Gastro Intestinal and Soft Tissue Clinic
Greenslopes Private Hospital
GASTRIC SLEEVE RESECTION
YOUR OPERATION - WHAT IS IT?
Sleeve Gastrectomy, is a purely restrictive bariatric operation. It involves converting the
stomach from a large sac (2 litres) to a tube (200ml). Weight is lost because of early satiety due
to the smaller volume stomach.
Figure 1. A narrow
Stomach Tube is
created and the
outer part of the
stomach removed
WHAT TO EXPECT AFTER YOUR OPERATION
POST OPERATIVE PERIOD
Most patients are transferred to the ward after surgery, although in some cases you may spend
the first night in the Intensive Care Unit. This is to provide a more monitored environment for
those with severe sleep apnoea, cardiac conditions or other existing health concerns. Your
family can visit you here although restrictions apply.
Pain Management: You will have a PCA (Patient Controlled Analgesia) to provide post operative
pain relief. Your nurse will regularly monitor your pain level. Be sure to notify your nurse if your
pain remains uncontrolled or you have nausea.
Mobilisation: You will be asked to sit up and dangle your legs over the edge of the bed four (4)
hours after the operation. Your nurse will assist you but you will be required to move by
yourself. Walking and sitting out of bed are vital activities to assist your recovery and will
decrease your chances of post-op complications. You will be encouraged to do deep breathing
and leg exercises whilst in bed.
Nutrition:
Day of operation: You may have ice to suck to keep your mouth moist.
Day One: You can start having sips of water to drink.
Day Two: Your diet will increase to full fluids today. This diet includes clear soup, jelly, custard,
milk and cordial. Remember to take VERY SMALL SIPS and start with a teaspoon. All your
medications can be taken by mouth but tablets often need to be crushed.
Day Three: Today you may take any type of liquid. You should drink very slowly. When you
sense fullness, STOP.
At Home: It is important to maintain an active life. You will do better and reduce your risk of
complications if you are working towards getting back to normal quickly. Try to walk at least 5
blocks each and every day. No other exercises are encouraged at this time. Please do not drive
for the first week.
Remember to drink a lot of fluids but avoid soft drinks. Aim for at least 1 litre of water per day.
LIFE AFTER A SLEEVE GASTRECTOMY
After your operation you may experience some of the following:
Dizziness: Occasionally you may feel light headed. This is due to the fact that you are not
drinking as much liquid as you were able to before surgery; therefore the volume in your body
is reduced. When this occurs do not panic. If you can find a comfortable place to sit or lie down,
do so. Your body will adjust and the blood will be redistributed adequately after a short
interval. Aim to drink 1.5 litres of fluid per day.
Altered Bowel Habits: Bowel habits may be altered after the surgery. In the beginning, you may
have watery bowel movements. Do not expect your bowel movements to be regular until you
start eating solid food. For most, bowel habits should become regular and you should have one
bowel movement every day and usually less in quantity than you are used to.
Vomiting: During the two months after surgery, you will probably experience a few episodes of
vomiting. It is important to remember your new stomach is approximately 200ml and can be
easily overwhelmed. You must eat slowly and stop when you feel full. Meals will take up to 45
minutes. Vomiting can occur due to too fast eating, poor chewing and inappropriate food.
Too much vomiting or retching will cause secondary swelling and possible obstruction of the
passageway.
Nausea: Nausea is a side effect of any gastric operation. This problem may start on the third
day after the operation or a couple of weeks after discharge from hospital. This is a side effect
of the operation that is responsible for some of the massive rapid weight loss.
Even though you may experience severe nausea you should make an effort to eat at least three
to four small meals a day and drink at least three to four cups of water a day.
Anorexia: Anorexia, complete lack of appetite or forgetting to eat, is a problem some patients
experience. This is dangerous. Make an effort to eat at least three to four meals a day.
Hypoglycaemia: Light headedness, passing out and running heart beat are typical of
hypoglycaemia. This is due to your not eating at regular intervals as recommended. Do not go
for more than six hours without eating.
GENERAL DIET GUIDELINES
Initially patients are on a pureed diet for 3 weeks, but as the operation settle, the diet can
progress to normal consistency of healthy choices. Patients get used to eating three small meals
a day, approximately 25% of previous serves. When going to a restaurant they can eat an
entrée sized meal and feel satisfied. The key point being that a small meal satisfies hence the
experience is different to dieting and therefore sustainable in the long term.
Apart from a commitment to healthy eating no foods are specifically banned. Snacking
especially with junk foods is to be avoided, as it will greatly negate the effects of the surgery.
NUTRITIONAL ADVICE AFTER YOUR SURGERY
A sleeve gastrectomy procedure reduces the size of your stomach. This means you will feel full
and satisfied after a small amount of food. Initially the volume of food that can be eaten is very
limited and you may also experience intolerances towards certain foods. Therefore, eating a
well balanced diet is essential in preventing any nutritional deficiencies and also gaining the
maximum benefit from your surgery. Compliance to the suggested diet in the first 6 months is
very important to ensure adequate nutrition in this phase of rapid weight loss. As the surgical
site heals you will be able to eat a ‘normal’ diet. After 6 months most people can tolerate
normal meals and eat 3 small meals including most of the food groups.
Diet after Surgery:
Stage 1 Fluids: You may have clear fluids one day after your operation. These include water,
cordial, soup, jelly, fruit juice, tea and coffee. On days 2-3, your diet is progressed to Free Fluids,
which includes all items on clear fluids as well as milk, drinking yoghurt, thicker-style vitamised
soups and custard.
Do not attempt to eat all the food provided. Eat and drink very slowly and stop when you feel
full.
Stage 2 Puree Diet: From 3-4 days after surgery you may have a puree diet. Everything you eat
should be a smooth, pureed consistency. You need to continue with this diet when discharged
for 3 weeks. When you tolerate this diet, without any pain, reflux or indigestion, you may
progress to a soft diet.
For each stage of the diet it is important to: Have small meals, chew your food well, eat slowly,
and stop when you are full.
PUREE DIET
Breads and Cereals
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Quick/instant porridge or semolina
Spaghetti or noodles or rice (well cooked)
AVOID BREAD, BISCUITS, SEMI COOKED PASTA AND RICE
Fruit and Vegetables
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Pureed, tinned or stewed fruit (with no added sugar)
Vegetable juice
Mashed potato, pumpkin, squash, carrot, zucchini
Pureed cauliflower, peas, corn or other vegetables
AVOID STRINGY FRUIT, FRUIT SKINS AND RAW VEGETABLES
Dairy Products (3 serves per day)
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Drinking yoghurt (maximum 200ml per day)
Low fat or calorie reduced yoghurt (1 tub of 200g per day)
AVOID ICE-CREAM, MILKSHAKES AND FLAVOURED MILKS
Meat, Fish, Poultry, Eggs, Legumes (2 serves per day = 50g of pureed meat)
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Eggs – try scrambled or poached
Pureed lean meat (lamb, pork, veal, chicken)
Meat that has been stewed or casseroled is suitable to puree
Mash softly cooked beans and legumes – try adding to soups and casseroles
Tuna/Salmon
AVOID FATTY OR FRIED MEATS
SOFT DIET
Breads and Cereals
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
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Quick/ instant porridge or semolina
Weetbix (soaked in low fat milk)
Sago, Tapioca
Spaghetti or noodles or rice (well cooked)
Couscous
Toast
AVOID FRESH OR SOFT BREAD
Fruit and Vegetables



