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Procedure · Gastric sleeve

Sleeve gastrectomy, explained

What the operation does, the weeks before it, what happens on the day and the first nights in hospital.

The short answer

A sleeve gastrectomy (a gastric sleeve, or VSG) removes about 80% of the stomach by keyhole surgery, leaving a narrow tube about the shape of a banana. You feel full on much less food, and hunger usually drops too. Most people go home after one to three days. It can't be reversed.

  • About 80%of the stomach removed
  • Keyholea few small cuts
  • 1 to 3 daysin hospital
  • Up to 25 to 30%of body weight lost

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Your enquiry is on its way to one Irish clinic. Here's what happens next:

  1. Today. We pass your answers to one clinic whose bariatric surgeons are on the Medical Council's Specialist Register. No one else gets them.
  2. Usually within two working days. The clinic rings or texts you to arrange a first consultation.
  3. At the consultation. A surgeon and the team assess you, explain your options and give you a written quote. Nothing is booked unless you say yes.

Changed your mind? Email hello@gastricsleeve.ie and we'll delete your enquiry and tell the clinic.

What the operation does

The surgeon works through a few small cuts in your tummy using a camera and long instruments. Most of the stomach, the stretchy outer curve, is stapled and removed. What's left is a narrow tube, the sleeve, joined to the bowel as before. Food takes the normal route, there's just far less room for it.

Part of the effect is the size: you feel full after a few mouthfuls at first. Part is hormonal: the part of the stomach that's removed makes much of the hunger hormone, so many people find they simply want less.

A theatre team in grey scrubs standing at an operating table

Before the day

You'll meet the team first. The HSE describes a multidisciplinary team: usually a surgeon, a doctor, a dietitian, a psychologist and a nurse, and sometimes a physiotherapist, an occupational therapist and a social worker. Expect blood tests and sometimes a camera test of your stomach.

Many teams ask you to follow a low-calorie, liquid-heavy diet for a short time before the operation. It shrinks the liver, which sits over the stomach, and makes keyhole surgery safer. If you smoke, you'll be asked to stop. The HSE also advises cutting down fizzy drinks and alcohol and starting the eating habits you'll keep afterwards.

On the day

  • MorningYou come in fasting. The anaesthetist and surgeon see you, check your consent and answer last questions.
  • The operationUnder a general anaesthetic, done by keyhole surgery. It usually takes one to two hours.
  • Waking upYou wake in recovery with small dressings on your tummy. Some shoulder-tip pain from the gas used in keyhole surgery is common.
  • The same dayNurses get you up and walking early, to lower the risk of blood clots. You'll start sips of water.
  • The next daysClear fluids, then protein drinks. Many people get blood-thinning injections to take home. The HSE says you can usually leave hospital one to three days after the operation. Someone needs to drive you home.

Realistic results

One NHS bariatric unit reports weight loss of up to 25 to 30% of total body weight over 12 to 24 months after a sleeve. Most of it comes off in the first 6 to 12 months, and weight usually settles between one and two years. The HSE says some regain after 12 to 18 months is common and is not a sign the surgery has failed.

Weight-related conditions such as type 2 diabetes, sleep apnoea and high blood pressure often improve. A surgeon can't promise any of it, because results depend on your health and the changes you keep up.

Who it isn't for

  • Anyone for whom an anaesthetic and surgery aren't safe, in the team's judgement.
  • Anyone who can't commit to lifelong follow-up, vitamins and blood tests.
  • People planning a pregnancy in the next 12 to 18 months. The HSE advises waiting that long after surgery.
  • People with severe acid reflux. A sleeve can make reflux worse, so a bypass is often suggested instead.
  • Anyone under 18. This site deals with adults only.

The risks are on their own page: gastric sleeve risks and side effects.

Questions people ask

How long does a gastric sleeve operation take?

Usually one to two hours, under a general anaesthetic, by keyhole surgery.

How long will I be in hospital?

The HSE says you can usually leave one to three days after bariatric surgery.

Is a gastric sleeve reversible?

No. The removed part of the stomach is gone. A sleeve can be converted to a bypass later if needed, which is a second operation.

What's the difference between a sleeve and a VSG?

None. VSG stands for vertical sleeve gastrectomy, another name for the same operation.

Read next

Recovery week by weekFrom the hospital bed to the first anniversaryDiet after a sleeveThe three food stages, the habits that make a sleeve workRisks and side effectsEvery operation has risks

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