Gastric Sleeve Resection

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By Denise Mann; reviewed by Christine Ren, MD, FACS

Gastric sleeve resection is a relatively new kid on the block when it comes to bariatric surgery. Gastric sleeve resection is typically used to safely jump-start the surgical weight loss process in people who are too obese or sick to undergo more invasive weight loss surgeries or are not candidates for gastric banding.

Put another way, gastric sleeve resections allow such individuals to reach a safe weight so they can then undergo the more radical gastric bypass surgery or duodenal switch procedure. The American Society for Metabolic and Bariatric Surgery states that this is the most useful application of gastric sleeve resection at this time, because it appears to be faster and/or easier than other weight loss surgeries in these high-risk people.

Other names for gastric sleeve resection are sleeve gastrectomy, vertical sleeve gastrectromy, tube gastrectomy and laparoscopic sleeve gastrectomy.

How Gastric Sleeve Resection Works

To perform gastric sleeve resection, a bariatric surgeon removes about 60 percent of the stomach so that it takes the shape of a tube or sleeve. This operation is performed laparoscopically, meaning that the surgeon makes small incisions as opposed to one large incision. He or she inserts a viewing tube with a small camera (laparoscope) and other tiny instruments into these small incisions to remove part of the stomach. The tube-shaped stomach that is left is sealed closed with staples.

It is often followed by a gastric bypass or duodenal switch after the patient has lost a significant amount of weight. Called a "staged" approach to weight loss surgery, this makes the second procedure less risky than it would have been had it been the first and only procedure. The timing of the second surgery varies according to the degree of weight loss. It usually occurs within six to 18 months.

Who Is a Good Candidate for Gastric Sleeve Resection?

No reliable statistics exist yet for how many of these procedures have been done, but gastric sleeve resection is typically reserved for people who are considered super-super obese, meaning they have a body mass index (BMI) of more than 60, or for those who are not in appropriate physical condition to undergo gastric bypass surgery or other more radical weight loss surgeries. A BMI takes height and weight into account to measure body fatness, and a BMI of 30 or higher in adults is considered obese. [Read more about body mass index, and use our BMI calculator.]

Gastric sleeve resection may also be appropriate for people who can't return for the follow-up visits required by gastric banding.

Pre-Surgery Considerations for Gastric Sleeve Resection

Before gastric sleeve resection or any bariatric surgery, you must resolve to quit smoking, as smoking increases the risk for infections, pneumonia, blood clots, slow healing and other life-threatening complications after surgery. Ideally, quitting smoking should be permanent, but you must quit for at least one month before and one month after bariatric surgery.

Some surgeons require patients to go on special diets in the week(s) before a gastric sleeve resection.

What to Expect After Gastric Sleeve Resection

The non-reversible surgery is performed under general anesthesia and takes about one to two hours. Afterward you would probably stay in the hospital for one or two days, and recovery from gastric sleeve resection may last a few weeks.

The abdomen is often swollen and sore for several days. Your surgeon may prescribe pain medication to help treat this discomfort. In addition, some scarring may occur, but this can be covered with clothing. You would need to become re-used to eating solid foods. This typically starts with two weeks on a liquid-only diet, two weeks of semi-solid, pureed foods and then solids.

As far as weight loss goes, most people who undergo gastric sleeve resection lose 30 to 50 percent of their excess body weight over six months to one year.

Studies have shown that after gastric sleeve resection procedure people show improvements in diabetes, high blood pressure, high cholesterol and sleep apnea within one to two years. These improvements are comparable with those seen after other weight loss surgeries.

As this is a relatively new procedure, no data is available yet on long-term weight loss or overall health improvements.

Certain lifestyle changes and follow-up care occur after the surgery; people who undergo gastric sleeve resection must:

Engage in regular exercise.
Learn behavior modification techniques.
Follow very specific dietary instructions, including eating very slowly, consuming only small quantities of food at a time, chewing thoroughly and swallowing food only when it is mashed, and not eating and drinking at the same time.