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The Khalili Center’s Gastric Sleeve Aftercare Recovery Program

Our aftercare recovery program is a comprehensive partnership that helps you deal with significant changes that come with gastric sleeve surgery.

The Khalili Center can support every aspect of your well-being, whether medical, mental, or physical. Our aftercare program includes monthly walks with the doctors, consultations with our dietitian, counseling sessions, community activities, and health information support. 

Learn more about our patients’ success stories after gastric sleeve surgery.

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A Leader in Gastric Sleeve Surgery in California

Our founder, Dr. Theodore M. Khalili, is an accomplished board-certified surgeon who has performed over 8,000 bariatric surgeries, including sleeve gastrectomy, gastric bypass, and Lap-Band. 

Dr. Khalili is a pioneer in minimally-invasive and robotic-assisted weight-loss surgeries. In 2002, he performed the first robotic-assisted gastric bypass surgery in the United States. Dr. Khalili is also a very influential educator, having won the Golden Apple Award as an outstanding educator in 2005. 

Dr. Khalili has trained many general surgeons who have moved on to become successful leaders in various minimally-invasive bariatric programs all over the world.

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My name is Dr. Theodore Khalili, surgeon and founder of Weight Loss Surgery of Southern California. I founded the Center because I have dedicated my life-long professional work to patient care. My approach to patient-centric partnerships and service-oriented facilities offer a comprehensive and holistic approach to bariatric treatment – all in one place.

I believe that patient care does not end right after surgery – it’s only the beginning. I founded the Center to give patients access to a supportive community that guides them through each step of the weight loss journey. We work with a team of registered dieticians, psychologists and general doctors to create tailored, best-in-class care available.

I have performed over 8,000 bariatric surgeries…

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Dr. Theodore M. Khalili,
Founder and Director of the Khalili Center for Bariatric Care

Post-op Notes: What to Expect During Recovery

Recovery time for gastric sleeve surgery is faster compared to open surgeries. You may be discharged from the hospital around two to three days after the surgery. During the first week, your surgeon will prescribe you medication to manage your pain. The recovery period depends on how the patient responds to the operation. You must allow your body to heal by taking time off work for two to three weeks after the procedure. The first follow-up appointment is usually around four to five weeks after surgery(1).

 

Changes in Diet

On the first day of your recovery period, you should only consume clear liquids to let your stomach rest. On the third day, depending on your surgeon’s advice, a liquid diet of soup, broth, or unsweetened juice may be recommended. Our dietitian will provide you with a post-op nutrition plan. During the first few weeks, you must maintain a full liquid diet

Once you get used to your new stomach (around the third week), you can transition to pureed foods with the occasional crackers. After four or five weeks, you can gradually change your diet to solid foods. Since the gastric sleeve procedure is permanent, you must only consume a small amount of food during meals to avoid stretching your stomach. 

By eight weeks, you can carry on with a regular balanced diet. The post-surgery-liquid diet is the first step to the new nutritional protocol. The transition from a liquid diet to pureed food and then to solid food encourage patients to make healthy choices(2).

 

Pain Medication and Supplements

Our bariatric surgeon will prescribe a pain medication for you to take during the first week. Most patients do not need additional pain medication after the first week(3). Our dietitian will also recommend that you take multivitamins due to the lack of nutrients caused by the liquid diet.

 

Activities and Work

On your first or second day after surgery, the nurse will ask you to take only a few steps. You must not drive a vehicle during the first week, especially while you are on pain medicationDuring recovery, you will need help with daily tasks, like caring for small kids or doing house chores. 

In your second week, you can start taking short walks. Strenuous activities and heavy lifting are not recommended during the first six weeks. By your third and fourth week, you can gradually go back to work and other normal activities.

 

Guides and Tips for Better Healing

The Khalili Center will provide support while you make the necessary lifestyle changes. Here are our tips on how you can heal faster:

  • You can get plenty of nutrition from soft, pureed foods. Fruits and vegetables can be blended into smoothies. Protein shakes also help supplement the lack of protein caused by liquid and soft food diets. 
  • Since you can only consume a small amount of food during meals, you can opt for nutritious foods like lentils, high protein foods, soy products, meat, cottage cheese, fruits, and vegetables. 
  • Once you are fully recovered, you can start a regular exercise routine.  
  • If you are not too keen on exercising, you can participate in physical activities, such as running, cycling, swimming, and other sports. 
  • Avoid high calorie, low nutrition food high in sugar. 
  • Avoid caffeine and alcohol.
  • Avoid taking any pain medicine without consulting your doctor. Bariatric surgery patients have a higher risk of developing stomach ulcers due to non-steroidal anti-inflammatory drugs (NSAIDs)(4).
  • Join a support group to learn the experiences of other bariatric surgery patients and build healthy relationships.

Why Choose the Khalili Center for Gastric Sleeve Surgery.

The Khalili Center is home to qualified general surgeons who not only have impressive track records but also aim to build meaningful relationships with our patients. We believe that true collaboration between surgeons and patients contribute to the long-term success of the procedures.

