Which Tests Come Before a Sleeve Gastrectomy? Bloods, Imaging and the Anesthesia Review

The envelope from the surgical office is thicker than expected. Inside: a lab requisition with eighteen boxes ticked, an appointment card for a sleep study, a dietitian’s questionnaire, and a note that reads “anesthesia pre-assessment, please allow two hours.” Nobody mentioned any of this at the first consultation, and now the operation feels less like a single day and more like a term of school.

That reaction is almost universal. People who are considering a sleeve gastrectomy, the operation that removes most of the stomach and leaves a narrow tube, often say the tests before sleeve gastrectomy felt like the real hurdle, not the surgery itself. The volume can look like bureaucracy. It isn’t.

Each test answers a question the surgeon and anesthetist genuinely need answered before they alter your anatomy permanently. This article walks through what each one is for, which results change the plan, and what the weeks between “yes” and the operating room usually look like.

Why are there so many tests before sleeve gastrectomy?

Start with what the operation does. In a sleeve gastrectomy, the surgeon removes roughly 80 percent of the stomach through small keyhole incisions and staples the remainder into a banana-shaped tube, according to the Mayo Clinic. The portion removed includes the area that produces much of the hormone ghrelin, which signals hunger. Appetite falls, portions shrink, and the change is permanent.

Three things follow from that description. First, this is major abdominal surgery under general anesthesia, so the body’s capacity to tolerate anesthesia, blood loss and healing has to be checked. Second, obesity itself is associated with conditions that raise surgical risk, among them type 2 diabetes, high blood pressure, fatty liver and obstructive sleep apnea, and several of these can exist without symptoms. Third, the new stomach absorbs nutrients differently, so a deficiency that is mild today can become significant later. Pre-operative testing establishes a baseline to compare against.

Think of it the way an airline treats a long-haul flight: the aircraft is inspected not because anyone expects a fault, but because the consequences of missing one are high and the inspection is cheap by comparison. Blood tests and an ECG are quick; a leak, a clot or an undiagnosed heart problem found on the operating table is not.

There is one more purpose that patients sometimes miss. The testing phase is where the plan gets personalized. A low vitamin D result, a borderline HbA1c or a sleep study showing severe apnea does not usually cancel surgery. It changes what happens before it, and sometimes which operation is offered. The tests are less a gate than a map.

What is the prep before a gastric sleeve? The pathway from first visit to theater

Most programs follow a similar sequence, even though the paperwork differs. The surgeon’s consultation establishes whether you meet standard criteria and whether the sleeve is the right operation compared with alternatives such as gastric bypass. Then the multidisciplinary work begins: a dietitian, a psychologist or mental health clinician, a physician for medical optimization, and an anesthetist. The NHS describes weight-loss surgery as something offered after assessment by a specialist team, usually alongside a structured program of lifestyle change, rather than as a stand-alone procedure.

The psychological evaluation deserves a plain explanation, because it is the part people most fear. It is not a test you pass or fail by being “mentally tough.” The clinician is checking for conditions that make the post-operative routine harder to sustain: untreated depression, active eating disorders such as binge eating, current alcohol or substance misuse, and whether you have realistic expectations and practical support at home. The Mayo Clinic lists a psychological assessment as a routine part of bariatric preparation. If something is identified, the usual response is treatment and reassessment, not refusal.

The dietitian’s visits run in parallel. Expect a detailed account of what, when and how you eat now, then teaching about the staged diet after surgery, protein targets set by your team, and the lifelong supplement routine. Many programs also ask for evidence that you have attempted supervised weight management first, which is a requirement in several national guidelines, including those referenced by the NHS.

The anesthesia review and the formal pre-operative testing usually come toward the end, once the team is confident surgery is going ahead. In practice the whole pathway takes weeks to months. The length depends on how many issues need addressing, and your team, not a calendar, decides when you are ready.

Pre op tests for gastric sleeve: what each blood tube is looking for

Blood work is the backbone of pre-operative assessment, and the panel for bariatric patients is broader than for most other elective operations because it adds nutritional screening to the standard safety checks. Johns Hopkins describes typical pre-surgical blood tests as including a complete blood count, blood chemistry and clotting studies, with others added depending on the procedure and your health. For a sleeve, the “others” matter a great deal.

