Is the gastric sleeve safe?

As with all surgical operations, there are associated risks and a gastric sleeve is a more invasive procedure than a gastric band which is why it is important to choose a specialist bariatric surgeon with considerable gastric sleeve experience. In the hands of a highly experienced Healthier Weight surgeon, the gastric sleeve is still a safe and effective procedure.

Will I have loose skin after gastric sleeve?

Due to the considerable amount of weight that gastric sleeve patients typically lose, it’s possible that you will experience some excess, loose or saggy skin. This most commonly occurs in the abdominal apron, or trunk area. The amount of excess skin you’ll be left with following a gastric sleeve operation varies and will depend upon your age and weight before the procedure. Generally, the heavier and older you are, the more likely you are to have excess skin. Younger patients tend not to have as much lax skin due to greater natural skin elasticity.

How much weight will I lose with a gastric sleeve?

On average we expect weight loss results for gastric sleeve patients to be approx 60-70% of their excess weight during the first two years, although most of the weight is lost during the first year. Some people will inevitably do better than this, and some not so well.

How long does it take to recover from a gastric sleeve?

Most sleeve patients will stay in a hospital for 2 nights before going home. You should start to feel much more comfortable around 2 weeks after surgery, but it typically takes around 6-8 weeks for your stomach to heal completely.

What can you eat with a gastric sleeve?

You can eat most foods, providing they don’t cause you discomfort. However, because you will be consuming less food in general, it is important that you include foods that are rich in protein, but low in fat and sugar. We encourage you to eat vegetables, fruit, wholegrains, lean meat and fish. You will be provided with detailed nutritional information following your gastric sleeve operation.

Sleeve revision

The UK’s Leading Gastric Sleeve Revision Specialists

Weight loss after sleeve surgery typically follows a pattern of rapid loss in the first few years, followed by some regain. While exceptions exist, this is the norm across all procedures.

Weight regain can happen for various reasons. Slow regain is often due to the body adjusting to a smaller stomach, while faster regain usually results from stomach dilation, especially if portion sizes increase. In extreme cases, the stomach can stretch back to its original size. Sleeve size also varies depending on the bougie size chosen by the surgeon.

Revision surgery carries a higher risk of complications due to scar tissue from the initial procedure. However, in experienced hands, these risks can be minimised.

Diagnosing the problem

If you are regaining weight following sleeve surgery and would like a revision, the first step is to undertake a barium x ray to se how food and liquid passes through the stomach. This will enable us to diagnose the precise problem with your sleeve. We are also able to take some measurements of the stomach to see if it has stretched. This will also help to inform which revisional procedure might be best.

Revision to gastric bypass

This is the first choice procedure for failing sleeve patients. It involves doing a conventional bypass procedure in the same way as it would be done for a patient who had not had a sleeve. The procedure is safe and effective with patients expecting to lose in the region of 60% of their excess weight.

As with all revision surgery the incidence rates for complications are a little higher than for primary surgery. Your surgeon will explain the risks, incidence rates and implications of risks at your face to face consultation.

Re-sleeve

It’s unlikely that we would recommend a re-sleeve. If you have regained weight following primary sleeve surgery there would be a high risk of repeat the experience.

Generally speaking we would only consider re-sleeve in preference to bypass where you are a young patient (under 40), and we want to avoid the longer term nutritional risks of bypass, or where it is your strong preference. For these reasons ‘re-sleeves’ are rare.

Gastric banded sleeve

There is the option to place a gastric band around the sleeved stomach. This is a safe procedure, in fact the safest of the sleeve revision options, but we have to question whether you will be successful with a band. The band requires patients to make changes to the types of food they eat and they need to change their eating habits. The band will make you feel full on a smaller portion when you do these things but it won’t reduce your appetite in the way the sleeve (and bypass for that matter) does. Although a safe procedure banding the sleeve is less effective and not an option we would recommend. Exceptions would be cases where revision to bypass is not possible, where you express a strong personal preference not to have bypass or you are young and want to avoid the long term risk of micronutrient malabsorption.

Revision to BPD/DS

The revision to BPD/Switch is the most effective revision in terms of weight loss but it is not a popular option. The reason is that a very large part of the bowel, all but about 1.5 meter of it, is bypassed. This means that patients need very close nutritional management for the long term and there is a high risk of micronutrient malabsorption.

In recent years the revision from sleeve to gastric bypass has become the preferred approach. Although the bypass still needs careful nutritional management, the risks of malnutrition are not as high as with BPD/Switch.

This is not a procedure we offer in the private sector.

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