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All our surgeons are experts in bariatric surgeries and board-certified members of the American Society of Metabolic and Bariatric Surgery (ASMBS). Furthermore, the Khalili Center is also home to cutting-edge bariatric innovations. Dr. Khalili and our doctors have contributed several studies and research on laparoscopic surgeries and weight loss procedures

Click here to read more about our doctors and their credentials, and find out how they can help you best. 

Pre-SurgeryPreparation.

The reduced stomach size leads to lower absorption of calories and significant weight loss. Preoperative weight loss reduced the risks of surgery complications(15). Moreover, experts observed that patients with preoperative weight loss had a shorter hospital stay(16)

Our dietitian will provide a diet plan a few weeks before the surgery. The diet plan may include a few foods and drink restrictions. You will also be advised to follow an exercise routine to prepare for the surgery.

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Understanding Gastric Sleeve Surgery

Gastric sleeve surgery is an operation that removes a large part of the stomach to create a smaller stomach shaped like a tube. The reduced stomach size leads to lower absorption of calories and significant weight loss. Like other bariatric surgeries that our doctors perform, such as gastric bypass and Lap-Band, gastric sleeve surgery can effectively treat obesity and improve life quality. 

Laparoscopic gastric sleeve surgery is a safe and effective treatment for obesity. Five-year follow-ups generally show little to no signs of pos-operative complications(5).

Gastric sleeve surgery has been the preferred weight loss surgery method among patients compared to other procedures. 

According to the American Society for Metabolic and Bariatric Surgery (ASMBS), an estimated 252,000 bariatric procedures were performed in 2018, in which 61.4% were gastric sleeve surgeries(6)

If you are interested in getting gastric sleeve surgery, our screening process determines if you are a candidate. Our doctors will measure your body mass index (BMI) to determine if you are candidates for the surgery. 

You will also be evaluated according to your health information, history, and other medical conditions.  Like all bariatric procedures, gastric sleeve surgery is reserved for patients whose BMI is 40 or over. Most of our candidates have exhausted all diet and exercise forms to end up with short-term or no weight loss(7)

How Gastric Bypass Works

Sleeve gastrectomy is a less complicated procedure compared to gastric bypass surgery. Gastric sleeve surgery is usually performed laparoscopically. Our surgeon makes one-centimeter incisions on the abdomen. A (camera) laparoscope and special instruments are inserted through these incision sites to perform the surgery. The surgeon watches the operation through a monitor.  

The operation removes around 80% of the stomach, leaving a small-sized tube (sleeve). The narrow tube will empty the food from the stomach and move directly into the small intestine. Moreover, the removal of the large part of the stomach is known to reduce appetite-increasing hormones.

It has been observed that gastric sleeve surgery outcomes demonstrated lowered hunger-causing hormones that may contribute to weight management (8)

After your surgery, even small meals can make your small stomach feel full. You may also have a reduced appetite. The reduced calorie intake eventually leads to significant long-term weight loss

Expected Results of Gastric Bypass Surgery

It is well-documented that gastric sleeve surgery patients, during a three-month follow-up, demonstrated a 41.8% in excess weight loss. The surgery also led to significant improvement in hypertension in 68.2% of patients, while 65.8% showed reduced symptoms of Type 2 Diabetes (9). It is observed that 75% of gastric sleeve patients demonstrated resolution or improvement in hypertension. The improvement was observed around one to two years after laparoscopic sleeve gastrectomy (10).

Patients with preoperative obstructive sleep apnea syndrome have reported improvements within a year after the surgery (11)

Experts mentioned that the procedure might also reduce non-obesity related health conditions, such as gout, urinary incontinence, ovarian disorders, and musculoskeletal problems (12).  

Furthermore, it has been found that gastric sleeve surgery significantly reduced anxiety and depression among patients. Doctors have noted that 90% of gastric sleeve patients who presented these psychiatric conditions have decreased or discontinued medications (13)

Since the procedure is often done laparoscopically, the recovery period is faster compared to open surgeries. Also, the small incisions require less maintenance compared to larger incisions. 

The procedure reduces risks and symptoms of the following health problems (14):

  • Obstructive sleep apnea syndrome
  • Type 2 Diabetes
  • High blood pressure
  • Cardiovascular disease
  • Nonalcoholic fatty liver disease (NAFLD) 
  • Gastroesophageal reflux disease (GERD)
  • Osteoarthritis (joint pain)
  • Stroke
  • Infertility
Possible Side Effects of a Gastric Bypass Surgery

Like any major procedure, gastric sleeve surgery may present some risks and side effects. Our surgeons will ensure that you are well-informed of the complications before making your decision. 

Our screening process helps us determine the risks and predict the outcomes of the surgery. You will also be guided by our doctors accordingly to avoid some side effects.

