What is Sleeve Gastrectomy (Gastric Sleeve) Surgery and Who is Eligible?

Gastric sleeve surgery is a surgical method used in the treatment of obesity. Medically known as sleeve gastrectomy, or commonly referred to as gastric sleeve surgery, it is performed by removing approximately 70–80% of the stomach. As a result, the stomach takes the shape of a narrow, long tube, and the person feels full with less food.

The gastric sleeve surgery both reduces food intake and affects appetite hormones (especially ghrelin) by reducing the stomach volume. Thus, the patient physically eats less and psychologically feels less hungry.

Who Can Have Gastric Sleeve Surgery?

Gastric sleeve surgery is not performed on every person with weight problems. It is evaluated within certain criteria:

1. Body Mass Index (BMI) of 35 and above

For individuals with a BMI between 35 and 40, gastric sleeve surgery is recommended if there are additional diseases (such as type 2 diabetes, sleep apnea, hypertension).

For individuals with a BMI of 40 and above, surgery candidates are considered even if no additional diseases are present.

Example: A person who is 165 cm tall and weighs 110 kg has a BMI above 40 and can be a candidate for gastric sleeve surgery.

2. Those who cannot achieve permanent weight loss through diet and exercise

People who have failed to lose weight despite long-term professional diet support.

3. Individuals between the ages of 18 and 65

Surgery is generally not recommended for individuals under 18 or over 65, except in special cases.

4. Psychologically prepared individuals

Candidates are accepted as those who can adapt to lifestyle changes after surgery.

5. Those without serious gastrointestinal diseases

The method may be changed for people with ulcers, reflux, or other digestive system disorders.

Who Cannot Have Gastric Sleeve Surgery?

• Active addiction (alcohol, drugs)

• Severe psychiatric disorders

• Those planning pregnancy in the near future

• Severe cardiovascular diseases that increase surgical risk

How is Gastric Sleeve Surgery Performed?

Gastric sleeve surgery is an important operation performed with modern surgical methods and offers a permanent solution in obesity treatment. Medically known as sleeve gastrectomy, the procedure involves removing a large part of the patient's stomach. The main goal is to reduce stomach volume to create a feeling of fullness with less food.

Preoperative Process

Before answering the question "How is gastric sleeve surgery performed?", it is necessary to look at how patients prepare for this operation:

Preliminary Evaluation

Comprehensive examinations are performed by endocrinology, cardiology, psychiatry, and anesthesia departments.

BMI is calculated, and accompanying diseases are examined.

Preoperative diet is applied to reduce liver size and minimize operation risks.

Preoperative Tests

Blood tests, chest X-ray, gastroscopy, ECG

Gastric Sleeve Surgery Process

1. Anesthesia

The operation is performed under general anesthesia. The patient is put to sleep during the procedure and feels nothing.

2. Laparoscopic Surgery (Minimally Invasive Method)

Gastric sleeve surgery is usually performed with laparoscopic (minimally invasive) techniques. Surgical instruments are inserted through 4-5 small incisions in the abdominal area.

3. Removal of Large Part of the Stomach

Approximately 80% of the stomach is cut and removed using a special stapler device. Only a narrow, long tube-shaped stomach remains.

4. Leak Test

At the end of the surgery, it is tested whether there is any leakage at the stomach line. This is vital to reduce the risk of complications.

5. Surgery Duration

It lasts on average between 45 minutes and 1.5 hours. The patient starts waking up the same day and usually stays in the hospital for 3 days.

Postoperative Recovery Process

• Liquid diet for the first 15 days, then transition to pureed and solid foods.

• Pain is mild and generally controlled within a few days.

• Most patients can return to normal life within 1 month.

Conditions for Gastric Sleeve Surgery

Gastric sleeve surgery is an effective and permanent treatment option for individuals fighting obesity. However, it is not applied to everyone who wants it; decisions are made based on specific medical criteria, BMI values, and some health conditions.

The main criterion taken into account for gastric sleeve surgery is Body Mass Index (BMI). Weight alone is not sufficient; it must be evaluated along with height.

