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Gastric Sleeve (Vertical Sleeve Gastrectomy)

Tackling obesity requires the help of an experienced and dedicated group of medical professionals. If you are struggling to lose excess weight, Dr. Hossein Bagshahi, our board-certified weight loss surgeon in Fort Worth and Plano, and our extensively trained support team can help you determine if gastric sleeve surgery or another procedure may be able to achieve your goals. We are here to assist you in leading a healthier and more active life. Talk to us today to learn more.

What Is Gastric Sleeve Surgery?

The vertical sleeve gastrectomy, also known as the gastric sleeve, is a surgical weight loss procedure that reduces the size of the stomach and therefore restricts the amount of food you can eat. As with other metabolic surgeries, the gastric sleeve triggers hormonal changes in the body that modify the signals between the stomach, brain, and liver, allowing it to establish a healthier body fat set point, decrease appetite, and reverse or resolve many obesity-related health issues like sleep apnea, high blood pressure, high cholesterol, metabolic syndrome, and type 2 diabetes.
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The sleeve gastrectomy has proven successful as a standalone procedure with patients losing on average 66% of their excess body weight. For patients with very high BMIs ≥ 50, a gastric sleeve can be the first step of other surgical procedures such as the gastric bypass or duodenal switch (DS).

What Are the Benefits of Gastric Sleeve Surgery?

The gastric sleeve surgery is a simple, straightforward approach to weight loss that does not require the insertion of any foreign devices, such as the gastric band, or a modification or rerouting of the intestine like the gastric bypass and duodenal switch procedures.

Compared to other weight loss surgeries, the vertical sleeve gastrectomy offers benefits that include:

  • Limits the amount of food that can be eaten at one time without bypassing the intestine, minimizing the risk of vitamin deficiencies due to malabsorption.
  • Patients on average lose 66% of their excess body weight over a 12- to 18-month period.
  • Helps to resolve obesity-related metabolic syndrome, high blood pressure, and obstructive sleep apnea and improves type 2 diabetes and high cholesterol.
  • Shorter operating and recovery times.
  • Often performed on an outpatient basis.

What Are the Qualifications for a Vertical Sleeve Gastrectomy?

Most insurances require a candidate for the gastric sleeve procedure to have:

  • A BMI ≥ 40, or more than 100 pounds overweight
  • A BMI ≥ 35 and at least one or more obesity-related co-morbidities, such as type 2 diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease
  • Limited or zero success achieving healthy weight loss through a structured diet program, such as Jenny Craig® or Weight Watchers®

Gastric Sleeve vs. Gastric Bypass

Gastric sleeve and gastric bypass surgery are two of the primary treatment options for obesity. Both procedures have similar qualifications for candidacy, sometimes causing confusion for patients who are researching the best weight loss surgery options for their unique needs. A consultation with a surgeon is the most reliable way to learn the most ideal procedure for you, but the comparison below can provide a brief primer on the similarities and differences between gastric sleeve and gastric bypass surgery.

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Gastric Sleeve

  • Reduces the size of the stomach by forming a “tube” or “sleeve” shape to achieve weight loss
  • Patients can lose approximately 60 to 70 percent of excess weight
  • Can limit food intake and removes the ghrelin, which is known as the “hunger” hormone
  • Generally less complex to perform than gastric bypass surgery
  • Less likelihood of nutritional deficiencies, but fewer long-term studies conducted on the results
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Gastric Bypass

  • Re-routes a portion of the lower intestine and creates smaller stomach “pouch” to achieve weight loss
  • Patients can lose 60 to 80 percent of excess weight, providing a relatively more exhaustive weight loss system when compared to gastric sleeve
  • Can limit food intake as well as decrease the number of calories absorbed
  • More invasive than gastric sleeve surgery, but can promote long-term weight loss
  • Higher risk of nutritional deficiencies and digestive conditions, such as dumping syndrome

What Happens During the Laparoscopic Gastric Sleeve Procedure?