Here are the possible side effects of gastric bypass surgery (17):

  • Excessive bleeding 
  • Abscess 
  • Infection
  • Blood clots
  • Adverse reactions to anesthesia
  • Gastrointestinal obstruction
  • Gastrointestinal leaks or staple line leak
  • Gastroesophageal reflux disease (GERD)
  • Hernias
  • Hypoglycemia (low blood sugar)
  • Malnutrition
  • Vomiting
  • Gastric sleeve surgery is rarely fatal. 
  • Hair loss(18) 

Dumping syndrome (nausea, vomiting, diarrhea, abdominal cramping)(19)

References

  1. Leivonen, M. K., Juuti, A., Jaser, N., & Mustonen, H. (2011). Laparoscopic sleeve gastrectomy in patients over 59 years: early recovery and 12-month follow-up. Obesity surgery, 21(8), 1180–1187. https://doi.org/10.1007/s11695-011-0454-6
  2. ANDRADE, Camila Garcia da Costa, & LOBO, Amanda. (2014). Weight loss in the first month post-gastroplasty following diet progression with introduction of solid food three weeks after surgery. ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), 27(Suppl. 1), 13-16. https://doi.org/10.1590/s0102-6720201400s100004
  3. 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. OBES SURG 28, 1031–1039 (2018). https://doi.org/10.1007/s11695-017-2964-3
  4. Yska JP, Gertsen S, Flapper G, Emous M, Wilffert B, van Roon EN. NSAID Use after Bariatric Surgery: a Randomized Controlled Intervention Study. Obes Surg. 2016;26(12):2880-2885. doi:10.1007/s11695-016-2218-9
  5. Hoyuela C. (2017). Five-year outcomes of laparoscopic sleeve gastrectomy as a primary procedure for morbid obesity: A prospective study. World journal of gastrointestinal surgery, 9(4), 109–117. https://doi.org/10.4240/wjgs.v9.i4.109
  6. American Society for Metabolic and Bariatric Surgery. Bariatric Surgery Statistics. Retrieved from https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers
  7. Potential Candidates for Bariatric Surgery. Retrieved from https://www.niddk.nih.gov/health-information/weight-management/bariatric-surgery/potential-candidates
  8. Sethi, P., Thillai, M., Nain, P. S., Ahuja, A., Aulakh, N., & Khurana, P. (2018). Role of Hunger Hormone “Ghrelin” in Long-Term Weight Loss Following Laparoscopic Sleeve Gastrectomy. Nigerian journal of surgery : official publication of the Nigerian Surgical Research Society, 24(2), 121–124. https://doi.org/10.4103/njs.NJS_24_17
  9. Neagoe, R., Muresan, M., Timofte, D., Darie, R., Razvan, I., Voidazan, S., Muresan, S., & Sala, D. (2019). Long-term outcomes of laparoscopic sleeve gastrectomy – a single-center prospective observational study. Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other minimally invasive techniques, 14(2), 242–248. https://doi.org/10.5114/wiitm.2019.84194
  10. Jonathan G Owen, Farshid Yazdi, Efrain Reisin, Bariatric Surgery and Hypertension, American Journal of Hypertension, Volume 31, Issue 1, January 2018, Pages 11–17, https://doi.org/10.1093/ajh/hpx112
  1. Ibid
  2. Kheirvari, M., Dadkhah Nikroo, N., Jaafarinejad, H., Farsimadan, M., Eshghjoo, S., Hosseini, S., & Anbara, T. (2020). The advantages and disadvantages of sleeve gastrectomy; clinical laboratory to bedside review. Heliyon, 6(2), e03496. https://doi.org/10.1016/j.heliyon.2020.e03496
  3. Scott V. Monte, Kristen M. Russo, Esra Mustafa, Joseph A. Caruana, “Impact of Sleeve Gastrectomy on Psychiatric Medication Use and Symptoms”, Journal of Obesity, vol. 2018, Article ID 8532602, 5 pages, 2018. https://doi.org/10.1155/2018/8532602
  4. The Mayo Clinic. Sleeve Gasterectomy. Retrieved from https://www.mayoclinic.org/tests-procedures/sleeve-gastrectomy/about/pac-20385183
  5. Roman, M., Monaghan, A., Serraino, G.F., Miller, D., Pathak, S., Lai, F., Zaccardi, F., Ghanchi, A., Khunti, K., Davies, M.J. and Murphy, G.J. (2019), Meta‐analysis of the influence of lifestyle changes for preoperative weight loss on surgical outcomes. Br J Surg, 106: 181-189. doi:10.1002/bjs.11001
  6. Ibid
  7. The Mayo Clinic. Sleeve Gasterectomy. Op cit
  8. Ruiz-Tovar J, Oller I, Llavero C, et al. Hair loss in females after sleeve gastrectomy: predictive value of serum zinc and iron levels. Am Surg. 2014;80(5):466-471
  9. Ramadan, M., Loureiro, M., Laughlan, K., Caiazzo, R., Iannelli, A., Brunaud, L., Czernichow, S., Nedelcu, M., & Nocca, D. (2016). Risk of Dumping Syndrome after Sleeve Gastrectomy and Roux-en-Y Gastric Bypass: Early Results of a Multicentre Prospective Study. Gastroenterology research and practice, 2016, 2570237. https://doi.org/10.1155/2016/2570237

Your Journey to Overcoming Obesity Starts Here.

Weight loss surgery is a tool to reset your life.

Our comprehensive program is everything you need to set you up for your new life and to keep the weight off. All you have to to find out if we’re right for you is to book an appointment.