Test	What it measures	Why it matters before a sleeve
Full blood count	Red cells, white cells, platelets	Anemia and clotting capacity; a baseline for after surgery
Kidney and electrolytes	Creatinine, sodium, potassium	Safe anesthesia and medicine handling; fluid management
Liver function	Enzymes, bilirubin, albumin	Fatty liver is common with obesity and affects surgical access
Glucose and HbA1c	Current and three-month average blood sugar	Undiagnosed or poorly controlled diabetes raises infection and healing risk
Lipid profile	Cholesterol and triglycerides	Cardiovascular risk picture; baseline for later comparison
Iron studies, ferritin	Iron stores	Reduced absorption after surgery; low stores need correcting first
Vitamin B12, folate, vitamin D	Micronutrient levels	Commonly low before surgery; deficiency worsens afterward if untreated
Thyroid function	TSH, sometimes T4	An underactive thyroid can be a contributor to weight and affects anesthesia
Clotting screen	How quickly blood clots	Bleeding risk during stapling and surgery
Blood group and antibodies	Type and compatibility	Rare but possible transfusion

Some teams add a pregnancy test for anyone who could be pregnant, a hepatitis and HIV screen, and a cortisol or other hormone test if the history suggests an endocrine cause of weight gain. None of this is a verdict on you. A low ferritin reading is a problem to fix over a few weeks, not a reason to stop.

Why do they check vitamins before a stomach operation?

It seems backwards. Surgery for obesity, and the first thing the team worries about is malnutrition. Yet the logic is sound. The NIH’s National Institute of Diabetes and Digestive and Kidney Diseases notes that bariatric operations can lead to nutritional shortfalls and that patients are advised to take vitamin and mineral supplements for life. Pre-operative screening finds the gaps before the operation widens them.

Why are deficiencies common before surgery at all? Diets high in calories can still be low in nutrients. Vitamin D is stored in fat tissue, so blood levels tend to be lower in people with higher body fat. Iron deficiency is frequent in women of menstruating age regardless of weight. Vitamin B12 absorption depends on intrinsic factor, a protein made by cells in the stomach lining, and medicines that lower stomach acid, which many people with reflux take, reduce absorption further. Removing most of the stomach reduces both acid and intrinsic factor, so a borderline B12 result today is a predictable deficiency later.

The dietitian uses these results to set a correction plan before surgery and to decide which supplement formulation you will need afterward. Chewable or liquid forms are often preferred early on because the new stomach is small and swelling slows the passage of large tablets, though the choice is your team’s. The NIH Office of Dietary Supplements fact sheets on vitamin B12 and vitamin D explain why absorption, not intake alone, determines blood levels.

Protein is assessed too, usually through albumin on the liver panel and a dietary history. Adequate protein intake supports wound healing and preserves muscle as weight falls, and your dietitian will set a daily target for you rather than quoting a universal number. Treat the nutrition phase as rehearsal: the habits that matter after surgery are easier to build while you can still eat normally.

Heart tests before bariatric surgery: ECG, echocardiogram and stress testing

A resting ECG, a five-minute tracing of the heart’s electrical rhythm taken through sticky pads on the chest, is close to universal before sleeve gastrectomy. It picks up rhythm abnormalities, signs of previous silent heart damage, and conduction changes that affect how an anesthetist plans the operation. Johns Hopkins lists the ECG among the standard tests done before surgery for people with heart risk factors or who are having major operations.

What the ECG cannot do is show how the heart performs under load. For that, some patients are referred for an echocardiogram, an ultrasound of the heart that shows pumping function and valves, or a stress test, which measures the heart during exercise or with a medicine that mimics exertion. These are not routine for everyone. The usual triggers are symptoms such as chest pain or breathlessness out of proportion to activity, a history of heart disease or heart failure, poorly controlled high blood pressure, longstanding diabetes, or an abnormal resting ECG. The American Heart Association’s guidance on evaluation before non-cardiac surgery frames this as a stepwise process: identify risk, test only when the result would change management.

Why does this matter so much for weight-loss surgery specifically? Obesity increases the heart’s workload and is linked with left ventricular hypertrophy, a thickening of the heart’s main pumping chamber, and with atrial fibrillation, an irregular rhythm that raises stroke risk. Many people have never been tested, and breathlessness has often been attributed to weight alone. Occasionally the cardiac work-up finds something that needs treatment first, which delays surgery but makes it safer. Far more often it provides reassurance and a clear anesthetic plan. Either way, the cardiologist’s opinion becomes part of the file the anesthetist reads before meeting you.