BMI Limits for Gastric Sleeve Surgery

• BMI ≥ 40 (Morbid obesity)
  → Suitable for surgery even without any additional diseases.
  (Approximately 108 kg or above for 1.65 m height, 115 kg or above for 1.70 m height)

• BMI 35–39.9
  → Surgery may be recommended if there are obesity-related additional diseases such as type 2 diabetes, hypertension, sleep apnea, joint disorders, or fatty liver (NAFLD).

• BMI 30–34.9
  → Surgery is generally not recommended, but in some cases special evaluations may be made (experimental or metabolic reasons).

How is BMI Calculated?

BMI = Weight (kg) ÷ Height² (m²)
Example: 110 kg / (1.70 × 1.70) = 38.06 BMI

Is There an Age Limit for Gastric Sleeve Surgery?

Yes, there is an age limit for gastric sleeve surgery. These limits are important for physical development and postoperative adaptation.

Age Criteria

• Generally suitable for individuals aged 18–65.

• Surgery under 18 years old is possible only with family consent and multidisciplinary board decision.

• For individuals over 65, surgery is decided after general health assessment and risk analysis.

(Global Distribution of Gastric Sleeve Surgeries by Age and Gender)

Gastric Sleeve Surgery Prices 2025

Gastric sleeve surgery is one of the surgical methods proven effective in obesity treatment. In 2025, the cost of this surgery varies depending on where, how, and by whom the surgery is performed. It is important to carefully investigate whether the Social Security Institution (SGK) covers this process and the practices in private hospitals.

Does SGK Cover Gastric Sleeve Surgery?

Yes, SGK (Social Security Institution) can cover the costs of gastric sleeve surgery under certain conditions. However, some criteria must be met:

Required Conditions

• BMI 40 or above, or 35–39.9 with diabetes, hypertension, or other comorbidities.

• Surgery performed in state or university hospitals.

• Multidisciplinary committee report including approvals from endocrinology, general surgery, psychiatry, and dietitian.

• History of unsuccessful attempts to lose weight through diet and exercise.

• Institution must be contracted with SGK and procedure fully implemented.

When these conditions are met, the patient’s surgery costs may be fully or mostly covered by SGK. However, this process can differ depending on the hospital and city, so it is important to contact the hospital’s consultation unit for detailed information.

Gastric Sleeve Surgery in Private Hospitals

Private hospitals generally offer shorter waiting times, advanced technological infrastructure, and patient comfort-based services. However, these advantages can directly affect the cost of the surgery.

Points to Consider in Private Hospitals

• Experience of the surgeon and multidisciplinary team approach.

• Whether postoperative dietitian follow-up, psychological support, and lifestyle counseling are included.

• What the price includes: tests, hospital stay, follow-up appointments, additional tests, etc.

• Private hospitals with SGK contracts may bill part of the cost to SGK and the rest to the patient, which can vary by institution.

• Patients choosing private hospitals are advised to thoroughly research both their doctors and hospital service coverage.

Postoperative Period: First Days and Recovery

Gastric sleeve surgery is not limited to the day of the operation; the critical phase begins in the first days after surgery. Care and discipline during this period speed up recovery and determine long-term success.

What Happens in the First 24 Hours?

The operation is usually performed laparoscopically (minimally invasive), and after 1-2 hours of observation, the patient is transferred to the ward. Main conditions in the first days:

• Mild nausea and abdominal pain (controlled with medication).

• Fluid support through intravenous therapy.

• No oral intake initially; this process is slowly progressed under doctor supervision.

• Mobilization starts: The patient is generally helped to stand a few hours after surgery to prevent complications such as blood clots.

First Week: Adaptation and Observation

• Started with a liquid diet, usually clear liquids, then progresses to pureed foods.

• Hospital stay typically lasts 2 to 4 days.

• Postoperative bloating, gas pains, and mild stomach cramps may be felt.

• Daily walks and light activities support recovery.

• Medications (painkillers, stomach protectors, antibiotics, etc.) are prescribed by the doctor.

Second Week and Beyond: Return to Normal Life

• Under dietitian control, transition to soft foods begins gradually.

• Suture sites and scars are monitored; cleanliness and hygiene are critical to prevent infection.

• Intense exercise is not recommended yet, but regular movement accelerates healing.

• Psychological support and nutrition education are very important for sustainable weight control.