top of page

Gastric sleeve surgery is the most commonly performed surgery in the world today for the surgical treatment of obesity. After it was defined as a stand-alone surgery for the first time in 2005, the number of operations increased rapidly, and as of 2013, it ranked first among obesity surgeries.


Gastric sleeve gastrectomy, also known as sleeve gastrectomy, is in the group of restrictive, that is, volume-limiting surgeries among obesity surgeries. It can be defined that the part of the stomach on the left side of the body is removed, leaving a tube-shaped stomach resembling a banana (Picture 1). In this surgery, approximately 80% of the stomach is removed and its volume is reduced to 100-150 ml.


It provides weight loss with two mechanisms:

  1. It reduces the amount of food we take, and therefore the amount of calories we take, due to the shrinkage of the stomach volume and helps us to reach a negative calorie balance.

  2. The hunger hormone called 'Grelin' is secreted from the area in the pocket called 'fundus', where the foods waiting to be digested are kept in the upper part of the stomach. This hormone is also the reason for the cravings that force us between two meals, especially during diet periods. Since this area is surgically removed, there is a significant decrease in hunger and cravings, especially in the first year after surgery. ,

Picture 1

In this way, the patient enters a process in which he eats less and is full and does not get hungry between meals. As a matter of fact, this period is a period when the person is compelled to diet without effort and does not have any difficulties while doing this, so weight is lost.   

Gastric sleeve gastrectomy surgery is performed with the closed surgery method, namely laparoscopy. Instead of a large incision in the abdomen, 5 incisions of 1 cm in average are used. The intra-abdominal cavity is inflated with carbon dioxide and the surgery is performed with thin long instruments advanced through these holes. The post-operative process is not very troublesome. Pain is not a big problem. The patient, who goes home on the 2nd or 3rd day after the operation, can start work on the 7th day on average.

Of course, sleeve gastrectomy surgery has some risk of complications like other surgeries:

  • If we start with the most important, this surgery has a one-in-a-thousand risk of death, as in any surgery. This rate covers all patient groups (18-60 years old). It may vary according to the age and general health of the patient. For example, this probability will of course be lower in a young person who does not have any additional disease.

  • After the stomach is removed, the stomach is closed with tools called staples. This staple line is normally water and air tight. The leakage of stomach contents into the abdomen through this line is called leakage. It can be seen in 1% of patients. If detected on time, it can be treated with a new surgery  or with endoscopy methods. The important thing is not to delay the diagnosis.

  • Bleeding from the staple line is another possible complication. It can be seen in 1%. It is a risk that belongs to the night of the operation. It can be considered as practically zero in a patient who wakes up safely the next morning after surgery. If the bleeding does not stop with some precautions (blood donation, etc.), the patient is taken to surgery and the bleeding is stopped. This surgery is also done laparoscopically.

  • As a possible result of immobility and complete relaxation of the muscles during the surgery, a situation called pulmonary embolism may occur as a result of the blood clotting in the leg veins, which weakens the circulation, and the fragment that breaks off from this clot occludes the pulmonary vessel. Pulmonary embolism can lead to serious problems if not diagnosed in time. It can be seen in 1%. In order to prevent this situation from developing, many precautions are taken before, during and after the surgery 

  • In the long-term, the stomach, which has been turned into a tube, is bent at one point, creating a transitional difficulty. This complication is not life threatening. Intermittent vomiting, intolerance to solid foods, and low weight can lead to uncontrolled weight loss in patients undergoing surgery. Enlarging the narrow area with an expandable balloon with the endoscopic method eliminates the problem. It is seen in 1%.


Although we talk about these complications, the biggest and unsolved problem after sleeve gastrectomy, unlike what is predicted, is weight gain, not one of the above. Even this surgery does not provide a 100% solution to obesity and does not guarantee a lifetime of slimming. Those who have this surgery can gain the weight to be operated again by 10-15% within 10 years. Failure to do so is directly related to the patient's effort and respect and ownership of the surgery. 50-60% of patients lose weight and maintain their weight. 25-35% of patients gain some weight after losing weight, but do not return to their original weight.

The first 1-1,5 years after surgery, with a very good weight loss, is called the 'honeymoon period'. In this period, even if everything is done wrong, weight is lost, but the best possible point cannot be reached. After the honeymoon period, if the wrong practices continue, this will result in weight gain. If he gets rid of some wrong eating habits after the surgery, puts sports into his life, and stays away from alcohol, he will be successful. So, there is still a long way to go after the operation.     

It is very important for the patient to maintain his relationship with the center that undertakes the treatment and the support of his relatives after the surgery.


It should not be forgotten that the process after obesity surgery is very difficult and troublesome, just like the treatment of substance addiction, and one should be prepared for it.


It should not be forgotten that a patient who really wants to lose weight and sincerely strives for it cannot fail.


An important advantage of sleeve gastrectomy surgery is the possibility of converting this surgery to other obesity surgeries in case of weight regain. In short, sleeve gastrectomy surgery does not mortgage all the rights of the patient, it always allows a second chance.    _cc781905-5cde-3194-bb3b-136bad5cf139458dbb3cc781905

bottom of page