What is a gastric sleeve?: Sleeve Gastrectomy 101 for Beginners

Chapter 1

gastric sleeve weight loss timeline stage 1


Diet, exercise, fasting… you have tried it all but nothing worked. Now you are searching “what is a gastric sleeve”. Getting a life-changing surgery is a big decision to make, and it’s natural to feel nervous and have many questions. That’s why we’re here to guide you through the process and provide you with the information and support you need to make an informed decision.

This is the first chapter of our extensive guide on gastric sleeve surgery. Throughout this journey we will talk about anything and everything about this procedure; from the gastric sleeve requirements you have to meet, possible complications, diet, recovery, cost, and we will also discuss the possibility of a gastric sleeve in Turkey. By the time you are done reading, we hope that you have learned enough about the operation to make the best decision for yourself.

Some might find a solution with said exercise and diet, but we know that sometimes it is way more complicated than that. Gastric sleeve surgery is a life-changing procedure for those struggling with weight loss and obesity and has helped many people achieve significant weight loss, improved health, and a better quality of life.

If you’re considering this surgery, it is essential to be acknowledged about it. With the right support, you can achieve your weight loss goals, and we’re here to help you and make your journey a little bit easier. Now, let’s get started with the essential information you must have: what this surgery is, how it makes you lose weight and how much, the pros and cons, and the different types of this procedure.

gastric sleeve pros and cons

What is a gastric sleeve?

Gastric sleeve surgery, aka sleeve gastrectomy or vertical sleeve gastrectomy, is a minimally invasive weight loss surgery procedure where a considerable section of the patient’s stomach is removed, reducing its overall volume. This creates a smaller stomach, which is shaped like a tube and restricts the volume of food that you can have in one sitting. Annually, around 700K bariatric procedures are performed and more than 50% of those procedures consist of gastric sleeve.

During the procedure, a surgeon will use a stapling device to remove around 80% of the patient’s stomach, leaving only a narrow and tube-like portion. With a stomach size reduced, patients are able to feel full after having small amounts of food, which leads to fewer calories being consumed and weight loss as a result. The surgery also leads to a reduction in the production of the hunger hormone ghrelin, further contributing to feelings of fullness and decreased appetite.

The goal of gastric sleeve procedure is to help patients achieve significant and sustainable weight loss, which can lead to improved overall health and reduced risk of conditions related to obesity; such as hypertension (elevated blood pressure), type 2 diabetes, and sleep apnea.

However, it’s important to keep in mind that this surgery is not a stand-alone solution for successful and maintainable weight loss. Those who wish to take on this surgery will still need to make dietary changes and adopt a healthier lifestyle to see maximum benefits from the procedure. Remember, the choices you make during the gastric sleeve recovery are important.

Losing weight with gastric sleeve: How it works

On the extracted part of the stomach, there are cells that produce hunger hormones which are called ghrelin hormones. In the absence of this hormone, you will not feel hungry. Sometimes on rare occasions, some people might feel a little bit hungry after gastric sleeve surgery, but it’s important to remember that sometimes, thirst can be mistaken for hunger. So, make sure you’re staying hydrated and drinking enough fluids throughout the day.

It is worth noting that it’s possible for the cells that produce hunger hormones to regrow in your stomach over time. However, there’s no need to worry. This process usually takes about two years. By that time, you will likely have already adjusted to your new lifestyle and diet, which will help you maintain your weight loss goals.

Another factor is the new size of the stomach. Your food intake will be much less after the surgery. More than half of the stomach will be removed. This also means that your calorie intake will be much lower. So, in order to get energy, your body will burn the stored excess fat. And that is how your weight loss journey begins.

How does gastric sleeve affect metabolism: Introducing GLP-1

There is also another hormone that’s included in all of this: GLP-1. This hormone helps control hunger, helps the functioning of the gastrointestinal tract, and maintains blood sugar levels.

Studies have shown that after having gastric sleeve surgery, GLP-1 levels go up. This is thought to be because the part of the stomach that’s left and the small intestine get more exposure to food and digestive juices, which leads to an increase in GLP-1 production. And when GLP-1 levels go up, it can help improve how your body handles blood sugar.

