Bariatric Surgery

Sleeve Gastrectomy in Orlando

Sleeve gastrectomy, also called gastric sleeve surgery, is a weight loss procedure in which 75 to 85 percent of the stomach is removed, leaving behind a narrow tube-shaped stomach roughly the size of a banana. Because the new stomach can hold significantly less food, patients feel satisfied with smaller portions and have greater success reducing calorie intake. According to the American Society for Metabolic and Bariatric Surgery (ASMBS), most patients lose 50 to 70 percent of their excess body weight within one to two years of surgery.

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On this page
  1. 01What Is Sleeve Gastrectomy?
  2. 02Sleeve vs. Gastric Bypass
  3. 03Who Qualifies for Sleeve Gastrectomy?
  4. 04Surgery and Recovery
  5. 05Long-Term Results and Lifestyle
  6. 06Cost, Insurance, and Financing
  7. 07Sleeve vs. GLP-1 Medications
  8. 08Frequently Asked Questions

Procedure overview

What Is Sleeve Gastrectomy?

Sleeve gastrectomy is a permanent weight loss surgery. During the procedure, the stomach is divided along its length using a surgical stapler, isolating the large curved part of the stomach so that it can be removed from the body. What remains is a narrow sleeve-shaped pouch that holds considerably less food and produces significantly less ghrelin (hunger hormone) than before surgery.

How the procedure changes digestion

The gastric sleeve assists weight loss in two ways. First, the smaller stomach fills more quickly, which limits how much food the person can eat in one sitting. Second, removing the fundus of the stomach—the part where most ghrelin is produced—reduces the hormonal drive to eat. This is one reason patients often experience a meaningful reduction in appetite after surgery, in addition to feeling fuller sooner.

While the stomach is reduced in size, the digestive pathway itself is unchanged. Food moves from the sleeve into the small intestine along its normal route, and the body continues to absorb nutrients as it did before surgery.

Why we offer laparoscopic and robotic approaches

Our bariatric surgery program performs sleeve gastrectomy using two surgical techniques: laparoscopy, and with robotic assistance using the da Vinci system.

Laparoscopic

Laparoscopic surgery uses four to six small incisions and a camera to guide the procedure.

Robotic-assisted (da Vinci)

Robotic-assisted surgery using the da Vinci system gives Dr. Chetan Patel a magnified three-dimensional view and finer instrument movement in tight spaces.

For most patients, both approaches produce equivalent outcomes, and Dr. Patel will recommend the one best suited to your anatomy and prior surgical history.

Procedure comparison

Sleeve gastrectomy vs. gastric bypass

Both procedures can lead to significant weight loss, but they differ in mechanism and in which patients they suit best.

Sleeve Gastrectomy

Reshaped stomach sleeve

Mechanism
Stomach reshaped into a narrow sleeve. Restriction only — digestive route untouched.
Excess weight loss at 1 yr
50–70%
Type 2 diabetes
Good remission rate but less than bypass
Severe GERD
Can worsen reflux due to increased intragastric pressure
Operating time
60–90 minutes
Intestinal complications
No risk of dumping syndrome or marginal ulcers
Reversibility
Not reversible — removed stomach cannot be replaced
Best fit
BMI 35–45, no significant reflux, prefers less malabsorptive procedure

Gastric Bypass

Pouch + intestinal bypass

Mechanism
Small pouch connected to a downstream loop of small intestine. Restriction plus mild malabsorption.
Excess weight loss at 1 yr
65–80%
Type 2 diabetes
Highest published remission rates of any first-line bariatric surgery
Severe GERD
Often resolves — small pouch makes very little acid
Operating time
90–150 minutes
Intestinal complications
Some risk of dumping syndrome and marginal ulcers
Reversibility
Technically reversible (no tissue removed); rarely done in practice
Best fit
BMI >50, severe GERD, severe Type 2 diabetes

Read the full clinical write-up

The verbatim 'short version' from the sleeve write-up

Both sleeve gastrectomy and gastric bypass surgery can lead to significant weight loss, but they differ in their approach and effects on the body. Sleeve gastrectomy reshapes the existing stomach into a narrow "sleeve," while gastric bypass creates a small stomach pouch that is connected directly to the small intestine. Sleeve gastrectomy leaves the intestinal route untouched, while gastric bypass reroutes the small intestine to limit absorption as well as intake. Gastric bypass generally produces modestly greater long-term weight loss in high-BMI patients and tends to resolve acid reflux rather than worsen it. Sleeve gastrectomy is a shorter operation with somewhat lower complication rates and no risk of intestinal complications like dumping syndrome or marginal ulcers (which can occur after gastric bypass). We evaluate both options with every patient during the pre-surgery consultation and recommend the procedure that best fits their anatomy, medical history, and goals.

