Our experienced and integrated, multidisciplinary team provides a holistic approach to gastric sleeve surgery.

Topic: Gastric sleeve Canberra

Our doctors provide medical care and perform interventions or surgery. Our psychologist ensures you are mentally prepared for the ensuing changes before surgery. Our dietitians will prepare a personalised program so you feel empowered to manage your transition to your new eating habits after surgery.

Quick facts about gastric sleeve

A sleeve gastrectomy or gastric sleeve is a surgical weight loss procedure during which most of the stomach is removed (up to 80%).
In order to be eligible for gastric sleeve surgery, you need to have a BMI higher than 35, or a BMI higher than 30 with associated metabolic conditions.
After your surgery, you will be guided to follow a diet over 6 weeks before you can eat solids again.
Smaller and more frequent meals, with a focus on sipping fluids between meals will be an essential habit to cultivate for safe and enduring weight loss. 3 months after surgery, you may have lost about 20 to 30% of your excess weight, and about 70 to 80% after a year.

Weight loss surgery is far from the easy way out. Capital Metabolic Clinic is your ideal support network, as our doctors, dietitians and psychologist collaborate to make sure you are ready for this big change in your life.

Ready for change?

Contact our friendly team at
(02) 6210 1070

Why is gastric sleeve surgery so effective?

There are two things that you can expect to happen after having had a sleeve gastrectomy:

You will not be able to eat large portions. 6 weeks after surgery, you will start eating solids again, but the surgery restricts the portion sizes you can eat.
Your metabolic hormones will experience a change in regulation. Complex hormonal signaling will allow permissive weight loss without hunger for a period of 18 months.

Many of our patients find that after years of weight loss struggles, sometimes even decades, this is the first time they are able to lose a significant amount of weight and keep it off long-term

How much excess weight will I have lost 3 and 6 months after surgery?

At 3 months most patients have lost about 20-30% of their excess weight, and at 6 months the loss in excess weight generally ranges between 40 and 50%. There is a steep weight loss phase in the first 6 months.

Am I a candidate?

When you have a BMI of >30 with a medical illness related to excess weight, you are a candidate for gastric sleeve surgery. If your BMI is higher than 35 even without a related medical condition, you are also a candidate for gastric sleeve surgery.

Medical conditions linked to obesity typically include:

High blood pressure
High cholesterol
Type 2 diabetes
Sleep apnoea
Asthma
Arthritis
Soft tissue infections

For your own safety, our team will screen you for any potential barriers or contraindications for surgery. In other words, we will screen to see if weight loss surgery may not be safe for you.

Contraindications include:

Patients who are not committed to multi-disciplinary care and follow-up
Patients with unresolved eating disorders or unstable psychological conditions
Patients who are current smokers or recreational drug users
Patients who have uncontrolled medical conditions.

If there is a contraindication, we will give you the opportunity for further treatment and assessment before a final decision is made. Other medical, endoscopic and surgical options will also be available to patients.

We believe in optimising your health before surgery. We strongly believe that this will lead to better outcomes.

I am eligible from a BMI perspective. What’s next?

First, you will be assessed by the surgeon. Then you will meet the bariatrician, the psychologist and the dietitian.

Members of the team need to give a green light for surgery. This ensures that patients are prepared for major surgery, and are ready to reap the rewards

This is a safety mechanism we put in place for your own safety. If you are mentally not ready for sleeve surgery, you will not get the best outcomes, which makes the risks of surgery outweigh the benefits. This multidisciplinary, holistic approach is pivotal for your health, both before and after your weight loss surgery.

Once you have been consented and surgery is booked, our dietitians will guide you through a Very Low Energy Diet, abbreviated as VLED. It is a pre-operative diet based on calorie restriction that will reduce the fat content of the liver, making it less prone to injury during a sleeve gastrectomy. It often includes products such as soups, shakes and protein bars. Everyone is different, and our dietitians will ensure you are getting an individualised amount of protein and calories before surgery.

How long does the pre-operative diet take?

You start your VLED diet two to three weeks before your surgery. Our dietitians are very experienced in supporting patients through this challenging time and will work with you to make it feasible.

How can I best prepare for my gastric sleeve surgery?

Being active is associated with more weight loss, which can be as simple as walking 20 to 30 minutes every day.

If you have arthritis, you can participate in hydrotherapy or hydro-based exercises with our exercise physiologists.
If you are already living an active lifestyle, you can add a variety of strength training exercises to your activities which can increase the strength of your bones and protect against osteoporosis.
You may find it helpful to get some tools to measure fluids and meals, to help you adhere to your diet. Examples of this are measuring cups and spoons, water bottles (we recommend Hidrate, which comes with a Bluetooth connection and app), crockery that is partitioned or colour-coded, for ease of preparation, bariatric cookbooks for recipes, and inspiration. A diary may be useful to keep track of your food intake.

Ongoing support: before, during and after surgery

Whenever you meet other people who have had a sleeve gastrectomy, they will tell you it’s a weight loss journey. Your lifestyle habits will change dramatically and you will be keen to talk to people who understand the journey you are on.

Capital Metabolic Clinic strives to provide the latest in evidence based surgery with our enhanced recovery after surgery program. ERAS reduces complications and empowers patients with knowledge of their surgical journey.

Enhanced recovery after surgery (ERAS) is a standardised, multimodal, perioperative protocol of medications and post-operative instructions to help you recover from major surgery as quickly as possible.

The enhanced recovery after bariatric surgery protocol is published and vetted by other health professionals who are part of the ERAS society. You will receive handouts, scripts to participate in this protocol, and be able to attend education sessions, which are continued in the hospital when you are admitted for surgery.

How is the surgery performed?

