Gastric sleeve surgery day and the hospital stay

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Gastric sleeve surgery day and the hospital stay

On the day of a gastric sleeve you generally arrive at the hospital with an empty stomach, meet the anesthesia and nursing teams, and have the operation under general anesthesia, usually through small incisions. Afterward you wake in a recovery area, and walking and sips of clear liquid usually begin within hours. People generally go home once they can drink enough and their pain and nausea are controlled.

The night before and the morning

Follow the instructions you are given on when to stop eating and drinking, even if they differ from what you read here. If you are unsure of them, ask before the day. As background, the 2021 Enhanced Recovery After Surgery (ERAS) Society guideline for bariatric surgery supports solid food until six hours and clear liquids until two hours before anesthesia in people without a reason for stricter rules. Hospitals and anesthesiologists may set their own limits.

Take only the medicines you were told to take that morning. If you use a GLP-1 medication such as Wegovy, Zepbound, Ozempic or Mounjaro, follow the specific instruction you were given about it and mention it again at check-in. Leave jewelry at home, wear loose clothing, and bring your photo ID, insurance card, medication list, and CPAP machine if you use one for sleep apnea. The ERAS guideline says people on home CPAP should use their equipment in the period right after surgery.

At the hospital: before and during the operation

Before

The sleeve is done at a hospital where Dr. David G. Davtyan, MD, FACS, FICS, FASMBS, has surgical privileges. Ask the office which hospital, and what time to arrive. After check-in, a nurse typically confirms your details, starts an intravenous line, and checks your vital signs. An anesthesiologist reviews your history and explains the anesthetic. If you have last questions for your surgeon, ask how to raise them before you go to the operating room.

The operation

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says weight-loss surgery is mostly done laparoscopically, meaning through small cuts with a camera and long instruments, under general anesthesia. In a sleeve, the NIDDK explains, the surgeon removes about 80 percent of the stomach and closes the remaining banana-shaped section with staples. Because part of the stomach is removed, a sleeve cannot be reversed.

The ERAS guideline advises against routine use of tubes through the nose into the stomach and of abdominal drains. Ask your surgeon whether you should expect either one. Our page on how gastric sleeve surgery works describes the procedure in more detail.

Waking up and the first hours

You generally wake in a recovery area with nurses watching your breathing, heart rate and comfort. Several things usually happen early, each for a reason:

Nausea control. Nausea is common after a sleeve. The ERAS guideline recommends a combined approach to preventing nausea and vomiting for every patient.
Pain control. The same guideline recommends combining medicines, including local anesthetics, so that less opioid is needed. An ache in the shoulder from the gas used during laparoscopy can happen. Report any chest pain to your nurse.
Walking. The American Society for Metabolic and Bariatric Surgery (ASMBS) tells patients to expect easy, short walks while still in the hospital.
Blood clot prevention. The ERAS guideline recommends both mechanical measures, such as compression sleeves on the legs, and a blood-thinning medicine, with dose and duration set for the individual.
Sips of liquid. According to the ERAS guideline, clear liquids can usually begin several hours after surgery.

How long people stay

Ask your surgeon what to expect for your own stay, which can depend on your health, how the first hours go, and the hospital. National figures give a sense of the range. In an analysis of 702,622 sleeve operations recorded from 2015 to 2021 in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), a national quality registry, 58.3 percent of patients went home on the first day after surgery and 4.46 percent went home the same day. The same analysis found that same-day discharge carried higher odds of complications, readmission and reoperation than going home the next day.

Common conditions for going home are that you can drink enough to stay hydrated, your pain and nausea are manageable with medicines by mouth, you are walking, and your vital signs are steady.

Going home

Plan for an adult to drive you. Before you leave, make sure you understand your instructions on liquids and the diet stages, your medicines and which old ones to stop or change, wound care, activity, and your first follow-up appointment. Ask if anything is missing. Our week-by-week recovery timeline and the page on nausea, dehydration and constipation cover the days that follow, and returning to work and driving covers activity.

When to call after you are home

Call the office

You are drinking less than you were told to and cannot catch up.
Nausea is not controlled by the medicine you were given.
An incision is red, swollen, or draining.
You have a low fever or pain that is slowly getting worse.

If you cannot reach anyone and you are getting worse, go to the nearest emergency room.

Go to an emergency room or call 911

You cannot keep any liquids down.
You vomit blood or pass black stools.
You have severe chest or abdominal pain.
You have a fever with a fast heart rate or shortness of breath.
One calf is painful or swollen.

Do not wait for an appointment with these symptoms. Tell the emergency staff the date of your sleeve. Our page on emergency warning signs after a sleeve explains what each can mean.

Frequently asked questions

How common are serious problems in the first 30 days after a sleeve?

In a study of the 2015 MBSAQIP registry covering 93,062 sleeve patients, death within 30 days occurred in 0.1 percent, a staple-line leak in 0.8 percent, and a complication classed as morbidity in 5.8 percent. Your own risk depends on your health; the study found BMI, blood albumin and age mattered most. See sleeve risks.

Will I be in a lot of pain when I wake up?

It differs from person to person. Soreness at the incisions and a feeling of pressure or bloating are common, and some people have an ache in the shoulder from the gas used during surgery. Pain is usually treated with a combination of medicines, and doses can be adjusted. Tell the nurse early if it is not controlled.

What should I pack for the hospital?

Keep it light: ID and insurance card, your medication list, your CPAP machine if you use one, loose clothes with a soft waistband for the ride home, slip-on shoes, lip balm, a phone charger, and glasses or hearing aids. Leave valuables at home. If the hospital gives you its own list, follow that one.

Can a family member stay with me?

Visiting and overnight rules are set by the hospital, and they can change. When you ask the office which hospital you will be going to, also ask how to find its current visitor policy. Whatever the rule, make sure one adult is reachable by phone during the operation and is available to drive you home.

Talk with Dr. Davtyan in Rancho Cucamonga

If you want to go through the day step by step, book a consultation; the first one is complimentary. Davtyan Medical Weight Loss & Wellness is at 8330 Red Oak Street, Suite 201, Rancho Cucamonga, CA 91730. Call 909-355-2525 or 877-9-BE-SLIM (877-923-7546), use the contact page, or return to the Rancho Cucamonga gastric sleeve guide.

Gastric sleeve surgery day and the hospital stay

Gastric sleeve surgery day and the hospital stay

The night before and the morning

At the hospital: before and during the operation

Before

The operation

Waking up and the first hours

How long people stay

Going home

When to call after you are home

Call the office

Go to an emergency room or call 911

Frequently asked questions

How common are serious problems in the first 30 days after a sleeve?

Will I be in a lot of pain when I wake up?

What should I pack for the hospital?

Can a family member stay with me?

Talk with Dr. Davtyan in Rancho Cucamonga

Sources

More in the Gastric Sleeve in Rancho Cucamonga guide

Understanding the sleeve

Weighing your options

Getting care in Rancho Cucamonga

Adult BMI Calculator

Beverly Hills

Glendale

Rancho Cucamonga

South Coast Lap-Band

Marina Del Rey Hospital

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