Of course, this will affect the way your body metabolizes nutrients. In this case, it will boost the metabolism, which will lead to weight loss.

How much can you lose with a gastric sleeve?

The amount of weight you can expect to lose after gastric sleeve surgery varies from person to person, but on average, you can expect to lose 55-75% of your excess weight.

It’s important to keep in mind that weight loss is a journey, and you might experience ups and downs along the way, even after surgery. For example, you might go through a phase where your weight loss slows down or even stops for a little bit, maybe even a few times. This is totally normal and is called a “bariatric plateau” which can happen due to significant weight loss.

Your body is still adjusting to the changes from the surgery and your new diet. After each plateau, you’ll keep losing weight as your body goes through the necessary adjustments and acclimates. Just keep in mind that everyone’s journey is different and it’s important to be patient and stay positive.

Pros and cons of gastric sleeve – should you, or should you not?

As much as there are pros to gastric sleeve surgery, there are also cons. But these cons either come with the procedure itself or can be resolved in time. However, you should take these pros and cons into consideration before deciding to have a gastric sleeve.

Even though gastric sleeve is a life-saving operation for many, it may not be suitable for everyone. Technically qualifying for the surgery, doesn’t mean that it is the best choice for you. We recommend you carefully weigh all the pros and cons of this surgery with your bariatric surgeon and come to a conclusion based on their recommendation.

For now, let’s review some of the pros and cons of the procedure.


  • Dramatic and rapid weight loss, with long-lasting results.
  • Less risky and minimally invasive.
  • Improves obesity-related conditions like type 2 diabetes, hypertension, sleep apnea, and joint pain.
  • Improves self-esteem and confidence.
  • Improves quality of life.
  • One of the best treatments available for high-risk obese patients.


  • Irreversible and permanent.
  • You might miss your favorite comfort foods.
  • Like all surgeries, gastric sleeve complications are possible and can range from moderate to severe.
  • The recovery process can be uncomfortable.
  • If a carefully prepared diet plan is not followed, it can lead to some nutrient deficiencies.
  • If lifestyle adjustments are not made, there is a possibility of re-gaining the weight you lost.

At the end of the day, you have the choice to do what is best for you. Maybe some of the cons listed could be turned into pros. You can find new, more nutritious foods that can be just as comforting, for example.

If you have carefully considered the advantages and the disadvantages, had extensive conversations with your surgeon, and made a decision based on that, we believe that it will be the best decision for you.

If you are considering and want to be informed more about gastric sleeve contact us here or click the left WhatsApp icon down below. You can have your conversations in your native language. Our team will be in touch with you in no time!

Is gastric sleeve permanent?

Yes, the gastric sleeve is permanent. The removed part of the stomach can not be reattached. The surgical staples used to reshape the stomach will stay in place for the rest of your life. Over time, your stomach will heal around the staples.

With the support of the surgery and your dietitian, you have the potential to maintain your desired weight once you reach it. However, it’s important to note that there is always a chance your stomach may stretch and cause you to regain some weight. To avoid this, it’s crucial to commit to your new healthy lifestyle with a balanced diet and regular exercise.

Is gastric sleeve inpatient or outpatient – should you pack your bags?

Gastric sleeve is an inpatient procedure. Even though it is minimally invasive, it’s still a complex procedure that concerns one of your most important organs. To make sure that any possible post-op complications can be taken care of immediately, patients need to stay in the hospital 2-3 days after the surgery.

This stay will ensure that you’ll have a comfortable post-op period where painkillers, fluids, and nutrients can be administered to keep you pain-free and hydrated. And in case any complications occur, such as a leak, they can be taken care of by the medical staff before it reaches a critical point.

Who will perform my gastric sleeve surgery?

Your gastric sleeve surgery will be performed by a general surgeon or a bariatric surgeon. To become a general surgeon, surgeons must complete their general surgery studies that last 5 years. And to become a bariatric surgeon, they must dedicate their time and studies to bariatrics and must be able to perform all different types of bariatric surgeries.

Both general and bariatric surgeons can perform gastric sleeve surgery. But to achieve the best results possible, you should have your procedure performed by an experienced bariatric surgeon.

