Gastric Sleeve Recovery: What To Expect After LSG and ESG?

gastric sleeve recovery

Are you considering gastric sleeve surgery? As with any surgery, gastric sleeve recovery is unique for each patient. It is important to understand not only the requirements for surgery but also what is going to happen after surgery and during the recovery process. To ensure your recovery goes as smoothly as possible it is always good to plan and be prepared.

What Is Gastric Sleeve Surgery?

Gastric sleeve surgery is a procedure that permanently removes approximately 80% of a patient’s stomach to help the patient lose a significant amount of weight. It is normally performed on an individual with a BMI of over 40 or someone with a slightly lower BMI who has several health problems related to their weight.

Gastric sleeve surgery can be performed laparoscopically – laparoscopic gastric sleeve or LSG – through several small incisions made in the patient’s abdomen. It is performed under general anesthesia in a hospital and requires a hospital stay of 1-3 days. The procedure works by reducing the stomach size, limiting the number of calories being consumed as well as creating the feeling of being “full” so the patient does not feel as hungry. LGS is the most popular of the bariatric weight-loss surgeries and is considered the least invasive.

Preparing For Recovery From Gastric Sleeve Surgery

It is important to prepare not only yourself but your surroundings for the day you come home from the hospital after surgery. Even the simple things that you take for granted may be impossible for you to do when you first return home from your surgery. Things like going to the grocery store, taking the dog out for a walk, climbing up and down the stairs, or caring for your children.

You will need someone to drive you home from the hospital as you will not be able to drive for about two weeks until you are off your pain medications, and your incisions have started healing. This means, if you have surgery on Friday, you are not going to be driving the kids to carpool Monday morning or taking your big dog out for a walk (you know the one who usually “walks” you)!

You are going to need some help for at least the first week. Being well prepared will allow you to rest and recover faster.

To-Do List Before Your Gastric Sleeve Surgery:

1. Prepare to take off of work for 2-4 weeks.
2. Join support groups that your surgeon recommends and start engaging with them.
3. If you have a family member or friend that will be your support system throughout your weight loss journey, have them accompany you to some of the appointments so they know how to best support you. If they have not personally been through weight loss surgery, they will not understand what you are going through at all. They will be able to better support you if they have an understanding of not only the physical changes that you are going through but also the mental and emotional changes.
4. Arrange for help with children and pets for at least 2 weeks.
5. Arrange for someone to stay with you 24/7 for at least a week.
6. Stock up the pantry & fridge with groceries for your family as well as clear liquid choices for yourself, and approved choices from the list the surgeon provides to you (you will not be able to eat solids for about a month).
7. Fill any necessary prescriptions and replenish any personal care items that you need daily.
8. If you have stairs in your home, speak to the surgeon regarding your use after surgery. You may need to prepare an alternate plan for a few days if your bedroom is upstairs.
9. Set up your home to make it easier for you to navigate around while you are recovering.
10. Often surgeons will provide a “pre-surgery” diet plan so if this is the case for you, make sure you strictly follow it as it will help your surgery go smoother as well as your recovery.

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Gastric Sleeve Recovery Timeline

Day 1 – Surgery Day

After surgery, you’ll spend a few hours in the recovery room with an IV in your arm. Pain is normally moderate on this first day but well controlled through the IV medication. There will be several small incisions on your abdomen that have been closed with stitches and covered.

Some patients experience nausea caused by the anesthesia used during the surgery but this normally dissipates within the first few hours. Your throat may be sore and feel scratchy from the breathing tube that was necessary during surgery.

You will not be allowed to drink anything until the next day but some surgeons allow patients to have ice chips.

After being in the recovery room for a few hours, your surgeon may want you to get up a walk a little bit. This is not easy for most people but is necessary to prevent future complications. You will be transferred from the recovery room to a hospital room to spend the night.

Day 2 – The Day After Surgery

You may feel very thirsty but they will not let you drink anything until you have had a swallow test which will be administered by a radiologist. This normally happens first thing in the morning and is performed to ensure there are not any leaks in your stomach before you are allowed to drink water.

After you pass your swallow test, you will be allowed to drink liquids such as water, clear broth, unsweetened juice, and possibly others depending on what your surgeon allows. It is important that you drink so you do not get dehydrated but you will be instructed to take it slow (you will not be allowed to drink anything carbonated or caffeinated). The most common reason patients have to be readmitted to the hospital after bariatric surgery is due to dehydration so make sure you stay hydrated.

