Gastric sleeve surgery is a procedure that promotes rapid weight loss by removing a significant portion of the stomach. This operation helps patients with obesity, type 2 diabetes, hypertension (high blood pressure), sleep apnea, and other health conditions associated with excessive weight.
As with all such surgeries, if you’re considering this procedure, it’s important to understand what goes into preparation for this treatment, from pre-op lifestyle changes to considerations for the day of the operation.
Gastric Sleeve Surgery: Overview
Gastric sleeve surgery is generally performed as a laparoscopic procedure. A specialized tube and camera (known as a laparoscope) is used to access the stomach, making it a more minimally-invasive procedure.
Typically, this work is done in the surgery ward at a hospital. You can expect one to two nights of recovery in the hospital before you can go home.
Gastric sleeve surgery is the most common form of weight loss (bariatric) surgery performed in the U.S., rising steadily in popularity in the past decade.
When you come to the hospital, you’ll first consult with the anesthesiologist and other medical professionals in a pre-operative room. There you’ll be placed on an IV that will deliver anesthetic drugs that put you to sleep prior to the surgery.
Once you’re starting to become sedated, and everything else looks OK, you’ll be taken to the operating room. What sort of set up can you expect in the weight loss surgery operating room? Here’s a quick breakdown:
- Operating table: Surgery is performed while you lay prone on an adjustable operating table.
- Surgical instruments: Set up on surgical tables will be specialized tools, such as scalpels, forceps, among others, that surgeons use to perform the operation.
- Lighting: High-powered, adjustable lights will be necessary throughout the procedure.
- Laparoscope: Surgeons use these adjustable tubes, outfitted with cameras, to perform surgery without having to make large incisions.
- Imaging equipment: Diagnostic and imaging equipment help guide the surgeon’s work and may include X-ray and ultrasound, computerized tomography (CT) scanners, magnetic resonance imaging (MRI) devices, among others.
- Monitoring equipment: Throughout the surgery, while you’re asleep, you’ll be connected to devices that measure important vital signs like heart rate, level of oxygen in the body, and blood pressure.
- Ventilator: While under general anesthesia, you’ll be attached to this device to help you breathe.
- Defibrillator: In the highly unlikely case that the heart stops beating during the procedure, healthcare providers will have defibrillators on hand.
All told, the procedure, itself, usually takes less than three hours.
What to Wear
On the day of surgery, plan for a multiple-night stay in the hospital, and be sure to arrive early. Among the important considerations are what to wear and what articles of clothing to bring. Typical recommendations will include:
- Loose-fitting clothing should be worn; aim for comfort and practicality over style; you’ll be asked to change into a hospital gown for the procedure and during recovery. Most people wear the same outfit home.
- Slippers and a robe are good to bring along for extra warmth.
- Don’t wear jewelry or use cosmetics, including wedding rings, make-up, or face-creams on the day of the operation.
In most cases, you’ll get a great deal of guidance from your healthcare providers; don’t hesitate to ask them any questions you have about what to wear.
Food and Drink
Since gastric sleeve surgery is performed on the stomach, there will be numerous restrictions to diet prior to the procedure. In fact, in the months leading up to surgery, you’ll receive counseling about diet and exercise, and you will have to show that you can lose some weight on your own.
In addition, reduction in weight will also help reduce the size of the liver, which is essential for surgery success. This being the case, It’s very important that you have clear sense of what you can and cannot eat or drink prior to the operation.
Here’s a quick breakdown of what you should keep in mind, especially in the two weeks running up to your appointment:
- High protein diet: One of the most important changes you’ll need to make is to emphasize healthy, lean proteins in your diet, such as lean beef, chicken, turkey, fish, and cheese.
- Protein shakes: To help with the above, certain protein shakes may be recommended to incorporate into your diet during this time. These should serve as breakfasts as well as snacks.
- Fluids: Healthcare providers recommend that you drink at least eight cups (64 ounces) of non-carbonated liquid a day. Avoid sodas, most juices, and caffeine; choose water, fruit-infused water, decaf tea, or even low-sugar or sugar-free drinks like Powerade.
- Vitamins: Key to any healthy diet are vitamins, especially those coming from fresh vegetables and fruit. Emphasize these in your diet and take a daily multivitamin.
Particularly crucial will be the all-liquid diet you have to follow for the 24 hours preceding surgery, which should emphasize:
- Protein shakes: You can continue to consume these until about 3 p.m. the day before your surgery.
- Broth: Beef, chicken, or seafood broth can be a good source of liquid nourishment.
- Nonfat plain yogurt: This easy to digest food can be a good source of energy the day before surgery.
- Clear juices: These include cranberry, white grape, or apple juices.
- Herbal tea: Non-caffeinated herbal teas, such as chamomile, are safe to have.
- Non-dairy popsicles: While ice cream-based popsicles aren’t advised, those that are made from fruit juice are OK to eat.
- Water: Proper hydration is essential throughout the process.
- Sugar-free gelatin: Gelatin snacks, like Jell-O, are safe to eat as long as they’re sugar-free.