Reasons we sometimes recommend a different procedure

Sleeve gastrectomy is not the right answer for every patient who qualifies for bariatric surgery. For instance, when a patient has significant pre-existing acid reflux (GERD), we sometimes recommend gastric bypass instead because sleeve gastrectomy can worsen reflux in some patients. As another example, patients with very high BMI and complex metabolic disease may be better served by a malabsorptive procedure. We will discuss the full range of options with you during your consultation, and no decision will be made without a complete picture of your health history.

Candidacy

Who qualifies for sleeve gastrectomy

There are three published BMI thresholds for sleeve gastrectomy candidacy. We review every potential candidate individually before recommending the best weight loss strategy.

  • BMI of 40 or higher

    Patients may be evaluated as candidates regardless of other medical conditions.

  • BMI of 35 to 39.9

    Patients may be evaluated as candidates if accompanied by at least one obesity-related health condition.

  • BMI of 30 to 34.9

    Under some insurance plans, patients may be evaluated as candidates when metabolic disease is also present.

Most insurance carriers follow the first two thresholds, so meeting them is typically the starting point for both clinical and coverage decisions. The third threshold is less common and requires individual review.

Read the full clinical write-up

Candidacy lead-in, qualifying conditions, pre-surgery evaluation, and when we recommend a different procedure

Candidates for sleeve gastrectomy are determined based on the following ASMBS clinical guidelines and standard insurance criteria, but these are not the only factors we consider. We review every potential candidate individually before recommending the best weight loss strategy.

BMI thresholds (40+, or 35–39 with a related condition)

There are three published BMI thresholds for sleeve gastrectomy candidacy:

  • BMI of 40 or higher: Patients may be evaluated as candidates regardless of other medical conditions.
  • BMI of 35 to 39.9: Patients may be evaluated as candidates if accompanied by at least one obesity-related health condition.
  • BMI of 30 to 34.9: Under some insurance plans, patients may be evaluated as candidates when metabolic disease is also present.

Most insurance carriers follow the first two thresholds, so meeting them is typically the starting point for both clinical and coverage decisions. The third threshold is less common and requires individual review.

Conditions that often qualify patients (Type 2 diabetes, sleep apnea, hypertension)

The most common qualifying conditions in our gastric sleeve patients are Type 2 diabetes, severe sleep apnea, and high blood pressure (hypertension). Others that commonly meet criteria include non-alcoholic fatty liver disease, osteoarthritis affecting weight-bearing joints, and hyperlipidemia. For patients with a BMI of 35 to 39.9, having one of these conditions is often what makes the difference between qualifying and not qualifying for sleeve gastrectomy. If that applies to you, we can review your insurance plan's specific criteria during a consultation.

The pre-surgery evaluation

Candidacy for sleeve gastrectomy is based on more than BMI and comorbidity factors, so we also perform a full pre-operative workup before recommending surgery. We evaluate each candidate across clinical, nutritional, psychological, and insurance-related criteria:

  • Nutritional assessment with a registered dietitian to evaluate your current eating patterns and readiness for the dietary changes this surgery requires
  • Psychological evaluation to confirm you have realistic expectations and are emotionally prepared for the long-term commitment
  • Medical clearance from your primary care physician or an internist, including relevant lab work and imaging
  • Insurance requirements: Most plans require documentation of participation in a supervised medical weight management program (typically three to six months)

We coordinate the full evaluation and assist with insurance pre-authorization on your behalf, so you have one point of contact through what can otherwise be a confusing process.

Reasons we sometimes recommend a different procedure

Sleeve gastrectomy is not the right answer for every patient who qualifies for bariatric surgery. For instance, when a patient has significant pre-existing acid reflux (GERD), we sometimes recommend gastric bypass instead because sleeve gastrectomy can worsen reflux in some patients. As another example, patients with very high BMI and complex metabolic disease may be better served by a malabsorptive procedure. We will discuss the full range of options with you during your consultation, and no decision will be made without a complete picture of your health history.

Recovery

What recovery looks like

Most patients walk within hours of surgery and return to desk work in 1–2 weeks. Physical-labor jobs require 4–6 weeks off.

