How is gastric sleeve surgery performed?

Gastric sleeve surgery is performed laparoscopically under general anaesthetic. Several small incisions are made in the abdomen, and approximately 75 to 80 percent of the stomach is removed using a surgical stapling device to create a smaller sleeve-shaped stomach.

Will I be asleep during gastric sleeve surgery?

Yes. Patients receive general anaesthesia before the procedure begins and remain asleep throughout the operation. Breathing, heart rate, blood pressure, and oxygen levels are continuously monitored by the surgical team.

How much of the stomach is removed during gastric sleeve surgery?

Approximately 75 to 80 per cent of the stomach is removed during gastric sleeve surgery. The remaining stomach forms a narrow sleeve-shaped tube that holds significantly less food than the original stomach.

Is gastric sleeve surgery performed using keyhole surgery?

Yes. Most gastric sleeve procedures are performed laparoscopically using minimally invasive keyhole techniques. This approach involves several small incisions rather than a single large opening.

How many incisions are made during surgery?

Laparoscopic gastric sleeve surgery typically requires 5 small incisions in the abdomen to accommodate the surgical instruments. The exact number varies and is determined by the surgical approach used.

What happens immediately after surgery?

After the procedure is completed, patients are transferred to the recovery room where they are monitored until they wake from the anaesthetic. Pain management, early mobilisation where appropriate, and nursing care are provided during the hospital stay. Patients are typically discharged after a few days, depending on their recovery.

How does Mr. Niruben Rajasagaram perform gastric sleeve surgery?

Mr. Niruben Rajasagaram performs a comprehensive pre-operative assessment for every patient before proceeding with surgery. He follows established laparoscopic techniques, prioritises patient safety at every stage of the procedure, and provides structured follow-up care throughout the recovery period.

Gastric Sleeve Surgery Procedure

What Happens During Gastric Sleeve Surgery

Gastric sleeve surgery is a commonly performed bariatric procedure carried out using minimally invasive laparoscopic techniques. Understanding each stage of the operation can help patients feel more informed and prepared before making a decision about their treatment.

Mr. Niruben Rajasagaram is a Consultant Bariatric, Upper Gastrointestinal, and General Surgeon with over 14 years of surgical experience, including a four-year fellowship in bariatric and upper gastrointestinal surgery. He consults at clinics in Wantirna, Frankston, and Berwick.

During gastric sleeve surgery:

The procedure is performed under general anaesthetic.
Surgery is usually carried out laparoscopically, using small keyhole incisions.
Approximately 80 per cent of the stomach is removed to create a smaller, sleeve-shaped stomach.
The digestive system continues to function normally following the procedure.
The operation is designed to help patients eat smaller portions and support long-term weight loss.
Patient safety is monitored by the surgical team throughout every stage of the procedure.

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Step-by-Step Gastric Sleeve Surgery Procedure

Diet after gastric sleeve surgery generally moves through several stages, allowing your stomach to adjust gradually to different food textures. The table below outlines the general stages most patients move through during recovery.

Step	Description
Gastroscopy	This is a camera that goes down your mouth while you're asleep to assess your stomach, anti-reflux mechanism and the presence of a hiatal hernia. This is done at the same time as your operation.
Hospital Admission	Arrival at the hospital, completion of paperwork, and preparation for surgery
Pre-operative Assessment	Final health and safety checks completed by the surgical team before the operation
General Anaesthesia	The patient is safely put to sleep by the anaesthetist before surgery begins
Small Keyhole Incisions	Several small incisions are made in the abdomen to allow laparoscopic instruments to be inserted
Creating the Gastric Sleeve	Approximately 75 to 80 percent of the stomach is removed using a surgical stapling device, leaving a smaller sleeve-shaped stomach
Final Check	The newly created stomach is checked to confirm the staple line is secure before completing the operation
Closing the Incisions	The small incisions are carefully closed using sutures or surgical glue
Recovery Room	The patient is transferred to the recovery room and monitored until they wake from the anaesthetic

Why Is Gastric Sleeve Surgery Performed Laparoscopically

Most gastric sleeve procedures are performed using laparoscopic (keyhole) surgery. This minimally invasive approach is preferred over open surgery for a number of reasons.

Here are the reasons why it is performed laparoscopically:

Smaller Incisions

Laparoscopic surgery uses several small incisions rather than one large opening. This reduces the impact on surrounding tissue and generally supports a more comfortable recovery. In addition to this, he has not seen any additional benefit to consider doing this robotically; hence why Mr.Niruben continues to do this laparoscopically as a continued gold standard for this operation.

Reduced Pain

Many patients experience less post-operative discomfort following laparoscopic surgery compared with open surgery. This varies between individuals and depends on a range of factors.

Faster Recovery

Smaller incisions and reduced tissue disruption often support a quicker recovery compared with traditional open surgery, though recovery timelines vary between patients.

Lower Risk of Wound Complications

Minimally invasive surgery may reduce the risk of certain wound-related complications, including infection and hernia formation at the incision site.

Shorter Hospital Stay

Most patients undergoing laparoscopic gastric sleeve surgery return home within a few days of their procedure, depending on their individual recovery progress.

