Gastric sleeve, or vertical gastrectomy, is one of the methods of bariatric surgery, or weight loss surgery. Among weight loss surgeries, it is considered the most ‘natural’. Bariatric surgery significantly impacts a patient’s dietary preferences and habits. After the surgery, patients achieve a sense of fullness and satiety with much smaller portions of food than before. As a result, body weight begins to decrease and several associated health conditions improve, such as type II diabetes, sleep apnoea, high blood cholesterol levels, hypertension, joint pain and other obesity-related diseases. Bariatric surgery is currently the most effective method with lasting results for treating obesity, significantly improving quality of life and extending life expectancy.

What is gastric sleeve surgery?

Gastric sleeve is a weight loss surgery where a large portion of the stomach (approximately 70–85%) is removed. What remains is a small section of the stomach, shaped like a tube or ‘sleeve’. While the capacity of the stomach is normally around 1000–1500 mL, only 100–200 mL is left after the surgery. The small stomach fills up with food more quickly, creating a feeling of fullness and thereby limiting food intake. Additionally, food moves from the small stomach to the small intestine faster, further enhancing satiety. Partial removal of the stomach reduces hunger by reducing the amount of the hunger hormone, ghrelin, produced by the stomach.
After sleeve surgery, the food eaten still passes through all parts of the digestive tract and so the likelihood of vitamin and mineral deficiencies is lower than with other bariatric procedures.
As most of the stomach is permanently removed, the former anatomy cannot be restored.

How does gastric sleeve surgery work?

Several mechanisms contribute to weight loss after sleeve surgery. The reduced stomach size creates a feeling of fullness even with small amounts of food, helping to maintain satiety for longer. Food moves quickly from the small stomach to the beginning of the small intestine, accelerating the feeling of fullness and satiety. Removing most of the stomach from the body during surgery reduces the production of ghrelin, the hunger hormone. All of these components, when combined, help patients to achieve successful weight loss.

Expected weight loss after gastric sleeve

Studies show that in the first two years after sleeve surgery, patients lose 60–70% of their excess weight. Five years after surgery, the average weight loss is still 62%, according to various studies.
However, if the weight loss achieved with sleeve surgery is not enough, the surgery can be converted to bypass surgery. This option is also available if the weight has started to increase again over the years. Achieving and maintaining a permanent and long-term lower body weight also depends significantly on the patient’s personal commitment. It is important to make the necessary healthy lifestyle changes to ensure that diet and exercise habits align with specialist recommendations.

Which patients should consider gastric sleeve?

* Patients with a body mass index of at least 30 kg/m2.

* Younger women who wish to have children in the future.

* Sleeve surgery can be performed on those who are not suitable for other weight loss surgery methods. Such contraindications may include: Crohn’s disease, ulcerative colitis, continuous need for anti-inflammatory drugs or painkillers, previous major abdominal surgery (which has caused abdominal adhesions), previous organ transplant.

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Surgery information

Surgeon	Dr Rein Adamson / dr Martin Adamson / dr Sven Troost
Indications by body mass index	From 30, depending on comorbidities
Anaesthesia	General anaesthesia
Surgery duration	1–1,5 hours (laparoscopic)
Nights spent in hospital	1-2
Necessary time of rest	2 weeks
Expected weight loss	60–70% of excess weight (long-term approx. 60%)
Advantages	The pathway of food through the intestines remains unchanged Minimal issues with vitamin absorption
Disadvantages	May worsen or cause reflux disease Has less impact on eating behaviour compared to standard bypass
Reversible surgery	NO
Price	6300 €
Payment in instalments	From €146 per month. Apply for instalment payments here.

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Advantages of sleeve surgery

Reduces hunger in addition to restricting volume, as part of the stomach producing the hunger hormone is removed
Food continues to pass through all parts of the digestive system, making the digestion process closer to normal than with other bariatric surgery methods
The risk of vitamin and mineral deficiencies is lower
Endoscopic access to the stomach and the beginning of the small intestine is preserved
The likelihood of developing dumping syndrome is lower compared to standard bypass and mini-bypass methods
Regular use of painkillers does not increase the risk of stomach ulcers
Adhesions caused by previous abdominal surgeries do not prevent the procedure
Lower risk of complications
Possible to later convert the surgery to a bypass procedure

Disadvantages of sleeve surgery

Slightly less weight loss compared to standard bypass or mini-bypass surgery
Does not change eating behaviour as significantly as standard bypass or mini-bypass procedures
Can cause reflux, or heartburn, which needs treatment (20–40% of patients).
Type II diabetes is less likely to resolve than with bypass-type surgeries
The surgery is irreversible, meaning the anatomy cannot be restored, as a significant portion of the stomach is permanently removed

What is included in the price

Service in English
Lifetime customer support
Surgeon’s consultation
Clinical dietitian’s consultation before surgery
Pre- and post-surgery analyses and examinations (before hospital discharge)
All costs related to the surgery and hospital stay (1–2 nights depending on the procedure)
Clinical dietitian’s consultation after surgery
Post-surgery guidelines with informational materials
Medical report and other necessary documents in English for the doctor
Follow-up check-ups with the surgeon

Psychologist consultation
Clinical dietitian consultations at 6, 12, and 24 months after surgery (online or by phone)
All transportation between Tallinn port, airport, hotel, and hospital
One-night stay in a hotel in central Tallinn before surgery if necessary
Treatment of early and late complications – provided that the treatment is performed at the same hospital where the initial surgery was done
Discounted price for post-bariatric plastic surgery after significant weight loss (abdominal, arm, thigh, and breast plastic surgery)

Lue tyytyväisistä asiakkaistamme

Kokemus oli oikein hyvä, paikka oli etukäteen tuttu. Kipulääkitys oli riittävä. Kolmessa kuukaudessa paino on pudonnut lähes 20 kiloa, selkävaivat ja polviongelmat ovat kadonneet. Minulle leikkauksella ei ole ollut mitään sivuvaikutuksia. Tällä hetkellä pystyn syömään kaikkia ruokia kohtuudella. Liikunnan lisääminen on ollut painonpudotuksen myötä helpompaa. Tästä toimenpiteestä pelkkää hyvää sanottavaa!

Hyvä palvelu ennen ja jälkeen leikkauksen. Mukaan sain kattavan kirjallisen ohjeistuksen. 3kk leikkauksesta ja olen reilut 20 kg kevyempi minä! Elämänlaatuni ja jaksamiseni on parantunut huimasti!

Kaikki sujui oikein hyvin ja sovitusti. Ongelmia ei ole ollut toimenpiteen jälkeenkään. Olen parantunut mainiosti ja painonputoaminen on alkanut hyvin, kuukausi kulunut ja noin 6-7 kg pudonnut. Olen oikein tyytyväinen.

Oli todella hyvä vastaanotto heti satamassa oltiin vastassa. Se loi turvallisuuden tunnetta. Henkilökunta on ammattitaitoista ja tuli tunne, että on osaavissa käsissä.

Koko klinikan henkilökunta on ystävällistä, ja ilmapiiri on miellyttävä ja rauhallinen. Erityiskiitokset myös tri Adamsonille, joka kävi itse leikkauksen jälkeen varmistamassa, että kaikki oli kunnossa, ja antoi lahjapussin. Paljon kiitoksia kaikille vielä kerran. Olen äärettömän tyytyväinen uuteen kevyeen olooni.