Sleep apnea screening: the test many people don't know they need

Obstructive sleep apnea is a condition in which the upper airway repeatedly collapses during sleep, pausing breathing for seconds at a time and jolting the body partly awake. Cleveland Clinic notes that it is common, more frequent in people with obesity, and often undiagnosed because the person affected does not witness their own pauses. Loud snoring, a bed partner’s reports of gasping, morning headaches and daytime sleepiness are typical clues, but plenty of people with significant apnea feel fine.

Bariatric programs take it seriously for one specific reason: anesthesia and opioid pain relief both relax the airway and blunt the drive to breathe. In someone with untreated apnea, the hours after surgery carry a higher risk of low oxygen levels and breathing complications. Knowing in advance allows the team to plan airway management, monitoring and pain relief accordingly.

Screening usually begins with a questionnaire covering snoring, tiredness, observed pauses, blood pressure, body mass index, age, neck circumference and sex. A high score leads to a sleep study. The gold standard is overnight polysomnography in a sleep laboratory, where sensors record breathing, oxygen, heart rhythm and brain activity. Many centers now use home sleep tests, a simpler kit worn for one or two nights, when the picture is straightforward. Cleveland Clinic describes both approaches.

If moderate or severe apnea is found, the standard treatment is continuous positive airway pressure, a mask that delivers a gentle stream of air to hold the airway open. Teams often ask patients to use it for a period before surgery and to bring the machine to hospital. Weight loss after a sleeve frequently improves apnea, and some people are eventually able to stop treatment, but that decision belongs to the sleep physician after repeat testing, not to the calendar or to how you feel.

Imaging before a sleeve: ultrasound, endoscopy and what they look for

Not every program images the abdomen before a sleeve, but many do, and two investigations come up repeatedly. The first is an abdominal ultrasound, a painless scan using sound waves, performed mainly to look at the liver and gallbladder. The liver matters because an enlarged, fatty liver sits directly over the stomach and can make keyhole access difficult; the result often informs how strict the pre-operative diet needs to be. The gallbladder matters because gallstones are common in people with obesity and become more common during rapid weight loss. Some surgeons remove a gallbladder that already contains stones at the same operation; others monitor. Your team will explain their approach.

The second is an upper endoscopy, in which a thin flexible camera is passed through the mouth into the esophagus and stomach under sedation. It looks for inflammation, ulcers, a hiatal hernia (part of the stomach slipping up through the diaphragm) and Barrett’s esophagus, a change in the lining caused by long-term acid reflux. These findings are relevant because a sleeve gastrectomy tends to worsen reflux in some people, as the Mayo Clinic notes among potential long-term effects. Significant pre-existing reflux or Barrett’s changes may lead a surgeon to recommend gastric bypass instead, which generally improves reflux. A hiatal hernia found at endoscopy is often repaired during the same operation.

Some centers reserve endoscopy for people with reflux symptoms; others do it for everyone. Both practices are mainstream, and neither is a sign of over- or under-caution. A chest X-ray may be added for people with lung disease, smokers or older adults. Other imaging, such as CT scans, is unusual unless a specific problem is being investigated. Ask what your program’s standard is and why, and expect a reasoned answer.

Anesthesia evaluation before bariatric surgery: what the anesthetist wants to know

The anesthesia pre-assessment is the appointment that converts a pile of results into an operating-day plan. The anesthetist, the doctor who keeps you unconscious, breathing and stable throughout, reads your bloods, ECG, sleep study and specialist letters, then meets you to fill in what paper cannot show.

Expect detailed questions about previous anesthetics and any problems with them, including in blood relatives, since rare inherited reactions run in families. You will be asked about every medicine and supplement, allergies and what the reaction looked like, alcohol and tobacco use, exercise tolerance expressed in everyday terms such as how many flights of stairs you can climb, and symptoms like chest pain, breathlessness when lying flat, or heartburn. Reflux matters to anesthetists because stomach contents can enter the lungs during induction; a history of severe reflux changes technique.

Then comes the physical part: an airway assessment. The anesthetist looks at mouth opening, neck movement, jaw shape and the view of the back of the throat, and measures neck circumference. Higher body weight is associated with airways that are harder to manage, so planning for intubation, the placement of a breathing tube, is deliberate rather than improvised. Blood pressure, oxygen saturation and sometimes a breathing test complete the picture.