Before we explain the surgery, let’s quickly cover what happens in the week you are scheduled for your procedure. You will receive a phone call from the hospital to do a pre-admission check. In the days leading up to surgery, you will visit the pharmacy to collect your ERAS pack to help you prepare for surgery. In this pack, there are medications and preventative strategies to reduce complications and improve postoperative recovery.

On the day of surgery, you will have taken your medications and check in. The pre-admission nurse will check that documentation, fasting status, health history and allergy status are up to date.

When the allocated time for surgery approaches, you will be transferred to the holding bay of the theatre assigned. The anaesthetic nurse will perform a standard list of checks before the anaesthetist arrives to reassess readiness and prepare you for surgery.

Once the theatre staff are ready, you will be given a full anaesthetic. Once you are asleep, the bariatric surgeon will make 5 small incisions to allow for laparoscopic or keyhole surgery. Once the surgery is completed, the wounds are closed, the abdomen is cleaned and dressings are applied. The anaesthetist administers medications for when you wake up in the recovery bay.

Recovery nurses are very experienced in providing appropriate medication and ensuring a safe recovery from anaesthesia. You are then transferred to a high dependency unit for ongoing care prior to discharge.

Most of our primary or first-time sleeve gastrectomy patients leave the hospital within 24 hours. In patients with other medical conditions, chronic pain conditions, blood thinners, revision surgery or complex surgery, a longer stay may be indicated.

Do’s and don’ts after surgery?

You can drive your car once you are pain-free, off all pain medication and able to take evasive action when driving, in other words, fit to drive.
The dressings are made of waterproof glue and you can take a shower immediately. In the first 6 weeks, you will not be taking any baths.
Low impact exercise, like walking, is allowed from weeks 2-4. Higher impact activities can commence after week 6.
Swimming may start from week 6 and our exercise physiologists conduct weekly aqua classes for when you reach that stage.
Physical activity is very important for health, maintenance of weight loss, bone health and mental well-being.
Establishing better relationships with friends and family, centred away from eating and drinking, is also key.
Most patients are able to return to work after 2-3 weeks at reduced capacity or able to work from home. Almost all patients are back at work full-time by week 4.
A re-established relationship with food for nutrition and enjoyment is very important.
Focusing on health and nutritious food requires re-education to develop healthy habits like meal preparation, reading food labels and making better food choices when eating out or in the home.
It is not recommended to have alcohol in the first year after bariatric surgery.
- Increased transit times mean that alcohol is processed differently and possibly more quickly,
- Alcohol contains empty calories, which is highly processed and without the presence of other macro- or micro-nutrients,
- Alcohol is a gastric and small bowel mucosa irritant that can affect healing of the gastric staple line,
- Alcohol can cause liver inflammation/damage and add to the burden of weight loss.
  Speak to your bariatric physician or surgeon before deciding to consume alcohol.

It is important to consult with your dietitian to find the correct supplement regime long-term, this is highly individual and depends on both your surgery and your diet.

Additional calcium supplementation is often required as bariatric surgery reduces the reabsorption of calcium in the kidneys. In patients with osteoporosis, osteopaenia or menopause, bone health is especially important to maintain.

What are the most common side effects and consequences of sleeve gastrectomy?

Reflux, inability to eat larger meals, nausea, vomiting with overeating, aversion to sweet or carbohydrate-rich foods, need for daily multivitamins and need for regular blood tests.

Risks and complications after sleeve gastrectomy?

Risks with general laparoscopic surgery include: bleeding, infection, developing a collection of fluid, sepsis, gas pain and adhesions. Risks with sleeve gastrectomy include: staple-line leak, need for revision surgery, need for endoscopic treatment, stricture or obstruction of the staple line.

When is gastric bypass surgery a better choice?

Gastric bypass is the safest option for revision surgery. It is the best operation for patients with severe reflux or a moderate to large hiatus hernia who need weight loss surgery. Gastric bypass has superior outcomes for patients with diabetes and metabolic syndrome. It provides equivalent or better weight loss to sleeve gastrectomy and is a safe procedure performed by many surgeons in Australia.

Will the weight loss last after gastric sleeve surgery?

Weight loss by restriction and limited hormonal effects lasts about 18 months. After this time, the scar tissue along the staple line matures and is able to be stretched and accommodate pressure, reducing restriction and associated weight loss. Some patients start gaining weight again after this period. This is why ongoing support to maintain the lifestyle changes required to keep the weight loss off, is so important. After the initial 18 to 24 months, you should have adjusted to your routine of healthy eating habits and activity maintaining the weight loss you have achieved.

Diet after surgery

After surgery, your diet will look like this:

Week 1-2: fluid diet
Week 3-4: puree diet
Week 5-8: soft diet
After week 8: diet as tolerated.

Our dietitian will explain this new regime prior to your surgery, giving you time to begin changing routines. Small meals frequently are important. In the first three to six months typical volumes are ¼ to ½ cup. You are encouraged to engage with our dietitians to support you.

So, are you ready for a change?

Losing 70 to 80% of excess weight will be a huge change to your life. You have read through a lot of information and process that surgery has risks but also benefits that far outweigh them.

Harnessing the advantage of the rapid weight loss requires the knowledge of maintenance. Our experienced clinicians and allied health professionals can equip you with the knowledge required to keep the weight off by adopting sustainable strategies for health.

Conventional weight loss methods offer a slow and steady pace of weight loss that takes years and are often undone by short periods of non-compliance. Weight loss surgery provides rapid weight loss that encourages patients to keep working hard to maintain their goals. The magnitude of weight loss and effects on weight-related medical issues is unmatched by conventional and medical weight loss.

So, are you ready for a change? The team at Capital Metabolic Clinic looks forward to supporting you on your weight loss journey.

Ready for change?

Contact our friendly team at
(02) 6210 1070