Gastric sleeve recovery: hospital stay, daily routines, and diet

Chapter 4

Gastric sleeve recovery is where you start your weight loss journey. While it may feel like a long road ahead, it’s important to remember that the results you will see in the first few months will be worth it.

In this chapter, we’ll discuss what to expect during your recovery and help you throughout the process by providing tips on how to navigate this period successfully. Keep in mind that recovery timelines vary from person to person, and several factors can impact its duration. It’s essential to allow yourself time to recover both physically and mentally after weight-loss surgery.

So let’s get started and learn how to make the most out of this journey.

How long is the recovery process?

The whole gastric sleeve recovery process and the recovery after the gastric sleeve operation procedure are different things. While the recovery from the surgery contains mostly surgical healing, the whole recovery process includes both dietary healing and physical healing. When this is put into the equation, the whole process rounds up to 1 year.

You may ask “In light of this knowledge, how long does it take to recover from gastric sleeve surgery alone?” Gastric sleeve surgery recovery time will take about 6-8 weeks in total for your stomach. First 2-4 weeks, your incisions will heal. At the end of this immediate recovery, the staple line on your stomach will be healed completely.

Keep in mind that post-op behavior can lengthen the gastric sleeve recovery time. For a quick and healthy recovery, take good care of yourself and keep the no-no’s away for as long as you can.

What is the recovery process going to be like?

The recovery process includes many steps. Basically, you will go through a limited diet that lightens over time as you heal. You will be more active adding more to your mobility stage by stage. Last but not least, as you progress through the recovery process, you may find it easier to adapt to the new lifestyle changes and feel motivated by the positive changes you experience.

Recovery might seem long, and you may experience some discomfort or complication during this period of time. However, all that should resolve after a while as you heal. For instance, you might feel indigestion while trying certain foods. But as time passes, you can eat those food groups without any trouble.

Let’s elaborate on how your recovery will look month by month.

First month after the surgery

The first month of recovery is the most crucial part of your recovery because during this time, your stomach is at its most sensitive stage and you need to take good care of it. The first month includes a hospital stay, extensive care, diet and exercise, and certain restrictions.

Hospital stay

Following your surgery, you will spend 1-3 days in a hospital for the start of your recovery. The first few hours after waking up from anesthesia can be uncomfortable, but rest assured that this is a normal part of the recovery process. That is because you are still under the effects of anesthesia, and you are not able to mobilize yourself and release any of the trapped gas inside of you.

After a few hours, you will be mobilized. Meaning you will go on walks, and go up and down the stairs. This will help move and release the gas and, relieve stomach pain that is related to poor blood circulation.

While you are in the hospital, you will not be eating, drinking, or be able to take medicines orally. You will be fed and rehydrated via IV drips. You might feel your lips getting chapped. You can use a lip balm or you can wet a napkin and gently brush it against your lips.

After all the routine check-ups are done after your hospital stay, you will be discharged to continue your recovery at home.

Incision care

Your incisions will be sutured and your surgeon will apply tissue glue. Before suturing, a drain will be inserted in one of the incisions. Upon discharge, the drain will be taken out and the incision will be covered with a bandage, and you will be given additional surgical bandages for backup.

While your incisions are healing, you need to redress them regularly. You will be instructed on how to do it at the hospital. Before redressing them, make sure to clean your hands and not touch your incisions directly. Clean them as instructed, and carefully redress them. 

As they heal, your incisions may start to itch as they form a crust. You can use Bepanthol which contains 5% provitamin B5 and it effectively treats dry and irritated skin.

Diet & exercise

In your first month of recovery, you will go through 5 stages of a nutritional program. Of course, you will get to your 5th stage after your first month. You will gradually upgrade from clear liquids to solid foods. You will also be required to walk daily for at least 45 minutes which you can split into 15-minute walks.

Diet is very important during your whole recovery process. It is especially crucial in the first month. While changing stages, you might have some digestive problems with certain food. If you do, take a little break from eating them and do not force yourself too much.

Because your body is adjusting to your new diet, you might experience side effects because of vitamin and mineral deficiencies. To help with those, you are required to take good quality protein shakes, get multivitamins, and 2 liters of water a day. These will help you get back on your feet.

When can I go back to my daily routines?

For an adult, daily routines can include driving and work, besides physical activities, of course.

Patients frequently ask when they can drive after a gastric sleeve. You can start driving roughly 7-10 days after being discharged. To make driving after gastric sleeve safe, you should wait until at least you are off the pain meds. Because they might make you tired or sleepy as a side effect.