  1. Day of surgery

    In the OR — 60 to 90 minutes

    General anesthesia. 4 to 6 small incisions. A surgical stapler divides the stomach lengthwise and 75 to 85 percent is removed. Robotic-assisted via da Vinci for greater precision in tight spaces.

  2. Hospital stay · 1 night

    Walking within hours

    Most patients begin walking within a few hours of surgery to support circulation. Liquids only during week 1 — water, broth, and protein shakes.

  3. Weeks 2–4

    Diet advances, energy returns

    Soft pureed foods begin in week 2. Most patients return to desk work by week 2. Soft solid foods by the end of the first month. Vitamin and mineral supplements begin and continue long-term.

  4. Weeks 4–6+

    Soft solids, then regular textures

    Jobs involving physical labor, lifting, or sustained standing resume at 4 to 6 weeks. Structured exercise can resume once surgical sites have healed.

Read the full clinical write-up

Four detailed sub-sections — day of surgery through returning to work

The day of surgery

Sleeve gastrectomy is performed under general anesthesia. Dr. Patel will make four to six small incisions in the abdomen, insert a camera through one and surgical instruments through the others, then use a surgical stapler to divide and remove 75 to 85 percent of the stomach. For robotic-assisted procedures, the da Vinci system guides the same steps with greater precision in tight spaces. Total operating time is typically 60 to 90 minutes for an uncomplicated case.

The first week: hospital and coming home

Most patients stay one night in the hospital. Patients are encouraged to begin walking around within a few hours after surgery to support circulation and reduce the risk of blood clots. Most patients feel tired and sore for the first several days. Discomfort is manageable with prescribed pain medication and typically eases by the end of week one. Diet during the first week is liquids only: water, broth, and protein shakes.

Weeks 2–4: diet advances and energy returns

Most patients will notice their energy levels returning, and many can return to desk jobs by week two. Patients can also begin eating soft, pureed foods, and transition to soft solid foods by the end of the first month. Our dietitian provides individualized guidance at each stage based on how each patient is tolerating the progression. Vitamin and mineral supplements must be taken throughout this period and long-term, because the smaller stomach makes it difficult to get adequate nutrition from food alone.

Returning to work and physical activity

While desk jobs can often be resumed within one to two weeks, jobs involving physical labor, lifting, or sustained standing require four to six weeks off. Light walking is encouraged from day one; more structured exercise can typically resume by four to six weeks, once the surgical sites have healed. Dr. Patel will provide specific post-operative activity guidelines before discharge.

Long-term outcomes

Long-term results and lifestyle

Published data from ASMBS and peer-reviewed journals including Obesity Surgery and JAMA Surgery show a fairly consistent weight loss curve after sleeve gastrectomy.

What weight loss looks like at 6, 12, and 24 months

30–40%

Excess weight loss

within first 6 months

50–60%

Excess weight loss

at 12 months

50–70%

Long-term benchmark

12 to 24 months

Patients typically lose 30 to 40 percent of their excess body weight within the first 6 months. At 12 months, that figure moves toward 50 to 60 percent, and most patients reach the 50 to 70 percent excess body weight loss benchmark between 12 and 24 months. These are ranges drawn from large-population studies, and individual results depend on starting weight, adherence to dietary guidelines, and activity level.

10-year results and what holds them in place

Long-term data from studies published in Obesity Surgery show that patients who sustain dietary adherence and exercise habits keep off 15 to 20 percent of their total body weight a decade out. The patients who hold those results share consistent behaviors: regular protein-forward eating, avoidance of high-calorie liquids, and continued follow-up with their surgical team.

Patients who move away from those habits over time may experience gradual weight regain, even if the surgery initially helped them lose a significant amount of weight. While the sleeve itself does not stretch back to its original size, some patients may fall into a habit of grazing on small, calorie-dense foods throughout the day. That grazing pattern is the most common behavior behind long-term regain after bariatric surgery.

Eating-and-drinking rule

The 30/30 rule for eating and drinking

The 30/30 rule is a simple post-operative eating guideline: stop drinking fluids 30 minutes before a meal, and wait 30 minutes after eating before drinking again. Because the smaller stomach can't hold much at once, drinking while eating displaces food too quickly, which interferes with satiety, causes discomfort, and cuts into your daily fluid intake. Following this rule protects the sleeve and keeps you properly hydrated.