The visit is also where practical instructions are given: when to stop eating and drinking, which medicines to take on the morning of surgery and which to hold, and what to do with a CPAP machine. The Mayo Clinic’s sleeve gastrectomy guidance notes that your team will give specific instructions about medicines and eating before surgery; follow those, not general internet advice. Write your questions down beforehand. This is the right person to ask about nausea prevention, pain relief options and what waking up will be like.

What disqualifies you from bariatric surgery, and who is usually asked to wait?

Fewer things than people fear, and most of them are temporary. Start with eligibility. The NHS describes weight-loss surgery as typically available for adults with a body mass index of 40 or more, or 35 to 40 with a condition such as type 2 diabetes or high blood pressure that would likely improve with weight loss, who have tried other weight-loss methods and are fit for anesthesia, and who commit to long-term follow-up. Many international guidelines are moving toward offering surgery at lower BMI thresholds in specific circumstances, so a conversation with a specialist team is worth more than a number.

Permanent reasons to decline surgery are uncommon. They center on an inability to tolerate general anesthesia safely because of severe heart or lung disease, or a condition that makes the lifelong post-operative routine unsafe. More often the team identifies something to resolve first and asks the patient to wait. Typical reasons include:

• Active smoking, because nicotine impairs healing and raises the risk of staple-line leak and ulcers; most programs require a smoke-free period confirmed by testing.
• Poorly controlled diabetes, since high glucose levels increase infection risk and slow healing.
• Untreated sleep apnea, pending CPAP set-up.
• Active substance or alcohol misuse, which conflicts with the dietary and medical plan.
• An untreated eating disorder or unstable severe mental illness.
• Pregnancy, or plans to become pregnant within the first year or so after surgery, when nutrition is in flux.
• An unexpected finding on testing, such as a heart problem, that needs its own treatment.

None of these is a judgment of character. They are predictors of complications, and each is addressed rather than used to close the door. The decision to proceed, defer or choose a different operation always rests with the treating team, made with you and based on your results.

The gastric sleeve pre op diet and the medicines conversation

The pre-operative diet is the part of preparation people remember most vividly, and the one that has the clearest physiological purpose. A liver swollen with fat is heavy, friable and sits directly in the surgeon’s line of sight to the stomach. A short period of reduced calorie, low-carbohydrate, higher-protein eating, often using meal-replacement products chosen by the dietitian, pulls glycogen and water out of the liver and shrinks it. The Mayo Clinic notes that you may be placed on a special diet in the period before surgery. How long yours lasts, and whether it is mostly liquids, is set by your team based partly on your ultrasound and BMI. Follow their version exactly; a surgeon who cannot see clearly may have to convert to open surgery or stop.

Expect to feel hungry, irritable and tired in the first few days of the diet, then noticeably better as your body adjusts. People with diabetes need particular care here, because eating far less while taking the same glucose-lowering medicines can drive blood sugar too low. This is one of several reasons the medicine review happens before the diet begins.

Which medicines come up? Blood thinners of any class, because of bleeding during stapling. Some glucose-lowering drugs, including newer injectable classes that slow stomach emptying, which anesthetists want to know about. Blood pressure medicines, some of which are usually continued and some paused. Non-steroidal anti-inflammatory painkillers, which irritate the stomach lining and are generally avoided long term after a sleeve. Oral contraceptives, since absorption may change after surgery. The principle in every case is the same: do not stop, start or alter anything on your own. Bring a complete list, including over-the-counter products and herbal supplements, and let the prescribing clinician and anesthetist decide what changes and when.

What do the days and weeks around surgery usually look like?

Once testing is complete and the pre-operative diet has begun, the pace quickens. In the final week you will typically have a pre-admission phone call or visit confirming fasting times, medicine instructions and arrival details. The night before, most programs ask for no solid food after a set hour and clear fluids only until a few hours before anesthesia; your anesthetist’s instructions override any general rule.

On the day, you will meet the surgical and anesthetic teams again, have compression stockings fitted and often receive an injection to reduce clot risk, since blood clots in the legs or lungs are a recognized risk after any major surgery, as the NHS notes. The operation itself usually takes one to two hours according to MedlinePlus, performed laparoscopically through several small incisions. Most people stay in hospital for one to two nights; the Mayo Clinic describes the hospital stay as typically short unless complications arise.

The first days at home are about fluids, rest and movement. Sipping small amounts frequently, walking several times a day to protect against clots and chest infection, and managing incision discomfort are the tasks. The diet then advances in stages that your dietitian defines: clear liquids, then full liquids, then pureed foods, then soft foods, and finally regular textures, over a period that MedlinePlus and Mayo Clinic describe as several weeks. Each step is a test of tolerance, not a race.