The vertical sleeve gastrectomy is performed using the minimally invasive laparoscopic technique, allowing the majority of patients to return home the same day as surgery with less pain and significantly shorter healing times. During the gastric sleeve procedure, Dr. Bagshahi will make five incisions about the size of a quarter in the abdomen, which are used to insert a scope and surgical instruments. Dr. Bagshahi will then reduce the size of the stomach by 80% by forming a small tube or “sleeve” using a stapling device. He then removes the remainder of the stomach. The entire procedure is completed in about an hour.

How Long Do Results From Gastric Sleeve Surgery Last?

Results after gastric sleeve surgery depend, in large part, on how you maintain the dietary and exercise commitments outlined in your treatment plan. While the exact amount of weight lost will vary for each patient according to their unique situation, most individuals experience:

  • Losing 70 percent of their excess weight within the first year of their procedure
  • Losing 55 percent of their excess weight within five years

Weight loss following the gastric sleeve procedure typically occurs very quickly. Since the stomach is reduced and fewer hunger-inducing hormones are discharged, patients usually eat less and feel less hungry in general. However, overeating can still stretch the stomach and increase the risk of weight regain. For the longevity of your gastric sleeve results, it’s essential to stick to the routine developed by your dietician and bariatric surgeon as best as possible.

What Complications from Gastric Sleeve Surgery Could Occur?

There are risks associated with any surgery; however, advancements in bariatric surgery have reduced the incidence of serious complications. The risks include but are not limited to:

  • Gastric leak associated with a staple-line failure
  • Bleeding
  • Damage to adjacent structures
  • Development of reflux
  • Feeding intolerance

Another important consideration with gastric sleeve surgery is that the sleeve gastrectomy procedure is irreversible. Dr. Bagshahi will assess your candidacy for gastric sleeve surgery and review your goals as well as your medical history to make certain that this technique is the right weight loss option for you. All surgical procedures include some risk of potential complications, but this possibility is greatly reduced if you are under the care of a board-certified bariatric surgeon.

What Should I Expect During Gastric Sleeve Recovery?

Some soreness should be expected for the first few days after the operation, and we will provide a prescription to limit your discomfort. You will not be allowed to have food or liquids for the first day, so you may experience some thirst, although hunger is uncommon. The first several days, particularly those spent in the hospital, should be spent resting and recovering. In about one to two weeks, most patients can return to work, depending on their responsibilities, and many other normal activities. Weight loss should be noticeable after a few months as you follow the prescribed dietary and fitness guidelines.

Will Weight Loss From Gastric Sleeve Surgery Last Forever?

The longevity of your weight loss will depend on you and your commitment to your health. After the full extent of weight loss from gastric sleeve surgery is achieved, it’s crucial to stick to the dieting and exercise regimen outlined by Dr. Bagshahi and your team. As long as you’re committed to making the changes detailed in your treatment plan and leading an active lifestyle, lifetime results are possible after the procedure. However, returning to unhealthy habits like overeating and poor dietary choices can certainly cause additional weight gain in the future and reduce the impact of your sleeve gastrectomy. In some cases, revision weight loss surgery may be necessary.

This is why the best candidates for gastric sleeve surgery are patients who are willing to make lasting, long-term changes to their lifestyle. Rest assured that our team offers an ongoing continuum of care for bariatric surgery patients to ensure they stay on track with their health goals. In addition to having the support and guidance of Dr. Bagshahi, our team also includes our board-certified general surgery specialist, bariatric nutritionists, and certified medical weight loss professionals.

What Type of Gastric Sleeve Diet Should I Follow?

A surprising variety of foods are included in a typical gastric sleeve nutrition program, and you should not have much trouble finding options you enjoy. The most important piece of advice is to include lots of protein and limit sugar and fats. Initially, you will have several restrictions as your body heals from the surgery. You will start with a liquid diet, progress to a soft food diet, and eventually add solid foods. We will go over all the details of your recovery, including the dietary guidelines, so you can heal as comfortably and
confidently as possible.