Your pain level may be more noticeable today because your anesthesia from the procedure has worn off. The pain medication in your IV is still working but you are moving more and most likely feeling more discomfort.

Today you may be switched from IV administered medication to oral pain medication which takes a bit longer to kick in so ask for your medication before your pain level gets unbearable.

At some point today, your doctor will give you a complete check-up and remove your catheter if it is still in place. The surgeon ensures you can stand up and walk around a bit, and your vitals all look normal. Some patients are discharged a few hours after this check-up, and some stay in the hospital another day or two.

When you are discharged you will be provided with care instructions for your incisions and prescriptions for pain medication. Some surgeons will provide these prescriptions before the surgery so you can fill them and have them already at home.

Week 1 – Recovering At Home

For most people who have had gastric sleeve surgery, the pain after returning home is uncomfortable but bearable. Patients have reported that days 3 to 6 seem to be the most uncomfortable and this is attributed to the patient’s increased activity level and movements.

The pain will most likely be localized to the incision sites with the concentration at the site of the largest incision. If you are experiencing pain that is unbearable or seems out of the range listed on the discharge paperwork, are vomiting, have a fever or develop new pain along your shoulders or back, contact the surgeon right away.

  • Remember to keep drinking your liquids and staying hydrated. You may not feel hungry at all but it is important that you drink.
  • If you have special health concerns, make sure you are keeping up with medication that you take or check sugar levels, etc.
  • You may feel exhausted this week not only because you have had major surgery but because your body is used to eating considerably more calories, and much of your energy has been redirected to the areas needing healing during your gastric sleeve recovery.
  • Keep your activity limited to what is recommended by the surgeon. You do not want to overdo it and lengthen the time of your recovery or pull a stable loose from your surgery.
  • Take this much-needed rest time to binge-watch movies or read that book that you have been wanting to read. Call and chat with someone you need to catch up with. Try to keep your mind busy while letting your body rest.
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Weeks 2-4

From the beginning of the second week through the end of the 4th week you will become more and more active and continue to follow the diet your surgeon recommends during this time frame.

You may be feeling better and be tempted but, sticking to this diet is very important so you do not damage the staple line holding your stomach together. Deviating from your approved diet could cause leaks, which can be life-threatening or result in emergency surgery.

You will be taking short walks about 5 times a day but working out, lifting weights or any other type of exercise is off-limits until cleared by the surgeon.

Some patients return to work after the first week, while others are still too tired to perform their jobs. Keep the dialogue open with your surgeon about the best time for you to return to work. Remember that your body is recovering from major surgery and adjusting to its new food regime.

During this time, your surgeon should clear you for driving, which will probably be a welcome relief, although you may experience twinges of pain while getting in and out of your car. Most of your pain should be tolerable, without the need for prescription medication. You should not drive if you are taking anything stronger than over-the-counter medication.

Months 2 and 3 of Gastric Sleeve Recovery

  • You should be feeling pretty good by now and be encouraged by the fair amount of weight you’ve already lost.
  • Your energy levels should be elevating and you may feel like you have more than you did before surgery.
  • You should not be experiencing any pain from the surgery at this point so if you are, you need to contact your surgeon.
  • Many people also experience mood swings during this period of time which is completely normal. This is when you will really need to utilize your support systems and why they are so important.

By this point, your diet plan most likely includes soft solid food choices, which most patients appreciate. Baby food and pureed dinners get old really fast. But you have made it to this point and should feel proud!

Your surgeon may approve an increase in your activity level that includes swimming and low-impact aerobic exercise. Check to see if there is an indoor pool in your vicinity that offers water aerobics as it is an excellent option for cardio and easy on the body.

After 3-6 Months

Most patients are delighted that they have had gastric sleeve surgery by this point and have lost a considerable amount of weight. It is time to buy a few new outfits and show off all that hard work!

You have just gone through several major lifestyle changes and it is very important to consistently keep up with your support services. What you have done and continue to do is hard but the benefits you gain are worth it.

Many of the health-related issues that patients experience have been alleviated significantly or are gone.

Your diet is a bit more diverse with the addition of solid foods and you have more energy.

The surgeon has probably approved a more advanced exercise routine with longer walks and more cardio. Normally, surgeons recommend patients wait about six months before adding a weight training element to their exercise routine.

Patient's photo via few months after gastric sleeve

Is There a Weight Loss Procedure That Doesn’t Require Such A Long Recovery?

Yes, there is a fairly new procedure that is gaining in popularity called ESG or endoscopic sleeve gastroplasty. It is a non-surgical procedure that uses sutures to close up about 70% of the stomach, making it smaller, much like laparoscopic gastric sleeve surgery.