A brief history of gastric sleeve

Gastric sleeve is a relatively newly developed bariatric surgery. Initially, the surgery was performed as the first stage in a two-stage surgery for weight loss. However, over time, it has become a stand-alone procedure for many patients, particularly for those who are not candidates for other bariatric surgeries.

Did you know that the first gastric sleeve was performed in 1988? It was performed by Doug Hess openly as the first part of the duodenal switch procedure. He modified the plicated stomach to a vertical gastrectomy (stomach removal).

history of gastric sleeve

In 1997, Gary Anthone performed an open duodenal switch on a 13-year-old girl who had bile duct stones (gallstones in the bile duct). He could not remove the stones completely, so he decided to limit the procedure to an open-sleeve gastrectomy to leave access for a post-op ERCP (endoscopic retrograde cholangiopancreatography). Between the years 1997 and 2001, Anthone performed 21 open-sleeve gastrectomies in high-risk obese patients. And it turned out to be a success; patients were losing significant amounts of weight.

Gagner, MD further developed this procedure in 1999. He performed the first laparoscopic (closed, minimally invasive) duodenal switch on a pig. After he performed the procedure, he saw that the laparoscopic method was appropriate for gastric sleeve and rerouting the intestines.

After Gagner’s contributions, many surgeons and clinics performed gastric sleeve and other bariatric surgeries laparoscopically, unless it was necessary to open the patient. As time, technology, and science develops, the procedure gets even safer and more successful. 

(1) Brethauer SA. Sleeve Gastrectomy. Surgical Clinics of North America. 2011;91(6):1265-1279. doi:10.1016/j.suc.2011.08.012 Link

(2) Felsenreich DM, Bichler C, Langer FB, Gachabayov M, Prager G. Sleeve Gastrectomy: Surgical Technique, Outcomes, and Complications. Surgical Technology International. 2020;36:63-69. Accessed January 10, 2023. Link

(3) Popescu AL, Ioniţa-Radu F, Jinga M, Gavrilă AI, Săvulescu FA, Fierbinţeanu-Braticevici C. Laparoscopic sleeve gastrectomy and gastroesophageal reflux. Romanian Journal of Internal Medicine. 2018;56(4):227-232. doi:10.2478/rjim-2018-0019 Link

(4) Chung AY, Thompson R, Overby DW, Duke MC, Farrell TM. Sleeve Gastrectomy: Surgical Tips. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2018;28(8):930-937. doi:10.1089/lap.2018.0392 Link

(5) Cornejo-Pareja I, Clemente-Postigo M, Tinahones FJ. Metabolic and Endocrine Consequences of Bariatric Surgery. Frontiers in Endocrinology. 2019;10. doi:10.3389/fendo.2019.00626 Link

(6) Knop FK, Taylor R. Mechanism of Metabolic Advantages After Bariatric Surgery: It’s all gastrointestinal factors versus it’s all food restriction. Diabetes Care. 2013;36(Supplement_2):S287-S291. doi:10.2337/dcs13-2032 Link

(7) Jumbe S, Hamlet C, Meyrick J. Psychological Aspects of Bariatric Surgery as a Treatment for Obesity. Current Obesity Reports. 2017;6(1):71-78. doi:10.1007/s13679-017-0242-2 Link

(8) Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obesity Surgery. 1998;8(3):267-282. doi:10.1381/096089298765554476 Link

(9) Almogy G, Crookes PF, Anthone GJ. Longitudinal Gastrectomy as a Treatment for the High-Risk Super-Obese Patient. Obesity Surgery. 2004;14(4):492-497. doi:10.1381/096089204323013479 Link

(10) de Csepel J, Burpee S, Jossart G, et al. Laparoscopic biliopancreatic diversion with a duodenal switch for morbid obesity: a feasibility study in pigs. Journal of Laparoendoscopic & Advanced Surgical Techniques Part A. 2001;11(2):79-83. doi:10.1089/109264201750162293 Link

(11) Regan JP, Inabnet WB, Gagner M, Pomp A. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obesity Surgery. 2003;13(6):861-864. doi:10.1381/096089203322618669 Link

Leave a Comment

Your email address will not be published. Required fields are marked *

Scroll to Top