Earlier Return to Daily Activities

Many patients are able to resume light daily activities sooner after laparoscopic surgery than after open surgery. Recovery timelines vary and are guided by Mr Niruben Rajasagaram and the care team.

General Anaesthesia

Gastroscopy

Keyhole Surgery

Continuous Monitoring

Surgical Stapling Device

Final Check

Patient Safety Checks

Experienced Surgical Team

Sterile Operating Environment

Recovery Room Monitoring

Every Step Is Planned with Patient Safety in Mind

Throughout the gastric sleeve procedure, patient safety is the central priority. Once the patient is under general anaesthesia, they remain asleep for the duration of the operation.

The surgical team continuously monitors the patient's breathing, heart rate, blood pressure, and oxygen levels throughout the procedure. The stomach is carefully divided and shaped using a specialised surgical stapling device, and the staple line is tested for any leaks before the operation is concluded. Every stage of the procedure follows established safety protocols designed to minimise risk and support a safe outcome.

Mr. Niruben Rajasagaram reviews each patient's health history and surgical risk profile before proceeding, ensuring the approach is appropriate for their individual circumstances.

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How Long Does Gastric Sleeve Surgery Take?

The gastric sleeve operation itself typically takes approximately one to two hours, depending on the individual case. This does not include the time required for pre-operative preparation, anaesthetic induction, or post-operative monitoring in the recovery room.

Additional time in hospital is required before and after the procedure for preparation, observations, and early recovery. The total length of the hospital stay depends on the patient's recovery progress and is usually a few days for a straightforward laparoscopic procedure.

Previous abdominal surgery, complex medical conditions, or other individual factors may influence the overall operating time. Mr Niruben Rajasagaram and the surgical team will explain what patients can expect during their pre-operative appointments.

Have Questions About the Gastric Sleeve Surgery Procedure?

Understanding each stage of surgery can help patients feel more prepared and confident before making a decision. Mr. Niruben Rajasagaram provides personalised advice based on each patient's health history, surgical risk profile, and treatment goals.

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How to Prepare for Gastric Sleeve Surgery

Preparing for gastric sleeve surgery is an important part of supporting a safe procedure and smooth recovery. Mr Niruben Rajasagaram and the care team will provide specific instructions based on your individual needs.

Follow Pre-Operative Instructions

Follow the prescribed pre-operative diet, fasting requirements and all written instructions provided by the surgical team.

Attend Required Appointments

Attend all pre-admission appointments, pre-operative assessments and other consultations scheduled before your surgery.

Review Medications & Smoking

Discuss all current medications with Mr Niruben Rajasagaram and stop smoking or vaping.

Plan Your Hospital Stay

Pack appropriately for your hospital stay and arrange for someone to transport you home after discharge.

Understand Your Recovery Plan

Become familiar with your expected recovery, including dietary stages, activity guidance and follow-up appointments.

Ask Questions Before Surgery

Raise any questions or concerns with Mr Niruben Rajasagaram and the care team so you understand the procedure and what to expect.

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Frequently Asked Questions About the Gastric Sleeve Surgery Procedure

How is gastric sleeve surgery performed?

Gastric sleeve surgery is performed laparoscopically under general anaesthetic. Several small incisions are made in the abdomen, and approximately 75 to 80 percent of the stomach is removed using a surgical stapling device to create a smaller sleeve-shaped stomach.
How long does gastric sleeve surgery take?

The operation itself generally takes approximately one to two hours, though this varies between patients. Additional time in hospital is required for pre-operative preparation, anaesthesia, and post-operative monitoring.
Will I be asleep during gastric sleeve surgery?

Yes. Patients receive general anaesthesia before the procedure begins and remain asleep throughout the operation. Breathing, heart rate, blood pressure, and oxygen levels are continuously monitored by the surgical team.
How much of the stomach is removed during gastric sleeve surgery?

Approximately 75 to 80 per cent of the stomach is removed during gastric sleeve surgery. The remaining stomach forms a narrow sleeve-shaped tube that holds significantly less food than the original stomach.
Is gastric sleeve surgery performed using keyhole surgery?

Yes. Most gastric sleeve procedures are performed laparoscopically using minimally invasive keyhole techniques. This approach involves several small incisions rather than a single large opening.
How many incisions are made during surgery?

Laparoscopic gastric sleeve surgery typically requires 5 small incisions in the abdomen to accommodate the surgical instruments. The exact number varies and is determined by the surgical approach used.
What happens immediately after surgery?

After the procedure is completed, patients are transferred to the recovery room where they are monitored until they wake from the anaesthetic. Pain management, early mobilisation where appropriate, and nursing care are provided during the hospital stay. Patients are typically discharged after a few days, depending on their recovery.
How does Mr Niruben Rajasagaram perform gastric sleeve surgery?

Mr. Niruben Rajasagaram performs a comprehensive pre-operative assessment for every patient before proceeding with surgery. He follows established laparoscopic techniques, prioritises patient safety at every stage of the procedure, and provides structured follow-up care throughout the recovery period.