Follow-up visits are usually frequent in the first months and then settle into a lifelong rhythm that includes repeat blood tests to check the same nutrients measured before surgery. The NIH’s NIDDK emphasizes that ongoing medical follow-up and supplementation are part of the operation, not optional extras. This is the point of the baseline: the numbers from your pre-op panel are what every later result will be compared against.

What people often get wrong about tests before sleeve gastrectomy

“If I fail a test, surgery is off.” Almost never. An abnormal result usually means treatment and reassessment. Low iron is corrected; apnea gets CPAP; glucose control is tightened. The team’s aim is to get you to surgery safely, not to find reasons to stop.

“The psychology appointment is to judge whether I deserve it.” No. It screens for conditions that make the post-operative routine harder and checks that you understand what is permanent. Being nervous, having had depression in the past, or disliking the idea of lifelong supplements does not disqualify anyone.

“Bloods and scans are enough; the questionnaires are padding.” The sleep questionnaire and the dietary history catch problems that no blood test shows. Undiagnosed apnea is among the most consequential findings in the whole work-up.

“The 30/30 rule is a medical test.” It isn’t a test at all. People searching for it mean an eating convention taught by many programs after surgery: separating drinking from eating by a window of time either side of meals so that fluid does not fill the small stomach or wash food through too fast. The exact window and the rest of the eating rules come from your dietitian; the number is a teaching tool, not a law of physiology.

“Hospital stay is a good measure of how well it went.” Short stays reflect modern keyhole technique and protocols, not a guarantee against problems. Complications such as leaks can appear days after discharge, which is exactly why the red-flag list below exists.

“What I wish I knew before gastric sleeve surgery” threads are mostly about regret. Read them and a different pattern emerges: people wish they had understood the duration of the preparation, how emotional the pre-op diet can be, that reflux can worsen, and that supplements are forever. The tests are the first chapter of that honesty, not an obstacle to it.

Questions to ask your care team during the work-up

A good program expects questions, and the pre-operative phase is when answers change decisions. Take a written list to each appointment; it is easy to forget in a short slot.

For the surgeon: Which of my test results influenced the choice of sleeve over bypass or another operation? Did the endoscopy or ultrasound show a hiatal hernia, gallstones or reflux changes, and what is the plan for them? How will my fatty liver result affect the pre-operative diet? What is your program’s approach if a staple-line leak is suspected, and how would I recognize one?

For the anesthetist: Is there anything in my ECG, sleep study or airway assessment that changes your plan? How will pain be managed given that anti-inflammatory painkillers are generally avoided afterward? What should I do with my CPAP machine? Which medicines do I take on the morning of surgery?

For the dietitian: Which of my vitamin levels are low, and how will we know they have corrected? What protein target have you set for me and why? What will the staged diet look like week by week, and who do I call if I cannot keep fluids down?

For the psychologist or coordinator: What support is available in the first months if eating becomes emotionally difficult? How often are follow-up visits and repeat blood tests, and for how long? What is the plan if I want to become pregnant in the future?

For everyone: Is there a result you are waiting on before confirming a date? Who is my single point of contact if something feels wrong at home? The answers to those two questions tell you a lot about how the program works, and they are the ones most people forget to ask.

When to call your doctor

Red flags exist in both phases: the weeks of preparation and the days after the operation.

During the pre-operative diet or while waiting for surgery, contact your team the same day if you have symptoms of low blood sugar such as shakiness, sweating, confusion or faintness, particularly if you take glucose-lowering medicines; if you develop chest pain, new or worsening breathlessness, palpitations or fainting, which may need urgent assessment regardless of your surgical date; if you have a fever, a new infection, or a wound or dental problem that has not been reviewed; or if you discover you may be pregnant. If you are struggling to follow the diet or feeling overwhelmed, say so. Adjusting the plan is routine, and the team would rather know.

After a sleeve gastrectomy, seek urgent medical care, including emergency services if severe, for any of the following, which the Mayo Clinic and MedlinePlus list among signs of complications: a racing heartbeat, especially a sustained pulse that feels fast at rest; fever or chills; worsening abdominal pain, or pain spreading to the left shoulder; persistent vomiting or an inability to keep fluids down for more than a short period; shortness of breath or chest pain; redness, swelling, warmth or discharge at an incision; calf pain or swelling in one leg, which can signal a clot; or black or bloody stools or vomit. A fast heart rate combined with fever and abdominal pain is the classic early picture of a staple-line leak and should never be waited out overnight.

