What Is Gastric Sleeve Surgery? A Complete Guide

Understanding the Procedure

What Is Gastric Sleeve Surgery?

Gastric sleeve surgery, also known as sleeve gastrectomy or vertical sleeve gastrectomy (VSG), is a surgical weight loss procedure in which approximately 75–80% of the stomach is removed. The remaining stomach is shaped into a narrow, tube-like sleeve — roughly the size and shape of a banana.

This procedure is typically performed laparoscopically (keyhole surgery), using small incisions and a camera to guide the surgeon. It is one of the most commonly performed bariatric procedures in Australia and worldwide.

By significantly reducing the stomach's capacity, gastric sleeve surgery may help patients feel full more quickly and eat smaller portions. Additionally, the procedure can affect gut hormones involved in hunger, satiety, and blood sugar regulation.

Gastric sleeve surgery consultation with Dr Florica at Sydney Sleeve Surgery

How It Works

How Does Gastric Sleeve Surgery Work?

During a sleeve gastrectomy, the surgeon removes the larger, curved portion of the stomach (the fundus) along the greater curvature. This leaves a narrow gastric "sleeve" that holds significantly less food than the original stomach.

The procedure works through two primary mechanisms:

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Restriction

The smaller stomach can hold only about 100–150 millilitres of food, compared to approximately 1–1.5 litres before surgery. This means patients typically feel satisfied after eating much smaller meals.

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Hormonal Changes

The removed portion of the stomach produces much of the body's ghrelin — often called the "hunger hormone." Removing this tissue can reduce hunger signals, which may make it easier for patients to manage their appetite.

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Laparoscopic Technique

The surgery is typically performed laparoscopically through 4–5 small incisions. This minimally invasive approach generally results in less pain, shorter hospital stays, and faster recovery compared to open surgery.

The procedure typically takes 60–90 minutes and usually requires a hospital stay of 2–3 nights. Unlike gastric bypass, the gastric sleeve does not involve rerouting the intestines, which may result in fewer nutritional complications.

Candidate Criteria

Who May Be a Candidate for Gastric Sleeve Surgery?

Gastric sleeve surgery is generally considered for adults who meet certain criteria. While every patient is assessed individually, common eligibility factors include:

✓ A Body Mass Index (BMI) of 40 or above (severe obesity)
✓ A BMI of 35–39.9 with obesity-related health conditions such as type 2 diabetes, sleep apnoea, hypertension, or joint problems
✓ A BMI of 30–34.9 with poorly controlled type 2 diabetes or metabolic syndrome (in select cases)
✓ Previous unsuccessful attempts at sustained weight loss through diet and exercise
✓ A commitment to long-term lifestyle and dietary changes
✓ No medical conditions that would make surgery unsafe

Not sure if you qualify? Read our detailed guide on gastric sleeve eligibility and BMI criteria or book a consultation with Dr Florica.

Potential Benefits

Benefits of Gastric Sleeve Surgery

While individual results vary, gastric sleeve surgery may offer a range of health benefits:

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Significant Weight Loss

Patients may lose 50–70% of their excess body weight within 12–18 months following surgery. Long-term weight maintenance typically requires ongoing lifestyle changes.

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Improved Health Conditions

Many patients experience improvement or resolution of conditions such as type 2 diabetes, high blood pressure, sleep apnoea, and high cholesterol. Individual outcomes vary.

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Reduced Appetite

The reduction in ghrelin production may decrease feelings of hunger, which can make it easier to adhere to healthier eating patterns in the long term.

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Simpler Procedure

Compared to gastric bypass, sleeve gastrectomy does not involve rerouting the intestines, which may result in fewer malabsorptive complications and a more straightforward surgical process.

Considering your options? Read our gastric sleeve vs gastric bypass comparison to understand the differences.

Risks & Complications

Risks and Complications of Gastric Sleeve Surgery

As with all surgical procedures, gastric sleeve surgery carries risks. It is important to understand these before making a decision. Dr Florica will discuss all risks during your consultation.

Potential risks and complications may include:

⚠️ Staple line leak — a rare but serious complication where stomach contents may leak through the staple line
⚠️ Bleeding — internal or at the incision sites
⚠️ Blood clots — deep vein thrombosis (DVT) or pulmonary embolism
⚠️ Stricture — narrowing of the sleeve that can cause difficulty swallowing
⚠️ Gastro-oesophageal reflux (GORD) — some patients may develop or experience worsening reflux
⚠️ Nutritional deficiencies — particularly iron, vitamin B12, calcium, and vitamin D
⚠️ Infection — at incision sites or internally
⚠️ Anaesthetic risks — as with any procedure requiring general anaesthesia

Serious complications are uncommon, but patients should be fully informed. Dr Florica has performed over 20,000 surgical procedures and takes every precaution to minimise risk.

Recovery Overview

What to Expect During Recovery

Hospital Stay (Days 1–3)

Most patients stay in hospital for 2–3 nights. You will begin sipping clear fluids within 24 hours of surgery. Pain medication and anti-nausea medication are provided as needed.

Weeks 1–2: Rest & Recovery

Most patients take 1–2 weeks off work. You will follow a clear liquid diet progressing to full fluids. Light walking is encouraged to promote healing and reduce clot risk.

Weeks 3–6: Gradual Return

You will transition through puréed and soft food stages. Most patients can return to desk-based work within 2–3 weeks. Light exercise may be resumed with your surgeon's guidance.

Months 2–6: Ongoing Progress

Regular follow-up appointments with the surgical team to monitor weight loss, nutrition, and overall health. Gradual reintroduction of regular foods in small portions.

Read our detailed week-by-week gastric sleeve recovery timeline for more information.

What Is Gastric Sleeve Surgery?