If regain happens

When patients regain, and what we do about it

Some weight regain after the first year or two is common and does not indicate that surgery failed. What matters is the degree and the trajectory. Patients who regain modestly and then stabilize are generally within the expected long-term pattern. Patients who regain significantly, or who experience worsening reflux, nutritional deficiencies, or other complications, are evaluated for revisional surgery.

Because bariatric surgery is a long-term health commitment, our program emphasizes continued follow-up care to help patients protect their results and address concerns early. Our goal is to support patients not only through surgery and recovery, but through the long-term process of maintaining their health and weight loss results. Read our patient reviews to hear directly from patients who have completed the program.

Most patients lose 50 to 70 percent of their excess body weight within one to two years of sleeve gastrectomy surgery.
ASMBS · American Society for Metabolic and Bariatric Surgery

Cost & coverage

Cost, insurance, and financing in Florida

Three paths to coverage. We help every patient understand which applies before pre-authorization or self-pay paperwork begins.

Insurance coverage

Most major insurance carriers cover sleeve gastrectomy when the ASMBS candidacy criteria are met and documentation requirements are satisfied.

AetnaAnthem BCBSCignaUnitedHealthcareFlorida Blue

Standard documentation includes a physician referral, BMI records, a qualifying comorbidity when BMI is 35 to 39.9, and proof of participation in a medically supervised weight loss program (typically three to six months). We review insurance coverage for bariatric surgery with every patient before the pre-authorization process begins, so there are no surprises when paperwork is submitted.

Self-pay pricing in Orlando

$9,800–$16,000

Orlando market range

Sleeve gastrectomy in Florida typically runs from $9,800 to $16,000 or more, depending on the provider, facility, and what's included in the package. That range reflects the broader Orlando market, where all-inclusive self-pay packages from local centers start in the $9,800 to $11,000 range.

Before comparing prices, we recommend asking any provider for a clear itemization of what is and isn't included. Different bariatric surgery programs bundle very different services.

Financing through Cherry

For patients paying out-of-pocket, we offer Cherry financing options for qualified applicants.

Cherry runs payment plans with no prepayment penalty, so paying down faster doesn't cost more. Ask our patient coordinator about current terms and eligibility during your consultation.

Ask about financing

Surgery vs. medication

Sleeve gastrectomy and GLP-1 medications (Ozempic, Wegovy)

GLP-1 receptor agonists have changed the conversation around weight loss. Patients now have a real choice between a medication that works while they take it and a surgery that produces permanent structural change. The right answer depends on BMI, medical history, and the patient's willingness to commit to either path long-term.

Medication first

When medication may be the right starting point

GLP-1 medications produce meaningful weight loss in most patients who take them consistently. Published data from the SURMOUNT-1 and STEP 1 trials show average weight loss of 15 to 22 percent of total body weight with semaglutide and tirzepatide over 68 to 72 weeks. For patients with a BMI below 35, or for patients who want to avoid surgery and are willing to remain on medication indefinitely, a GLP-1 is a reasonable first-line option. We don't discourage patients from exploring this path, and it works for a meaningful share of the population.

Surgery long-term

When surgery is the better long-term answer

For long-term results, surgery can often be a better choice. The 75 to 85 percent of stomach tissue that is removed in sleeve gastrectomy does not grow back, and the reduction in ghrelin-producing tissue is permanent. By contrast, GLP-1 medications work only while the patient takes them, and weight regain after stopping is well-documented. Published data in JAMA Internal Medicine show that patients regain approximately two-thirds of their lost weight within a year of discontinuing semaglutide.

For patients with a BMI of 40 or higher, or 35 to 39.9 with significant metabolic disease, current comparative data shows that surgery produces greater total weight loss at five and ten years than GLP-1 therapy alone. Surgery also resolves Type 2 diabetes at a higher rate: bariatric studies report complete remission in 60 to 80 percent of patients at two years, whereas GLP-1 therapy more typically leads to glycemic improvement rather than full remission.

Combined plans

Combining the two: what the current evidence shows

In some cases, a carefully structured plan involving both GLP-1 medications and bariatric surgery may be recommended. Some patients may take GLP-1 medications before surgery to achieve pre-operative weight loss and reduce surgical risk (especially for high-BMI patients). After surgery, a subset of patients who experience weight loss plateau or regain may be prescribed GLP-1 medications as an adjunct. Early data suggests that patients who use GLP-1 therapy after bariatric surgery sustain more weight loss than those who don't. This is an evolving area of research, and our recommendations are guided by current peer-reviewed data rather than a fixed, one-size-fits-all protocol.