Your care team will give you a direct contact number before discharge. Use it for anything that worries you. This article explains what tests are for and what they commonly find; it cannot interpret your results. Every decision about whether, when and how to proceed belongs to the clinicians who have examined you.

Frequently asked questions

What is the prep before a gastric sleeve?

Preparation usually involves a surgical consultation, dietitian and psychological assessments, blood tests, an ECG, sleep apnea screening, sometimes an abdominal ultrasound or endoscopy, an anesthesia review, and a short pre-operative diet to shrink the liver. The sequence takes weeks to months depending on what needs correcting first. Your team sets the exact list and timing based on your history and results.

What disqualifies you for bariatric surgery?

Permanent reasons are uncommon and center on being unable to tolerate anesthesia safely. More often people are asked to wait while something is addressed: active smoking, poorly controlled diabetes, untreated sleep apnea, active alcohol or substance misuse, an untreated eating disorder, pregnancy or near-term pregnancy plans, or a new finding such as a heart problem. The treating team makes the final decision after assessment.

What is the 30/30 rule after gastric sleeve?

It is an eating convention taught by many programs, not a medical test. It refers to separating drinking from eating by a window of time before and after meals so that fluids do not fill the small stomach or push food through too quickly. The specific timing and the other eating rules come from your dietitian, and they can vary between programs.

Which pre op tests for gastric sleeve are done on everyone?

Nearly all programs require a full blood count, kidney and liver function, glucose and HbA1c, lipids, clotting, blood group, iron studies and vitamin levels, plus a resting ECG and a sleep apnea questionnaire. Dietitian, psychology and anesthesia reviews are also routine. Echocardiograms, stress tests, ultrasound, endoscopy and chest X-rays are added based on symptoms, history or program protocol.

What happens at the anesthesia evaluation before bariatric surgery?

The anesthetist reviews your results and asks about past anesthetics, family reactions, medicines, allergies, reflux, exercise tolerance and sleep apnea. They examine your airway, neck and breathing, then give specific instructions on fasting, which medicines to take or hold on the day, and what to do with a CPAP machine. It is the right appointment to ask about pain relief and nausea prevention.

Why do I need a sleep study before a sleeve gastrectomy?

Obstructive sleep apnea is common in people with obesity and frequently undiagnosed. Anesthesia and opioid painkillers relax the airway and reduce the drive to breathe, so untreated apnea raises the risk of low oxygen after surgery. A home or laboratory sleep study lets the team plan monitoring and pain relief and, if needed, start CPAP therapy before the operation.

What does the gastric sleeve pre op diet actually do?

It shrinks the liver. A fatty liver sits over the stomach and blocks the surgeon’s view during keyhole surgery. A short period of reduced-calorie, low-carbohydrate, higher-protein eating pulls glycogen and water out of the liver and makes it smaller and softer. Your team decides how long the diet lasts and what it contains, and people with diabetes need their medicines reviewed first.

Will a low vitamin level stop my surgery?

Usually not. Low iron, vitamin D or B12 are common findings before bariatric surgery and are typically corrected over several weeks before the operation. The results also tell the dietitian which supplement plan you will need afterward, since the new stomach absorbs these nutrients less efficiently. Correction is part of the pathway rather than a reason to cancel.

Do I need an endoscopy before a gastric sleeve?

Some programs perform an upper endoscopy for everyone; others reserve it for people with reflux symptoms. It looks for ulcers, inflammation, a hiatal hernia and Barrett’s esophagus. Because a sleeve can worsen reflux, significant findings may lead the surgeon to repair a hernia during surgery or to recommend gastric bypass instead. Ask your team which approach they use and why.

What do people wish they knew before gastric sleeve surgery?

Common themes are how long preparation takes, how emotionally hard the pre-operative diet can be, that reflux may worsen afterward, that supplements and blood tests are lifelong, and that the first weeks of staged eating are slower than expected. Understanding why each pre-operative test is done helps set realistic expectations, which is part of what the psychology and dietitian assessments are for.

References

• MedlinePlus: Vertical sleeve gastrectomy
• NHS: Weight loss surgery, who can have it
• NIH NIDDK: Types of weight-loss surgery
• Cleveland Clinic: Sleep apnea

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.