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Pre-Op Gastric Sleeve Diet

Before surgery, gastric sleeve patients typically prepare for their procedure by weaning fats, sugars, and carbohydrates from their diet. You may be advised to adhere to a daily caloric goal, and your diet will mostly consist of vegetables, lean proteins, and low-calorie meals. This will help you transition to consuming only clear, liquid meals starting two days before your gastric sleeve procedure.

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Post-Op Gastric Sleeve Diet

Following your procedure, the clear, liquid diet you started before surgery should continue for the first week of recovery. It’s essential to avoid sugar, caffeine, and carbonated beverages to prevent complications such as acid reflux, dumping syndrome, bowel obstruction, nausea, and dehydration. During the second post-operative week, you will continue a full liquid diet while incorporating foods such as sugarless protein shakes, non-fat and sugar-free yogurt, and thin broths. You will start incorporating soft, pureed foods around week three while still restricting yourself to low-fat and sugar-free foods. One month after surgery, you should graduate to a diet of healthy, solid foods that will ideally be maintained for the long-term future. Rest assured that Dr. Bagshahi will make sure you understand these and other dietary specifications during the treatment process.

How Much Does Gastric Sleeve Surgery Cost?

Gastric sleeve surgery will likely be covered by your medical insurance, and we recommend reviewing your benefits coverage with your insurance representative to be certain of what portion of the fees you are responsible for. Please call our office if you are interested in an insurance verification.

Choosing where to get care and have a sleeve gastrectomy is very important. Price should not dictate the care you seek, as these are specialized surgeries and require extensive pre-op education and appropriate aftercare. In the Dallas-Fort Worth market, we have negotiated extremely competitive prices with reputable hospitals that have the proper nursing care and surgical equipment, and we are constantly negotiating with hospitals to reduce the overall cost to the patient. While you may be able to get “rock bottom” pricing with medical tourism or clinics that offer this procedure at a cheaper price, this may not be in your best interest. In general, the cost of a sleeve gastrectomy is between $11,500-$12,000 in the DFW area. Please call our office to make an appointment to discuss your care and any further details. It would be unfair to the patient for us to discuss detailed costs until we have had the opportunity to meet you and discuss your care. As a warning to prospective patients, we recommend that you avoid medical tourism very far from home and practices that advertise unbelievably low costs.

We understand navigating the payment process can be confusing and requires a great deal of patience. Our team will act as your insurance concierge from verifying your insurance benefit, meeting requirements for coverage and seeking approval of your case. Should you choose to work outside of the insurance industry, we work with reputable lending agencies in the event you decide to use bariatric surgery financing to pay for your procedure. Please note that we do not accept Medicaid.

“If you are living with obesity, the cost of a sleeve gastrectomy is minor in the face of potential health issues and the cost related to them… you can’t afford to wait!”

“If you are living with obesity, the cost of a sleeve gastrectomy is minor in the face of potential health issues and the cost related to them… you can’t afford to wait!”

~ Actual Patient

Can Gastric Sleeve Be Performed with Robotic Surgery?

Yes, gastric sleeve surgery is commonly performed with laparoscopic, minimally invasive, and robotic techniques! Our practice is passionate about providing patients with the most advanced, cutting-edge treatment options to reduce recovery times, minimize invasiveness, and improve outcomes. With the state-of-the-art da Vinci® surgical system, the gastric sleeve procedure is performed with a higher degree of precision and control when compared to open surgery. Not only are incisions shorter (leading to less extensive scarring), but healing times, invasiveness, and the risk of complications are reduced. This approach may not be the best for all patients, but Dr. Bagshahi and our team can evaluate your needs, goals, and medical history to determine whether you could benefit from robotic gastric sleeve surgery.

Are There Alternatives to Gastric Sleeve Surgery?

Yes, Dr. Bagshahi performs a range of effective weight loss surgeries at our Dallas practice and is committed to identifying the best procedure for your unique needs. If gastric sleeve surgery is not the most ideal solution to help you lose weight, other treatment options like duodenal switch surgery and the gastric bypass procedure may be able to provide a better outcome. For patients affected by medical conditions like diabetes and high blood cholesterol duodenal switch surgery, duodenal switch surgery has been known to provide the greatest amount of excess weight loss, as well as the best results against these diseases compared to other bariatric procedures. This may be an ideal treatment, particularly for individuals with a BMI over 50.