Soft ripe, tinned or stewed fruit (with no added sugar)
Vegetable juice
Soft cooked vegetables
AVOID STRINGY FRUIT, FRUIT SKINS AND RAW VEGETABLES
Dairy Products (3 serves or more per day)


Skim or low fat milk (maximum 250ml per day)
Low fat or calorie reduced yoghurt (1 tub of 200 grams per day)
AVOID ICE CREAM, MILKSHAKES AND FLAVOURED MILKS
Meat, Fish, Poultry, Eggs, Legumes (2 serves per day)




Eggs – try scrambled or poached
Lean minced Meat (lamb, pork, veal, chicken), add to casseroles and mornays
Soft, marinated fish, canned Tuna/ Salmon
Well cooled beans and legumes – try adding to soups and casseroles
AVOID FATTY OR FRIED MEATS
GENERAL RECOMMENDATIONS
Meal Size:
After the surgery you will not be able to eat large amounts of food and fluid at one tie. Having
small frequent meals will help prevent pain, discomfort, nausea and vomiting. You should stop
eating when you feel full or experience discomfort.
Choosing a Balanced diet:
As mentioned earlier, you will only be able to eat a small amount of food at one time.
Therefore, once you are ready to progress to more solid foods it is important to include foods
from all food groups to ensure your diet is balanced and adequate in all nutrients.
Protein:
Protein is important in preserving your muscle. You should eat protein foods first at each
mealtime.
Fluids:
Fluids are important in preventing dehydration and also help keep your bowels regular.
 It is important to drink plenty of water (6-8 glasses per day)
 Avoid large amounts of fluids with meals. Drink 30 minutes before or after meals
 Avoid soft drinks and high calorie drinks such as cordials, milkshakes or sports drinks
Alcoholic beverages:
Alcoholic beverages such as wine, beer, spirits, sherry and port have no nutritional benefits and
are also very high in energy. It is best to limit these beverages.
Fibre:
Fibre is important to keep your bowels regular. If constipation is a problem as a result of your
restricted diet, discuss this with your Doctor/ dietitian.
Exercise:
Successful weight control is a result of healthy eating AND regular exercise.
The best type of exercise is one you can enjoy and can continue to do on a regular basis.
Exercise will help you to improve or maintain your weight loss, increase your metabolism and
also improve your general health.