Sleeve gastrectomy surgery, also known as vertical sleeve gastrectomy (VSG). This minimally invasive procedure not only helps individuals lose significant weight but also improves or resolves many obesity related health problems. The surgery works by permanently reducing the size of the stomach and altering hunger hormones, which supports long-term weight loss and healthier eating habits.

Obesity is a growing health concern across the globe, increasing the risk of several chronic conditions such as type 2 diabetes, hypertension, and heart disease. For individuals who struggle with weight loss through diet and exercise, bariatric surgery presents a medically proven solution. One of the most commonly performed bariatric procedures is sleeve gastrectomy surgery.

What is Sleeve Gastrectomy Surgery?

Sleeve gastrectomy, also known as vertical sleeve gastrectomy (VSG), is a type of weight loss surgery in which a large portion of the stomach is surgically removed, leaving a thin, sleeve shaped stomach that resembles a banana. The procedure is typically done laparoscopically, meaning it is minimally invasive and requires only a few small incisions.

By reducing the size of the stomach by nearly 75-80%, sleeve gastrectomy restricts the amount of food a person can consume. Additionally, the procedure removes the portion of the stomach that produces ghrelin the hormone responsible for triggering hunger thereby helping to reduce appetite and food intake.

How Sleeve Gastrectomy Works?

The primary goal of sleeve gastrectomy is to assist with long-term weight loss and to improve obesity-related health conditions. During the surgery, the surgeon uses a stapling device to remove the curved part of the stomach (called the greater curvature), transforming the stomach into a narrow tube.

Because the stomach is significantly smaller post-surgery, patients feel full after consuming much smaller portions of food. Moreover, the hormonal changes that occur after sleeve gastrectomy positively influence metabolism and blood sugar levels, making the procedure effective for improving or even resolving type 2 diabetes in many patients.

Unlike gastric bypass surgery, sleeve gastrectomy does not involve rerouting the intestines. This makes the procedure less complex and reduces the risk of complications related to nutrient malabsorption.

Who is a Candidate for Sleeve Gastrectomy?

Sleeve gastrectomy is typically recommended for individuals who :-

Have a Body Mass Index (BMI) of 40 or more
Have a BMI of 35-39.9 with obesity related health conditions such as diabetes, sleep apnea, or hypertension
Have not been able to achieve sustained weight loss through non-surgical methods
Are willing to make long term lifestyle changes, including diet, exercise, and regular follow up appointments

In some cases, it may also be considered for patients with a BMI between 30 and 35 if they have serious health issues related to obesity and have failed other treatments.

Benefits of Sleeve Gastrectomy Surgery

Sleeve gastrectomy offers several medical and lifestyle benefits beyond just weight loss. Some of the key advantages include :-

Significant Weight Loss :- Patients typically lose 50% to 70% of their excess weight within the first 12 to 18 months following surgery. This weight loss is often sustained in the long term with the right lifestyle changes.
Improvement in Obesity Related Conditions :- The surgery can lead to marked improvement or resolution of conditions such as type 2 diabetes, high blood pressure, high cholesterol, obstructive sleep apnea, and joint pain.
No Intestinal Bypass :- Since the intestines are not bypassed or rerouted, there is a lower risk of nutrient deficiencies compared to other bariatric procedures like gastric bypass.
Reduced Hunger :- Removal of the ghrelin producing part of the stomach often results in a reduced appetite, making it easier for patients to stick to smaller portions and healthier eating habits.

The Sleeve Gastrectomy Procedure: Step by Step

Sleeve gastrectomy is generally performed under general anesthesia and takes about 60 to 90 minutes. The typical steps include :-

The surgeon makes small incisions in the abdomen to insert a laparoscope and surgical instruments.
Approximately 75-80% of the stomach is removed, leaving behind a tubular “sleeve” that connects the esophagus to the small intestine.
The incisions are closed with sutures or surgical glue, and patients are moved to recovery.

Because it is minimally invasive, patients often experience less pain, fewer complications, and shorter hospital stays compared to open surgery.

Recovery and Post Surgery Guidelines

Recovery from sleeve gastrectomy is generally quicker than more invasive procedures, but it requires careful attention to diet and lifestyle changes.

Hospital Stay :- Most patients stay in the hospital for 1 to 2 days after surgery. During this time, doctors monitor vital signs and ensure there are no complications.
Diet Progression :- Recovery involves a staged dietary plan :-
1. Week 1-2 :- Clear liquids and protein rich fluids
2. Week 3-4 :- Pureed foods
3. Week 5-6 :- Soft foods
4. Week 7 and beyond :- Gradual transition to solid foods
Patients are encouraged to eat slowly, chew thoroughly, and avoid overeating to prevent nausea or discomfort.
Physical Activity :- Light activity such as walking is encouraged within a few days post-surgery. Most patients can resume normal activities within 2-4 weeks and start structured exercise routines within a month or two, based on their surgeon’s advice.

Potential Risks and Complications

As with any surgery, sleeve gastrectomy carries some risk. Though rare, possible complications include :-

Bleeding or infection
Leakage from the staple line
Gastroesophageal reflux disease (GERD)
Nutrient deficiencies (especially if dietary guidelines are not followed)
Blood clots

However, most of these risks can be minimized with proper surgical technique, patient education, and follow-up care.

Long Term Success: Lifestyle Changes Are Key

While sleeve gastrectomy significantly reduces stomach size and hunger, the surgery is not a quick fix. Long-term weight management requires :-

Commitment to a healthy, balanced diet
Regular physical activity
Avoidance of high calorie or processed foods
Routine medical follow ups and support groups

Patients who adhere to these lifestyle changes typically achieve and maintain substantial weight loss, improve their overall health, and enjoy a better quality of life.

Conclusion

Sleeve gastrectomy surgery is a safe, effective, and widely practiced weight loss procedure that offers significant health benefits for individuals struggling with obesity. By reducing stomach size and hunger hormones, the surgery empowers patients to make sustainable lifestyle changes that lead to lasting weight loss and improved well being.