In other cases, a Roux-en-Y procedure — also known as gastric bypass surgery — may be the best weight loss option if gastric sleeve and other treatments are not thought to be effective. This procedure reduces the size of the stomach to restrict the amount of calories that can be consumed, resulting in long-term weight loss. While these major weight loss procedures can all be successful, the only way to determine the most optimal treatment for your health and personal needs is to consult with a board-certified bariatric surgeon. 

Is Gastric Sleeve Surgery Safe?

Compared to other elective procedures, bariatric treatment options like gastric sleeve surgery are considered very safe and effective for treating obesity and weight-related health conditions. In addition, the risks of living with obesity typically outweigh the risks of undergoing weight loss surgery. Patient safety is our top priority at Dr. Hossein Bagshahi’s office, which is why we also perform many weight loss procedures with minimally invasive, laparoscopic, and robotic-assisted techniques to further reduce the risks of surgery. These less invasive approaches decrease bleeding, swelling, the amount of recovery time necessary, and the overall risk of complications. We encourage patients to focus on selecting an experienced, highly qualified board-certified weight loss surgeon to help maximize their health, safety, and potential results.

What are Common Symptoms of a Gastric Sleeve Leak?

A gastric leak is an exceedingly rare, yet life-threatening complication possible after gastric sleeve surgery. This involves a hole or disruption in a patient’s new stomach pouch, causing food, digestive juices, and other contents to leak. Leaking fluids can cause major harm to the organs and internal tissues of the body, so it’s important to remain vigilant of the symptoms that may signify a potential gastric sleeve leak, such as:

  • Rapid heart rate
  • Fever-like symptoms
  • Dizziness and shortness of breath
  • Chest pain
  • Abdominal pain that doesn’t go away

Increasing discomfort and pain that worsens with each passing day are some of the most telling indications of a gastric sleeve leak. While a gastric sleeve leak can occur immediately after surgery, it also may not develop until days later during the healing process. Please contact Dr. Bagshahi if you have any concerns about a gastric sleeve leak or another complication associated with bariatric surgery.

Why Choose Dr. Bagshahi For Your Gastric Sleeve Surgery?

Choosing Bagshahi Bariatric and General Surgery for your Gastric Sleeve surgery ensures you’ll receive the highest quality of care during and after your surgery, while giving you the nutritional guidance and support you need to maintain your weight loss — and health — over the long term. Some reasons why you should consider Dr. Hossein Bagshahi for your weight loss goals include:

  • Fellowship-Trained: In addition to maintaining accreditation by the American Board of Surgery, Dr. Bagshahi holds the rare distinction of being a Fellow of the American Society of Metabolic and Bariatric Surgery (FASMBS). This achievement demonstrates a high threshold of training and experience in weight loss medicine surpassed by very few surgeons.
  • Ongoing Support System: At our practice, we care about your health and wellness for the long-term future—not just until the end of your recovery. We can provide the compassion and support necessary to help you maintain a healthier, more positive quality of life over an extended period of time.
  • An Unmatched Level of Care: Our experienced team of medical professionals, nurses, support specialists, and office staff are among the best in their field. We are committed to providing exceptional service and thorough patient education to help you throughout every stage of your weight loss journey.
  • State-of-the-Art Techniques and Technology: Our accredited facility is fully equipped with the latest equipment to help you achieve your goals safely and effectively. Cutting-edge technology like the daVinci® Robotic Surgical System and other advanced laparoscopic equipment ensure you receive a wide range of effective treatment options for your goals.

If you would like to learn more about how we can help you achieve healthy weight loss, please don’t hesitate to contact Bagshahi Bariatric and General Surgery for a consultation with Dr. Bagshahi.

Additional Gastric Sleeve FAQs

What is the gastric sleeve success rate?

