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Safety guide · Sleeve gastrectomy
Serious complications after a gastric sleeve are uncommon, but every surgery has risks. This guide covers the side effects you may notice in the first months, the complications that can happen later, the symptoms that need urgent care and how to lower your risk.
Your package includes three leak tests, take-home medications and aftercare with our nutritionists.
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The big picture
In US and Canadian data, serious short-term problems after the sleeve were uncommon and fell over time. The main long-term trade-off is reflux.
The first months
Your body reacts to rapid weight loss in the first 3 to 6 months. These changes are common and usually pass (Mayo Clinic).
You may feel tired, as if you have the flu, with body aches.
Both are common while you lose weight quickly.
Hair thinning and hair loss can happen in the first months. Protein and your vitamins help.
Tell your care team if your mood changes. Support is part of aftercare.
Nausea, vomiting and trouble getting enough fluids can happen while your stomach heals. Small sips through the day and the staged post-op diet help. Tell your care team if you can’t keep liquids down.
The first weeks
These are similar to other abdominal surgeries: bleeding, infection, reactions to anesthesia, blood clots, breathing problems and leaks from the cut edge of the stomach (Mayo Clinic).
A leak from the staple line is one of the most serious complications. Signs include fever, a fast heart rate and worsening belly, shoulder or chest pain. Gastric sleeve leaks.
Bleeding along the staple line or inside the abdomen, which your care team watches for during your hospital stay.
Clots can form in the legs and travel to the lungs. Walking soon after surgery lowers the risk.
Red, hot or swollen skin, pain or pus around an incision. It is usually treated with antibiotics.
Months and years later
| What it is | What helps | |
|---|---|---|
| Reflux (GERD) | Heartburn or acid coming up. It can be new or get worse after the sleeve. At 10 years, 64% of sleeve patients took reflux medication (SLEEVEPASS) | Medication and diet changes. If it doesn’t improve, conversion to gastric bypass may help |
| Stricture | A narrowing of the sleeve that makes solid food hard to eat and can cause nausea, vomiting and trouble swallowing (NIDDK) | Tell your care team, and your surgeon will explain the treatment options |
| Nutrient deficiencies | Not getting enough vitamins and minerals, which can lead to anemia and bone loss (NIDDK) | Take your vitamins every day for life, and keep up with your labs |
| Gallstones | Stones in the gallbladder, which are more likely after rapid weight loss (NIDDK) | Some doctors prescribe medicine for about 6 months after surgery to help prevent them |
| Hernias | A hernia at an incision or inside the abdomen (NIDDK) | Get checked for a new bulge or pain |
| Weight recurrence | Regaining weight over time. Can your stomach stretch? | Nutrition support, GLP-1 medication or revision |
Other long-term risks listed by Mayo Clinic include blockage, low blood sugar, malnutrition and vomiting.
When to get help
If you notice any of these, go to the nearest emergency room. Then let the Renew care team know.
Especially with belly, shoulder or chest pain in the first weeks, which can signal a leak.
Vomiting after eating or drinking, or not being able to keep fluids down.
Swelling, warmth or pain in a calf, shortness of breath or sharp chest pain can mean a blood clot.
Pain that keeps getting worse instead of better.
Vomiting blood, black stools, or feeling dizzy or faint.
Redness, heat, swelling, pus or fluid leaking from an incision.
Before and after surgery
Follow the pre-op diet and your surgeon’s instructions. See the pre-op checklist.
Every day, for life, with the regular labs your care team orders.
Liquids first, then pureed foods, then regular foods about four weeks after surgery. Post-op diet.
Our nutritionists stay with you after you go home. Tell them about any new symptoms early.
Send it to us and our surgeons will review your risks before recommending a procedure. Virtual consultations are available.
5-star Google reviews. Want to talk with a past patient? Ask your coordinator.
“I underwent the gastric sleeve surgery with Dr. Jorge Green. The surgery went very well. I had a lot of pain and soreness right after but once the IV pain meds kicked in all was right with the world.”
“I highly recommend Dr Green with Renew Bariatrics. I had gastric sleeve surgery on 8/21/20. I received excellent medical care. Everyone was very friendly and I felt safe the whole time.”
“Everything went so smooth it put me at peace that I chose the right people to perform my gastric sleeve. Everyone was very nice and professional, all my nurses took such good care of me and doctor Green was great.”
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In the first 3 to 6 months, many people feel tired, cold or achy, and notice dry skin, hair thinning or mood changes as they lose weight quickly. Nausea is also common while the stomach heals.
Uncommon. In US and Canadian data on 434,030 sleeve patients, the 30-day leak rate fell from 0.48% in 2015 to 0.26% in 2018.
It can. In the SLEEVEPASS trial, 31% of sleeve patients had reflux-related esophagitis at 10 years, vs 7% after gastric bypass. Tell your surgeon about any reflux before surgery.
Hair thinning is common in the first months of rapid weight loss. Eating enough protein and taking your vitamins helps.
Yes. You take vitamin supplements for life, with regular labs to check your levels.
If you have a fever, a fast heart rate, chest or belly pain, leg swelling or can’t keep liquids down, go to the nearest emergency room. Then let the Renew care team know.
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