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How to Avoid Gastric Sleeve Failure

Gastric Sleeve Articles

Gastric Sleeve FailureMorbidly obese people are often treated with surgical procedures that are directed at reducing the capacity or absorptive ability of the stomach with subsequent maintenance of dietary modifications all with the aim of reducing weight. One of such surgical procedures is gastric sleeve surgery (laparoscopic sleeve gastrectomy LSG). It involves the resection of about 80-90% of the stomach, leaving a 10-20% banana (sleeve) shaped portion.

The final aim of gastric sleeve surgery is to achieve weight loss and keep the body mass index below 30 Gastric Sleeve can be said to have failed when the optimum goal of weight loss has not been reached, or the patient has regained weight after initial weight loss.

The exact failure rate of sleeve gastrectomy is unknown. Using the Spanish National Registry for bariatric surgery, Sanchez-Santos et al. reviewed 540 patients who had undergone SG either as a primary or staged procedure over a six-year period. The authors reported excellent overall outcomes; however, 15 percent of the subjects were considered failures based on weight recidivism in the first three years, with 3.3 percent of patients submitting to a second bariatric procedure (Mehran & Koleilat, 2010). Sometimes patients who have failed will need to try another bariatric procedure more suited to ensure higher levels of normal weight loss.

The success of gastric sleeve surgery partly depends on the patient and the surgeons. The patient’s aspect is to maintain a health/weight reducing diet after surgery. However, it is the doctor’s duty to ensure a successful and quality operation devoid of complications.

Thus, to avoid gastric sleeve failure, the following must be done:

Choose the Best Surgeon

The outcome of gastric sleeve surgery regarding percentage estimated weight loss (EWL) has been found to vary from one surgeon to the other with the best surgeon having EWL of 78% and the worst doctor having EWL of 42% (Fischer et al., 2012). In the absence of other factors that may lead to failure of gastric sleeve, the choice of surgeon determines to a large extent the success rate of the gastric sleeve surgery.

Maintain Dietary and Lifestyle Changes As Prescribed By Your Surgeon/Dietician

Maintaining a healthy diet and eating habit will prevent the stomach from stretching following gastric sleeve. This can be achieved by ensuring the following:

Obey your satiety (sensation of fullness) brain signals.

Following gastric sleeve, your stomach takes a little food, and become stretched. This sends a signal to the brain, and you feel the sense of fullness. If you can control yourself and obey your satiety brain signal, then your stomach will remain small and will not stretch. However, if you keep eating, and disobeying your brain satiety signals, then your stomach will stretch, and you will eat more and continue to gain weight.

Avoid eating and drinking at the same time

Always ensure that you have at least 1hour between eating and drinking to reduce the risk of overstretching your stomach.

Avoid carbonated drinks and refined sugar

Carbonated drinks contain gas that may cause gastric overdistention. Refined sugars are high in calories and deficient in nutrients. They will be counterproductive to your weight reduction goal.

Avoid high dietary fats

Dietary fat intake may also prevent you from losing weight post gastric sleeve.

Regular exercise

A sedentary lifestyle will be counterproductive to the weight loss target following gastric sleeve. Always ensure a regular exercise as recommended by your doctor. This will provide the breakdown of the excess fat and protect against cardiovascular diseases associated with obesity.

Gastric sleeve surgery requires a lot of preparation in other to achieve success. Choosing the best of the surgeon is the first step in the prevention of failure of the procedure. However, no matter how good a doctor is, the patient must be ready to sustain the dietary and lifestyle modifications if failure is to be prevented and weight loss target is to be achieved.



  • Fischer, L., Hildebrandt, C., Bruckner, T., Kenngott, H., Linke, G. R., Gehrig, T., Buchler, M. W. (2012, May). Excessive weight loss after sleeve gastrectomy: a systematic review. – PubMed – NCBI. Retrieved from

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