About going back to work, if your job does not require physical labor, you can go back to it in 1-2 weeks. If it does require physical labor, it is recommended that you go back to it in 3-4 weeks, provided you will not lift more than 10 pounds for the first 5-6 weeks. You can gradually increase the weight, but keep your stomach safe and don’t force it.

Some of you may ask “Can I work from home after gastric sleeve?”. The answer is, absolutely yes! If your work allows it, you can work from home. It can even be better if you do so. However, resting is very important for recovery. Do not tire yourself when you are also working from home.

1-3 months - baby steps

During this period, your dietitian will add more things to your “good-to-eat” list. At the start of this period, you’ll be starting to eat solid food. Meaning you can try new foods you couldn’t have last month such as cooked veggies, ground beef, chicken, fish… Without mincing or blending them into baby food! However, you should take your time with them. If you are having trouble digesting a certain food, try again next week. As your stomach heals, you should be able to digest it without feeling any pain.

During this time, you should keep yourself active. On top of walking, you will be recommended to start swimming if you can. Swimming is a great exercise after bariatric surgery. It will not put stress on your stomach. And all your muscles can work while swimming!

Try and enjoy a variety of activities as much as you can. You can still go for a walk, ride a bicycle, stretch… Do whatever you enjoy! Just don’t forget to ask your surgeon if it is okay for you to do so.

3-6 months - leaving the training wheels behind

During this time period, you will have more opportunities when it comes to mobility. This is when the hardest parts of recovery are over, and you’ll be able to do a lot more things freely. You can start going to the gym, going for a run, or doing anything you can do without forcing your stomach. You will also get to a new diet! You can now have raw veggies and fruits, hot or gassy spices, nuts… You’ll be able to try new foods you weren’t allowed to have before.

Remember to take it slow, and give them a second chance if they do not work with you the first time. Your new stomach will tell you when to stop. So, you should portion your food accordingly and always start with your proteins. You can also start drinking a small amount of alcohol every now and then. Simply because you won’t have the same tolerance to alcohol as you did before surgery. But nothing sugary or carbonated. For instance, you can enjoy half a glass of wine every other week.

On your 6-month checkpoint, your surgeon/dietitians will ask you to get a blood test. This is to check your blood count and to see if there is any deficiency or the opposite. If you do have a deficiency or the opposite, dietitians will add new items or remove certain items from your diet to balance the vitamins and minerals in your body.

1 year after - like a champ!

Congratulations, you have hit the 1-year mark! At this point, you will have lost most of your excess weight, which is around 70%, and fully recovered. So you can start enjoying your results!

Your brain and your body are now used to your new calorie intake. You have adapted to being more physically active. You can of course keep seeing your dietitian if you are not sure which foods you can enjoy. Remember, “diet” is not all bland boiled chicken and plain oatmeal. Explore your options, there are plenty of delicious and healthy foods you can enjoy.

This is the point where consistency becomes the key. It’s important to remember that the stomach can stretch and weight regain is a possibility, but there are ways to prevent this from happening: Keep on going on! You won’t have to regret or feel unsure about your gastric sleeve.

Recommended activities during your recovery

In the first month of your recovery, you are only allowed to go on walks and go up and down the stairs as post-gastric sleeve activities. After a month, you are allowed to swim, bike, and do some stretching that does not force your abdomen. You can do these activities until your 3rd month.

The activities that you can do should be slow-paced and soft. Your stomach is still sensitive, so we should keep it safe while we do our activities. 

You can gradually increase your activity levels and intensity. For instance, you can start by exercising 3 times a week and make that 4 and later 5 days a week. Just make sure you keep in touch with your surgeon and ask if you are unsure if something is good or bad for you.

If you have something else in mind, ask your healthcare provider if you can or cannot do them!

Sapin A, Hilden P, Cinicolo L, et al. Enhanced recovery after surgery for sleeve gastrectomies: improved patient outcomes. Surgery for Obesity and Related Diseases. 2021;17(9):1541-1547. doi:https://doi.org/10.1016/j.soard.2021.04.017 

Major P, Stefura T, Małczak P, et al. Postoperative Care and Functional Recovery After Laparoscopic Sleeve Gastrectomy vs. Laparoscopic Roux-en-Y Gastric Bypass Among Patients Under ERAS Protocol. Obesity Surgery. 2017;28(4):1031-1039. doi:https://doi.org/10.1007/s11695-017-2964-3 

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