The success rate of a sleeve gastrectomy is roughly 80 to 90 percent, with the procedure’s success typically measured in terms of the amount of weight lost post-operatively. That said, the outcome will ultimately depend on your commitment to a healthier lifestyle after gastric sleeve surgery. The most successful patients generally make long-term dietary and lifestyle changes, such as exercising regularly, committing to a high-protein and low-carb diet, and attending follow-up appointments as necessary. Many patients also experience improvements in health conditions precipitated by obesity, such as type 2 diabetes, sleep apnea, and fatty liver disease.

Will I have any gastric sleeve scars?

While all surgical procedures will leave scars behind to some extent, Dr. Bagshahi’s laparoscopic technique when performing a sleeve gastrectomy can allow smaller incisions than more invasive weight loss surgeries. This should minimize scarring after your gastric sleeve surgery as much as possible, and lead to a relatively shorter recovery period. In general, following Dr. Bagshahi’s instructions regarding proper wound care after the gastric sleeve procedure can help optimize the healing of your scars. With time, many patients find that their gastric sleeve scars lighten and fade to some degree—especially with regular application of scar-reducing skincare products.

Will I need to take any vitamins after gastric sleeve surgery?

Yes, it’s very important for bariatric surgery patients to supplement their diet with the daily consumption of necessary vitamins and nutrients. Dr. Bagshahi will go over the appropriate dietary guidelines with you in person, but patients generally take a combination of multivitamins and calcium, as well as vitamins D and B12 to prevent nutritional deficiencies.

Can I get pregnant after gastric sleeve surgery?

It’s crucial that patients who are interested in starting a family wait at least 18 months after their gastric sleeve procedure before having children. Bariatric surgery causes many strenuous changes in the body that can potentially complicate a pregnancy if a baby is conceived too soon after surgery; therefore, it’s essential to wait until your weight stabilizes to have children. Once enough time has passed to safely start your family, working with a dietician can help ensure you and your baby receive the vitamins and nutrients necessary to facilitate a healthy pregnancy.

Can the gastric sleeve procedure be reversed?

Gastric sleeve surgery is irreversible, emphasizing the importance of consulting with a qualified weight loss surgeon before the procedure so he or she can help ensure sleeve gastrectomy is the best treatment for your specific needs. There are many other clinically-supported weight loss options available at our Fort Worth practice, and our team is committed to finding the most effective solution for you.

Is gastric sleeve revision an option?

Yes — some gastric sleeve patients experience complications after their procedure, which gastric sleeve revision surgery can help address. It’s important to keep in mind that a revision procedure is a very complex procedure and patients are evaluated on a case-by-case basis to determine whether the potential benefits of a secondary surgery outweigh the risks. Revision bariatric surgery is mostly performed to resolve complications, and Dr. Bagshahi would be happy to discuss your concerns if you did not achieve your desired results from a sleeve gastrectomy. 

What is the average recovery time after gastric sleeve surgery? 

Full recovery after a sleeve gastrectomy is often achieved after four to six weeks, though this timeline may vary. Many patients are able to return to their jobs after three weeks as long as their work is not strenuous or physically demanding. You will receive detailed recovery information, as well as what you can expect during the healing process, after your procedure.  

Is weight gain after gastric sleeve surgery possible?

Although the stomach is reduced to allow patients to feel full with less food, it’s still possible to gain weight after gastric sleeve surgery. The stomach can still expand from eating larger portions than necessary, making it possible for individuals to overeat and regain their excess weight. This is why sticking to your diet and exercise regimen is of the utmost importance if you want to help ensure long-term weight loss results.  

What are good recipes after gastric sleeve surgery? 

Our North Dallas office has compiled a variety of delicious, healthy, and fulfilling recipes to help weight loss patients maintain a nutritious diet without sacrificing tasty meals. We encourage you to stay updated with our blog and newsletter to keep abreast of new, healthy recipes that are conducive to your weight loss goals. In general, it’s recommended to stick to high-protein, low-sugar and low-fat meals after bariatric surgery.