Sleeve Gastrectomy: Benefits, Risks, and Long-Term Follow-Up

Severe obesity is one of the major health challenges of modern life, as it is associated with an increased risk of diabetes, high blood pressure, heart disease, sleep apnea, and many other health problems. When diet, exercise, and conservative treatments fail to achieve sustainable results, bariatric surgery becomes an effective treatment option. Among the most common and successful procedures is laparoscopic sleeve gastrectomy.

What is sleeve gastrectomy?

Sleeve gastrectomy is a surgical procedure in which approximately 75–80% of the stomach is removed, transforming the stomach from its normal shape into a narrow tube or “sleeve” that resembles a banana.

The procedure is performed laparoscopically through several small openings in the abdominal wall, which reduces pain and speeds up recovery compared with open surgery.

How does the procedure help with weight loss?

The procedure works through two main mechanisms:

Reducing stomach size
Reducing the size of the stomach leads to a feeling of fullness after eating small amounts of food.
Hormonal effect
The part responsible for producing a large proportion of the hunger hormone ghrelin is removed, which leads to reduced appetite in most patients.

For this reason, the success of the procedure is not limited to reducing the amount of food only, but also includes reducing the desire to eat.

Who are the candidates for the procedure?

The procedure is usually recommended in the following cases:

Body mass index (BMI) > 35.
Body mass index ≥ 30 with associated conditions such as diabetes or high blood pressure.

Each case should be evaluated individually by a bariatric surgeon.

Benefits of sleeve gastrectomy

The expected benefits include:

Losing 60–80% of excess weight during the first one to two years.
Improvement or remission of type 2 diabetes in a large percentage of patients.
Improvement in blood pressure.
Improvement in blood lipids.
Improvement in sleep apnea.
Increased physical activity and improved quality of life.

What happens after the procedure?

The patient usually stays in the hospital for one to two nights and starts walking a few hours after the procedure.

A gradual dietary program is then followed, including:

Clear fluids.
Full fluids.
Pureed foods.
Soft foods.
Gradual return to normal food.

This transition usually takes 4 to 6 weeks.

Possible complications

Like any surgical procedure, there are some possible risks, although their rate is low when the procedure is performed in specialized centers. These include:

Bleeding.
Leakage from the staple line.
Venous blood clots.
Stricture.
Gastroesophageal reflux disease in some patients.
Deficiency of vitamins and nutrients if supplements are not followed as recommended.

The importance of long-term follow-up

The success of the procedure does not depend on surgery alone, but also requires:

Adherence to the dietary plan.
Regular physical activity.
Taking the prescribed vitamins.
Regular follow-up with the medical team.

The procedure is a powerful tool to support weight loss, but it requires patient cooperation to maintain long-term results.

Why has sleeve gastrectomy become the most common procedure?

Sleeve gastrectomy has become one of the most common bariatric procedures worldwide because of:

Its high effectiveness in weight loss.
The simplicity of the procedure compared with some other operations.
No need for intestinal bypass.
Excellent long-term results.
Low complication rates when performed by experienced surgeons.

Conclusion

Sleeve gastrectomy represents an effective and safe treatment option for patients with severe obesity or obesity-related conditions. When performed as part of an integrated program that includes medical and nutritional assessment and continuous follow-up, it can achieve excellent results in improving overall health and quality of life.