarthritis. It also means that you are less likely to experience joint problems in the hips, knees, ankles, feet and shoulders.
The weight loss resulting from gastric sleeve surgery can also help to improve fertility, cut miscarriage risk and reduce pregnancy complications in women.
Substantial weight loss not only improves physical health, but it also improves psychological health too. People who are obese or morbily obese suffer a higher rate of mental health issues, such as depression and anxiety. They may choose to avoid certain social situations or certain activities such as swimming, which will expose the body. This can also have a negative impact on intimate relationships too. This all feeds into mental ill health.
Depression, anxiety and low self-esteem can also trigger binge eating disorder. A gastric sleeve will help with this.
Your surgeon will help you to weigh up the benefits and risks of gastric sleeve surgery and help you decide whether this is the right weight-loss surgery for you.
How long does a gastric sleeve last?
A gastric sleeve is permanent. Because a large part of the stomach has been removed, the procedure cannot be reversed, unlike gastric band surgery.
However, the gastric sleeve can be converted to a gastric bypass or could even be combined with a gastric band if required. However this is major surgery and should not be entered into lightly.
If you follow all the aftercare instructions issued by your surgeon, including a diet plan and exercise plan, there is no reason why you can’t enjoy the results of your gastric sleeve for many years to come.
Book an appointment with one of our weight-loss surgeons at the Cadogan Clinic to discuss gastric sleeve surgery in London.
Is gastric sleeve surgery painful?
Gastric sleeve surgery is not painful. The procedure itself is carried out under a general anaesthetic. This means that you will be unconscious and not able to feel the incisions being made or a portion of the stomach being removed.
When you wake up after gastric sleeve surgery, you may find that you are experiencing pain or discomfort. If this is the case, our nursing team will administer painkillers. Once you have left the clinic, any pain or discomfort can be controlled with over-the-counter painkillers.
As part of your treatment journey with the Cadogan Clinic, you will have access to 24/7 on-call nurse assistance for the duration of your recovery.
After your surgery you may have some mild pain in the left shoulder as a result of the carbon dioxide gas that is used to inflate the abdomen during the operation. Rest assured that this is normal and the gas will disperse in the hours following surgery.
What is the difference between a gastric sleeve and bypass?
Gastric sleeve surgery and a gastric bypass are both major weight-loss surgeries. But although the goal is ultimately the same, they are two very different procedures.
Sleeve gastrectomy is a one-step procedure which sees part of the stomach removed. In a gastric bypass, surgical staples are used to create a small pouch at the top of the stomach. The surgeon then attaches this pouch directly to your small intestine, bypassing the rest of the stomach. Gastric bypass makes the stomach smaller and bypasses part of the bowels. This alters the signals sent between the bowel and brain that controls your appetite and how full you are feeling.
One of the Cadogan Clinic’s expert surgeons will be able to identify which type of weight-loss surgery is best for you.
How should my diet change following a gastric sleeve?
Once you have fully recovered from your sleeve gastrectomy, it is important that you follow the diet plan issued by your consultant.
Because you have reduced stomach capacity, you should reduce your portion size accordingly. You can eat most foods, as long as they don’t cause you discomfort (ie acid reflux), but as you will now be consuming less food overall, it’s important that you have a balanced diet, eating healthy foods which are high in protein but low in sugar and fat. You should include fruit, vegetables, wholegrains, lean meat and fish. You may find that eating small amounts more frequently during the day is preferable with a gastric sleeve. You can drink alcohol, but only in moderation, as alcohol has a very high calorie count.
Sometimes people may experience something called dumping syndrome after gastric sleeve surgery. This happens when particularly sugary or starchy food moves too quickly through the stomach and is 'dumped' into the small intestine. This can cause unwelcome symptoms such as a drop in blood pressure, bloating, nausea, indigestion or diarrhoea. Not everyone who has a gastric sleeve will experience dumping syndrome.
Can I stretch my stomach after gastric sleeve surgery?
Although your stomach will be around a tenth of the size it was before gastric sleeve surgery, it is still possible to stretch the remaining part of your stomach.
If you overeat, this will cause your stomach to stretch. Overeating on a regular basis causes the signals sent between the stomach and brain to become confused, so your stomach only feels full up once stretched. This cycle of overeating will lead to your stomach becoming permanently stretched and you will be in danger of putting back on all of the weight you have lost since your gastric sleeve surgery.
However if you follow the nutritional advice issued to you after your sleeve gastrectomy, and stick to smaller portion sizes, then you can prevent your stomach from stretching.
How much weight can I expect to lose following gastric sleeve surgery?
A person who has undergone a sleeve gastrectomy should expect to lose in the region of 60 to 70 percent of their excess weight within the first two years. Most of this weight loss occurs within the first 12 months of surgery.
However this figure varies from person to person. Some people may lose more weight while others may no lose so much. The outcome depends in part on how closely the patient is following their diet and exercise plan. Those who are eating healthily and doing regular exercise should expect to lose more weight than those who don’t.
More people tend to lose more weight more quickly with a gastric sleeve than with a gastric band.
How do I maintain my gastric sleeve?
A gastric sleeve is easy to maintain if you follow the diet and exercise plan issued by your surgeon. Exercise, eat healthily and eat smaller portions to avoid stretching your stomach.
To help prevent stretching the stomach, you should also practice eating slowly, putting a small amount of food in your mouth each time. You should make sure you drink at least 1.5 litres of fluid a day. But avoid all fizzy drinks as these make you bloat and contribute to stretching your stomach. Fizzy drinks like cola can also be very calorific.
After your sleeve gastrectomy you will have a number of follow up appointments here at the Cadogan Clinic to make sure you are following your plan. If you have any concerns, our team will be able to offer you help and advice.
Founded in 2004 by world renowned plastic surgeon Mr Bryan Mayou, we now work with over 100 leading consultants and successfully treat over 20,000 patients each year. We have been winning industry awards since inception.About Us
Best in Class Facilities
All of our treatments take place at our beautiful boutique premises in Chelsea. We have six consulting rooms and five operating rooms, as well as a dedicated pre and post-operative suite, and a full team of specialist nursing staff.Our Clinic
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We were founded in 2004 by world renown plastic surgeon Mr Bryan Mayou, best known for his pioneering work in the area of liposuction, lasers and microvascular surgery. We continue to collaborate with pioneers in our field.Our History
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We offer surgical consultations in London, Birmingham, Chelmsford and Bristol, and attract international patients from all corners of the globe such as as the USA, the Middle East and Europe.Get in Touch
Gastric sleeve surgery is a major operation, so it is not without risk. Sleeve gastrectomy has a higher risk of serious surgical complications compared to having a gastric band.
Risks associated with sleeve gastrectomy can include leaks from the cut edge of the stomach, breathing difficulties, blood clots and excessive bleeding. Long term risks and complications can include malnutrition, vomiting, hernias, low blood sugar, gastroesophageal reflux disease (GERD) and gastrointestinal obstruction.
General complications from any type of surgery include wound infection, bleeding, pain, scarring, blood clots (deep vein thrombosis) and an adverse reaction to the anaesthetic.
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