Laparoscopic Sleeve Gastrectomy

Sleeve gastrectomy converts the stomach from a pouch into a narrow tube. The outer portion is separated along a sizing guide and removed, leaving a stomach that holds considerably less.

Capacity is only part of it. The removed portion is the region most involved in producing the hormonal signals that drive hunger, so appetite regulation changes as well. That hormonal effect is why the operation improves metabolic disease in ways that restriction alone would not explain.

The naming matters. This is not a cosmetic procedure and it is not a shortcut. It is an operation performed to treat a chronic metabolic disease that is driven by physiology.

The clinical position of this practice is consistent: treat the cause, not the symptom. The number on a scale is a downstream measurement. Blood sugar control, blood pressure, liver health, sleep quality, and joint load are the outcomes worth tracking, and they are what the operation is aimed at.

Candidacy follows established criteria that consider your metabolic picture, your other conditions, your history of treatment, and your medical fitness for an operation. It is not decided by one measurement and it is not decided at a first visit alone.

The evaluation includes laboratory work, an assessment of reflux, upper endoscopy where indicated, nutrition consultation, and a discussion about the alternatives, including nonsurgical treatment and endoscopic options. If reflux disease or a hiatal hernia is present, it changes the conversation, because a sleeve can affect reflux and that must be considered before rather than after.

• Metabolic laboratory assessment and review of related conditions
• Reflux assessment, with endoscopy where indicated
• Nutrition consultation before scheduling
• Review of nonsurgical and endoscopic alternatives
• Medical clearance appropriate to your history

The procedure is performed laparoscopically through several small incisions, or with a robotic platform, which is discussed separately. Instruments and a camera pass through those ports, so the abdomen is not opened.

The stomach is freed along its outer curve, a narrow tube is created along a sizing guide, and the separated portion is removed. The staple line is inspected carefully before finishing. The removed portion does not grow back, which is what makes the change permanent.

Most people stay in hospital a short time and walk the same day, because early movement reduces the risk of complications more reliably than rest does. Pain is managed with a plan that limits reliance on opioids.

Diet advances through clear liquids, full liquids, soft foods, and then regular textures over several weeks. Protein targets and hydration come first, and small frequent intake replaces large meals permanently. Lifting restrictions apply while the abdominal wall heals, and they are given specifically rather than generically.

Vitamin and mineral supplementation is lifelong and it is not negotiable. Absorption and intake both change, and deficiencies develop quietly over years when supplementation lapses.

Follow up visits are frequent in the first year and continue after. Laboratory monitoring, nutrition support, and management of the other metabolic conditions all continue. Medication for diabetes and blood pressure often needs adjusting, sometimes quickly, which is a reason not to disappear from care after a good early result.

This page is educational information, not medical advice. What is right for you is decided in consultation, after a review of your history, your symptoms, and your testing.