Laparoscopic sleeve
Five or six small incisions, a camera, and staplers that divide the stomach along its greater curvature. The open part is removed through one of the ports, so the stomach that remains is a tube rather than a pouch with a bypass.
Weight-loss surgery
Gastric Sleeve Surgery in Istanbul
The stomach is reshaped into a narrow tube — roughly 60–70% of it is removed — so it holds far less and empties more slowly. It is a tool that makes appetite and portion size easier to manage; it does not lose the weight for you.
- Operating time
- 1–2 h
- Hospital stay
- 2–3 nights
- Until weight settles
- 12–18 months
Who is a good candidate
The decision is not made on weight alone. It rests on body-mass index, on the conditions that come with excess weight, on what has already been tried under supervision — and on a genuine willingness to be followed up for years, not months.
- A BMI of 40 or above, or 35 or above with a weight-related condition such as type 2 diabetes, high blood pressure or sleep apnoea
- A BMI of 30 or above with poorly controlled type 2 diabetes — permitted by some international guidance, decided case by case
- Previous structured attempts at weight loss — diet, activity, behavioural support — that did not hold over the long term
- Commitment to lifelong follow-up: blood tests, supplements and clinic visits, including the years when the weight is stable
No operation is booked before a psychological assessment, an anaesthetic review and a dietetic assessment. Active substance misuse or untreated psychiatric illness postpones surgery until it is treated — not because of a rule, but because the follow-up will not survive otherwise.
How the operation is done
The principle is the same in every case; what changes is the diameter of the tube left behind and whether a hernia is repaired at the same time.
Calibration — how narrow the tube is
The tube is built over a sizing tube passed through the mouth, typically 36–40 French. Narrower gives more restriction but more narrowing and reflux; wider gives less. This is a surgical judgement, not a patient choice.
Hiatal hernia repair and reflux
The diaphragm is inspected during the operation, and a hiatal hernia is repaired in the same session if found. Reflux that already exists can worsen after a sleeve, so it is assessed beforehand and sometimes changes the operation chosen.
From consultation to long-term follow-up
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Assessment
Blood tests including iron, B12, folate, vitamin D and thyroid function; an endoscopy where indicated; a dietetic review; a psychological assessment; and an anaesthetic opinion. Only then is a date offered.
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The two weeks before
A low-calorie diet, usually liquid or very low energy, shrinks the liver so the stomach can be reached safely. Smoking stops at least four weeks before. Blood thinners are paused on instruction.
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The operation and the stay
Under general anaesthesia, one to two hours. Most patients stay two to three nights. A contrast study is done on day one or two if there is any concern about the staple line, and fluids start the same day.
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The first six weeks
Liquids for one to two weeks, purée for two weeks, soft food for two, then normal textures. Small portions, eaten slowly, with protein first and fluids kept apart from meals. Desk work is usually possible after two to three weeks.
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The long term
Vitamin B12, iron, folate, vitamin D and calcium for life, with blood tests at three, six and twelve months and then yearly. Follow-up continues when the weight stops moving — that is when deficiencies and regain appear.
What can go wrong
A sleeve is a permanent change to a healthy organ. These are the complications patients are actually warned about, and they are the reason the operation is done in a hospital with bariatric cover.
- Leak from the staple line in roughly 1–3% of patients, usually between day 3 and day 10; it needs drainage, sometimes a stent, occasionally further surgery
- Bleeding from the staple line or the spleen, which may require transfusion and, rarely, reoperation
- Narrowing or twisting of the tube, causing repeated vomiting and difficulty swallowing, treated by endoscopic dilatation
- New or worse acid reflux — one of the most common complaints after a sleeve, and a reason some patients are steered towards a bypass instead
- Long-term deficiency of B12, iron, folate, vitamin D and calcium if supplements and monitoring lapse
Weight regain happens, most often from year three onward, when portions creep back and follow-up stops. Surgery is a tool, not a cure: it buys a window in which eating patterns can be rebuilt, and the window closes if nothing is rebuilt inside it.
Questions patients ask
How much weight will I lose?
Typically around 25–30% of total body weight over the first one to two years, though the range between patients is wide and depends on starting weight, adherence and follow-up. Nobody can promise a figure before the assessment.
Will I need supplements for life?
In most cases, yes — vitamin B12, iron, folate, vitamin D and calcium, with blood tests to adjust them. The stomach that is removed produces intrinsic factor and acid, so absorption changes permanently.
Can it be undone?
The stomach is not restored to its original shape. If a sleeve fails — severe reflux, poor weight loss, weight regain — the usual next step is conversion to a gastric bypass, which is a larger operation.
What about pregnancy afterwards?
Pregnancy is possible, but most surgeons advise waiting 12–18 months so that weight has stabilised and nutritional status is stable. Supplements and monitoring continue through the pregnancy.
Send your height, weight and medical history
A bariatric surgeon reviews them and a coordinator comes back with whether an assessment is sensible, what tests would be needed first, and a written quote — no obligation to book.
General information, not medical advice. Suitability can only be judged after a full assessment by a bariatric surgeon, including psychological and nutritional review; results and risks vary between patients.
