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Gastric Sleeve Surgery Pros and Cons

Gastric Sleeve Pros Cons

If you are thinking about the next steps in your weight loss journey, you may be considering bariatric surgery. Listed below are pros and cons of the most common bariatric surgery performed; gastric sleeve surgery. 

Takeaways of Gastric Sleeve Surgery Pros and Cons

Pros of Gastric Sleeve Surgery

  • Your smaller stomach should still function normally. 
  • The procedure can later be converted to a Roux-En-Y gastric bypass. 
  • Your appetite may be lessened due to the removal of the upper part of the stomach that produces ghrelin. 
  • You can be completely asleep during the procedure and recovery is generally quick. 
  • The surgery has a success rate of around 85%
  • Comorbidities, such as diabetes and sleep apnea, may improve after surgery. 
  • No foreign bodies are implanted into the body. 

Cons of Gastric Sleeve Surgery

  • Since part of the stomach is completely removed, the procedure is not reversible. 
  • There is a risk of leaking and bleeding at the staple lines. 
  • The abdominal area may be sore, which may require short-term use of pain medication. 
  • Before physical activity can resume, patients will need approval from their care team. 
  • Most people will not be able to have carbonated beverages. 

What is Ghrelin?

Ghrelin is also known as the hunger hormone. It is a hormone that sends signals to your brain to tell you that your stomach is empty and you are hungry. This is the hormone that helps to stimulate your appetite, as well as increase food intake. 

Gastric sleeve surgery utilizes the first mechanism (i.e., reducing the amount of food intake). This is made possible through the reduction of the stomach capacity by resecting (cutting away) about 80-90% of the stomach leaving a sleeve (banana) shaped 10-20% to perform the function of the stomach. This leads to the sensation of fullness earlier during the meal and subsequently reduces the amount of food intake.

However, for every surgical procedure, there are advantages and disadvantages associated with it. Below are the pros and cons of the gastric sleeve surgery.

Gastric Sleeve Surgery Advantages

Early Recovery

Gastric sleeve surgery is currently done by laparoscopically, reducing blood loss during operation; there are a less postoperative pain and early postoperative rehabilitation. Most patients get discharged by 72 hours post-op. The complication of deep vein thrombosis associated with prolonged immobilization is therefore avoided.

High Expected Weight Loss

Gastric sleeve surgery is one of the bariatric surgeries that achieve the highest weight reduction within the shortest possible time. The average expected weight loss at 12 months after surgery is about 56.1-59% of the excess weight.

Nutritional Deficiencies

Nutritional deficiency is not a typical complication of gastric sleeve surgery as the procedure is purely restrictive with no malabsorptive component. When dietary deficiencies occur in this group of people, it is often due to inadequate intake of such nutrients probably from non-compliance with the post-op dietary plan. Therefore individuals who undergo gastric sleeve surgery spend a lesser amount of nutritional supplements as compared with other bariatric surgeries.

Less Dumping Syndrome

As the intestine is left undisturbed, the chance of developing dumping syndrome after the gastric sleeve is negligible. Thus, your risk of developing diarrhea, abdominal cramps, sweating, tremor, and headache after eating, due to the rapid and untimely dumping of the stomach contents into the intestine, is less in the gastric sleeve when compared with other bariatric procedures.

Revision Surgery

If weight loss becomes inadequate, gastric sleeve surgery can easily be converted to other forms of bariatric surgeries. In fact, if the conversion is to duodenal switch, it reduces the operative time as the gastric sleeve is one of the components of duodenal.

Gastric Sleeve Surgery Disadvantages

Stomach Could Stretch

The remaining stomach can stretch and become more prominent if you do not follow the proper eating habit. This may lead to inadequate weight loss or regain the already lost weight, necessitate a pouch reset or revision surgery.

Gastric Leak is a Serious Complication

The most feared complication of gastric sleeve is leakage of stomach content through the staple line into the abdominal cavity. Although the chance of this complication occurring is 2.4- 5%3, 4, it can be life-threatening if not promptly diagnosed and managed. The most gastric leak will occur within 3days post-op while few may be delayed until one month after surgery. Another surgery is often required to correct this complication.

Heartburn Can Occur

For obese individuals who experience heartburn, it is advisable to choose other bariatric surgery. Heartburn in overweight people is due to reflux of acidic contents of the stomach into the lower part of the esophagus with subsequent irritation of the lining. This results in a burning sensation in the chest which is often aggravated by lying down. People who had gastric sleeve surgery have been found to develop heartburn after surgery while the symptoms get worse in those that had it before surgery. Only a few people experience relief.


As opposed to intragastric balloon devices that are removable and laparoscopic gastric banding that is reversible, gastric sleeve surgery is not reversible once a portion of the stomach has been resected. The procedure can only be converted to another bariatric surgery.

Hair Loss Can Happen

Hair loss can occur in up to 41% of people after gastric sleeve surgery. It is however transient and often resolves by 6-9 months after gastric sleeve can be prevented by adequate nutritional supplements.

In conclusion, gastric sleeve surgery has advantages and disadvantages. The pros, however, outweigh the cons and in the hands of best surgeons and nutritionists, the drawbacks can further be minimized.

In comparing other bariatric procedures, gastric sleeve pros outweigh the cons for most people.

Gastric Sleeve Surgery General FAQs

Is Gastric Sleeve Surgery the right option for me?

No two individuals are the same, especially when surgical procedures are under consideration. It is important that a patient speaks with a surgeon that they are comfortable with, as they will need to be open about their expectations and concerns when it comes to the weight loss procedure that they have in mind.

Your surgeon will go over your previous medical history, your current medical history, any medications you are taking, and give you an overall evaluation to assess your needs. Then, they will be able to determine if gastric sleeve surgery is the right option for you.

Are there long-term effects of a gastric sleeve procedure? 

Many of the long-term risks associated with gastric sleeve surgery have to do with nutrient intake. Patients can help to lower their risk by following the guidelines presented by their surgeon or care team. Long-term gastric sleeve complications that could develop could include hernias, reflux, hypoglycemia, and vomiting. 

Although the long-term side effects merit consideration, it’s important to consider the potential benefits of having the gastric sleeve procedure. We recommend you read our 10 years after gastric sleeve surgery for what life is like after gastric sleeve surgery.

What are side effects of gastric sleeve surgery?

As with any surgery, gastric sleeve surgery may result in some side effects. These side effects may be short-term or long-term in nature. They typically resolve in the months following the surgery. These side effects may include aches, tiredness, dry skin, hair thinning, and mood changes. If you are concerned with any of the side effects you may be experiencing, consult your care team. 

This article is based on scientific evidence, written by experts and fact checked by experts.

Our editorial team strives to present both sides of the argument with in-depth analysis and links to resources.

This article contains scientific and health-related references. The numbers in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.

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