Your care, guided from start to finish

At Orlando Minimally Invasive Surgery, we stay by your side throughout your surgical journey, ensuring you feel informed, supported, and cared for at every stage.

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Frequently asked questions about sleeve gastrectomy

  • How much does sleeve gastrectomy cost in Florida?

    Sleeve gastrectomy in Florida typically ranges from $9,800 to $16,000 or more, depending on the provider, facility, and what the package includes. This is the Orlando market self-pay range. Insurance coverage is available for qualifying patients and substantially reduces out-of-pocket cost. Visit our Cherry financing options page for payment plan details.

  • Can I get a sleeve gastrectomy if I have GERD?

    Pre-existing GERD requires careful evaluation before sleeve gastrectomy. The procedure can worsen acid reflux in some patients because the reduced stomach volume and increased intragastric pressure can promote reflux. ASMBS guidelines note that for patients with significant pre-existing reflux, gastric bypass is often recommended instead. We review GERD treatment options and reflux history during every bariatric consultation.

  • What is the 30/30 rule after gastric sleeve?

    The 30/30 rule is a simple eating guideline: stop drinking fluids 30 minutes before a meal, and wait 30 minutes after eating before drinking again. Because the smaller stomach can't hold much at once, drinking while eating displaces food too quickly and can cause discomfort and early satiety. Waiting to drink 30 minutes after meals allows full absorption of the meal and supports adequate daily hydration.

  • What results can I expect 10 years after gastric sleeve?

    Long-term data from studies published in Obesity Surgery show patients who maintain dietary adherence typically sustain 15 to 20 percent of total body weight lost at ten years. Patients are advised that some regain is common after the first two to three years, particularly in patients who graze or return to high-calorie liquid intake. Sustained dietary habits and consistent follow-up with your bariatric team are the primary factors that hold long-term results in place.

  • Is Ozempic better than gastric sleeve?

    Ozempic and other GLP-1 medications reduce appetite and can be effective tools for weight loss, especially for patients who are not ready for surgery or do not qualify for bariatric surgery. Clinical trials show an average weight loss of 15 to 22 percent of total body weight for patients taking GLP-1s. However, they usually require ongoing use to maintain results, and published studies show that patients regain approximately two-thirds of lost weight within a year of stopping GLP-1 therapy. Sleeve gastrectomy, on the other hand, creates a lasting structural change to the size of the stomach and produces 50 to 70 percent of excess body weight loss over one to two years. Long-term dietary adjustments are still necessary, but for patients with high BMI and significant metabolic disease, surgery produces greater total weight loss at five and ten years in current comparative data. The better option depends on your BMI, health history, weight loss goals, medication tolerance, and whether you are looking for a surgical or non-surgical approach.

  • How much weight will I lose 3 months after sleeve gastrectomy?

    By three months after surgery, most patients have lost 10 to 15 percent of their total body weight. The rate of weight loss is typically fastest in the first three months, when the sleeve restriction is strongest and the patient is following a structured post-operative diet. This is a reference range drawn from published data, and individual results vary based on starting weight, adherence, and activity level.

  • How long is recovery from gastric sleeve surgery?

    Hospital stay is typically one night. Most patients feel recovered enough to return to desk work within one to two weeks of surgery. Jobs involving physical labor or lifting require four to six weeks off. Light walking begins the first day, and more structured physical activity typically resumes at four to six weeks once the surgical sites are healed.

  • What are the most common complications of sleeve gastrectomy?

    ASMBS-reported complication data for sleeve gastrectomy include: staple line leak in approximately 1 percent of cases, sleeve stricture (narrowing) in approximately 1 to 3 percent, and vitamin or mineral deficiencies in patients who don't maintain their supplement regimen consistently. Bleeding and blood clots are risks of any abdominal surgery. Overall major complication rates for sleeve gastrectomy at experienced centers are below 3 percent, which is comparable to other common abdominal procedures.

  • What does the sleeve gastrectomy procedure look like, step by step?

    First, general anesthesia is administered. Once the patient is asleep, four to six small incisions are made in the abdomen, and a laparoscopic camera and surgical instruments (or the da Vinci robotic system) are inserted. A calibration tube is placed inside the stomach to guide sizing. A surgical stapler divides the stomach lengthwise, and 75 to 85 percent of the stomach is removed. The staple line is inspected and reinforced if needed. Finally, the incisions are closed. The patient is moved to a recovery area and then to a hospital room for an overnight stay.

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