The entire ESG procedure is done internally, there are no incisions, and no part of the stomach is removed. The procedure makes the stomach smaller so fewer calories can be consumed in one sitting. Much like gastric sleeve surgery, this is a tool to help individuals control their portions and feeling of hunger to help them lose weight and become healthier.

The procedure does not take as long as gastric sleeve surgery so the patient is not under anesthesia for quite as long. Also, because there are no incisions involved, the risks associated with ESG are less than 1%. The endoscopic gastric sleeve (ESG) recovery time is much shorter with less pain and fewer restrictions.

Real Surgery Video: ESG Endoscopic Sleeve Gastroplasty at IBI Healthcare Institute

Typical Recovery Timeline For ESG

Day 1 – Procedure Day

After the ESG procedure is complete, patients will spend about 3 hours in the recovery room where they will be closely monitored as they are waking up from general anesthesia.

When the patient is able, a nurse will assist the patient to begin walking around the room and down the hallways to avoid blood clots. The patient will also be allowed to drink sugar-free and non-carbonated, low-fat, clear liquids.

During endoscopic gastric sleeve recovery, some patients may experience post-procedure nausea due to general anesthesia.

Once the patient can walk around and drink without any problems, the patient will be discharged and released to a caregiver. Similar to after gastric sleeve surgery, the patient will not be able to drive themselves home on the day of surgery but unlike gastric sleeve surgery patients, who cannot drive for at least 2 weeks, ESG patients only have to wait 24 hours to drive.

Week 1 – Recovering From ESG At Home

It is important to work with your surgeon regarding any medications you were taking before the ESG procedure. Necessary medications should be continued at normal intervals after the procedure.

Patients will not be able to swallow pills or capsules this first week, so tablets should be crushed and capsules opened up and taken with water. The surgeon will provide instructions for specific medications, such as medications for the treatment of cholesterol, diabetes, and high blood pressure, etc.

  • Most likely have a follow-up appointment this week so your surgeon can check on your progress.
  • Patients must still adhere to the pre-approved clear liquid diet.
  • Patients are encouraged to go about their daily routine, such as going up and down the stairs, showering, etc. Moving around and getting light exercise are encouraged.
  • There are no lifting or activity restrictions after ESG, and patients are encouraged to exercise and become active as soon as possible.
  • Patients may drive as long as they are not taking narcotic pain medications.
  • Patients may return to work as soon as they feel comfortable enough to do so.

The first week following the procedure the patient will be on a clear liquid, no sugar diet, and must not attempt to eat soft or solid foods yet to ensure that your sutures are not broken down and have time to stabilize. Carbonated beverages must be avoided for at least one month.

Week 2

  • Medications can all be taken according to doctors’ orders in tablet or capsule form.
  • Bariatric procedures often reduce the body’s ability to absorb vitamins and nutrients, so patients should begin taking a multivitamin that contains folic acid after the first week and continue them for a while. Consult your doctor.
  • Most individuals are back to their normal routine at work and home by this point.
  • Soft foods, low-sugar, and low-fat foods are introduced in week two and continue for the next three weeks. To compare, gastric sleeve surgery patients are still on a liquid diet at this stage. It is critical that you do not overeat after ESG as you may compromise the suture line and reverse the procedure.

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IBI Healthcare Institute provides an unmatched patient experience and outstanding results. You matter to us.

Week 3 And Beyond

Patients are encouraged to increase their exercise and activity as their energy levels elevate. It is very important to follow the ongoing dietary restrictions as you add different foods to your diet according to the plan. It is suggested that you measure out meal portions prior to eating to ensure you do not overeat and stretch your sutures or stomach.

Welcome to a Healthier and Happier Future

Whether you choose gastric sleeve surgery or non-surgical ESG, the surgical team has done their part and has provided a tool to help you lose weight and keep it off. You have worked hard to get here but you must persevere the result and stick to your diet and exercise plan as these are the keys to your new lifestyle.

The patients who have the most remarkable success are the ones who understand that a successful outcome is operator-dependent and they use their new “tool” correctly. Neither laparoscopic sleeve gastroplasty nor endoscopic sleeve gastroplasty is a quick fix. Both require complete lifestyle changes and will take steadfast dedication and determination.

If you are ready to make the commitment to yourself and your health, we are here to support you all the way, before and after the procedure. To learn more about weight loss and the solution that is best for you, contact IBI Healthcare Institute for a personal consultation.

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