Importantly, a number of food and drink items should absolutely be avoided:
- Orange juice
- Milk-based soups
Keep in mind, too, that on the day of surgery, you can only have small sips of water and are asked not to eat anything.
Why You Can't Eat or Drink Before Surgery
Both prescribed and over-the-counter medications and supplements can lead to complications during surgery. During your pre-op consultations and on the day of surgery, make sure you have a full list of any pills or herbs you’re taking.
Your healthcare provider will advise you on what you can and cannot take in the period prior to surgery; be sure to listen carefully to their recommendations. Medications, drugs, and supplements to avoid include:
- Hormones: Birth control drugs or other hormone therapies should not be taken for at least one month prior to surgery.
- Herbal supplements: You’ll be asked to stop taking any herbal supplements you take for at least two weeks prior to the surgery. Some herbs can cause excessive bleeding and impact healing.
- Aspirin/Ibuprofen: Non-steroidal anti-inflammatory drugs (NSAIDs) like anything with aspirin should be avoided for at least one week prior to surgery. These include Ibuprofen, Advil, Midol, Naproxen, and Aleve, among others. Tylenol is an acceptable alternative.
- Some prescribed drugs: Certain drugs you’re taking may also impact outcomes. Your healthcare provider will advise you on what you can take, and whether you need to stop prior to surgery.
You’ll also be given some medications to take before for the procedure. These include:
- Laxative: For the two days prior to surgery, you may be given magnesium citrate, a laxative, to take in the mornings.
- Anticoagulants: After check-in and as you’re preparing to undergo surgery, you’ll be given drugs that thin the blood to prevent clots or other problems.
- Antibiotics: To help prevent infection, you’ll also be administered antibiotics prior to surgery.
- Anesthetic drugs: Before going into surgery, you’ll be put to sleep using anesthetic drugs delivered via IV.
Medications Before and After Surgery
What to Bring
As noted above, gastric sleeve surgery will typically require a couple of nights stay in the hospital, so preparations should be made with that in mind. What’s important to bring along on surgery day? Here's a quick list:
- Insurance information: It’s a good idea to bring your insurance information for the hospital staff.
- Picture ID: Bring photo identification with you as well.
- Advance directives: It’s recommended that you fill out this form, which provides instructions about what to do if something goes wrong and who your health proxy is. If you’ve already filled one out, then this should be accessible in your medical records.
- Pacemaker: If you’re on a pacemaker bring it, as well as the associated ID card.
- Inhalers, eye drops, and nasal sprays: If you use these, make sure to bring them along and list them with your healthcare team.
- Breathing devices: If you use devices to help you breathe, such as continuous positive airway pressure (CPAP), automatic positive airway pressure (APAP), or bilevel positive airway pressure (BiPAP) machines, it’s essential you bring it along.
- Books, magazine, e-book reader, or iPad: To help pass the time in the hospital, you may want to bring along reading material or an iPad loaded up with favored shows or movies.
Notably, you’ll also be advised to leave home large sums of money as well as any other valuables.
Pre-Op Lifestyle Changes
Outcomes for gastric sleeve surgery depend a great deal on changes in behavior; while the procedure helps promote rapid weight loss, it will be your own behavior that determines success. As mentioned, healthcare providers often need to see some ability to enact dietary and health changes prior to being cleared for surgery.
As such, many lifestyle changes may need to be made, including:
- Quit smoking: Smoking tobacco products, as well as all sources of nicotine, can impact the body’s ability to heal from surgery; you’ll be told to stop smoking or chewing for at least one month prior to the procedure.
- Track food intake: To aid in both preoperative and postoperative weight loss, it’s a good idea to log what you’re eating and drinking. This will give you a better understanding of your own diet, allowing you (and your healthcare provider or dietician) to spot problem areas.
- Exercise: Along with diet, a solid fitness regimen is essential for weight loss. Get in the habit of healthy, regular exercise. Start small, with daily walks or chair exercises, and see if you can level up. In addition to guidance from your healthcare provider, consider taking fitness classes or working with a trainer.
- Change your relationship to eating: A great deal of progress can be made simply by changing how you view what you eat. Think of it more as a source of energy, and pay attention to how your body feels as you eat. Be mindful. Eat slowly. Try to avoid excessive eating when bored, tired, or stressed.
- Emotional care: Before surgery, you’ll likely undergo mental health screening and counseling to get at the source of any eating disorders or other issues. As you prepare for surgery, be mindful of where you’re at emotionally, and don’t hesitate to seek out support from loved ones, friends, or mental health professionals.
A Word From Verywell
While gastric sleeve surgery may seem like an intimidating prospect, the fact of the matter is that this procedure is very safe and highly effective. In fact, the procedure has a very low complication rate and produces successful results in 80 to 90 percent of cases.
Furthermore, the techniques and technologies associated with this surgery have greatly improved in the 20 years since it’s been done. Today, you’re much more likely to see success than even 10 years ago.
While preparation for this procedure is intense and extensive, with the support of family, friends, and your medical team, you’ll surely see great results.