A gastric sleeve procedure, also called sleeve gastrectomy, is a transformative surgical intervention that permanently reduces the size of the stomach to help achieve significant weight loss. At our practice, we understand that the decision to pursue bariatric surgery comes after a long journey of weight management challenges and careful consideration. That's why we're committed to providing compassionate, expert care while helping you understand each step of your weight loss journey.
This effective procedure helps patients with obesity achieve substantial and sustainable weight loss by creating a smaller stomach that restricts food intake while also reducing hunger hormones. At Lifetime Surgical, our gastric sleeve approach utilizes the state-of-the-art DaVinci robotic surgical system, offering unmatched precision, enhanced visualization, and superior control compared to traditional laparoscopic techniques. We employ careful surgical planning, precise staple line creation, and comprehensive pre- and post-operative support, resulting in not only significant weight loss but also improvement or resolution of many obesity-related health conditions. The robotic approach provides additional benefits including smaller incisions, reduced post-operative pain, minimal scarring, and faster recovery time. Our multidisciplinary team guides you through the entire process, from pre-surgical preparation through post-operative lifestyle adaptation, ensuring the best possible outcomes for your individual health goals.
You may be a candidate for gastric sleeve surgery if you:
Have a body mass index (BMI) of 40 or higher (extreme obesity)
Have a BMI between 35-40 with obesity-related health conditions such as:
Type 2 diabetes
High blood pressure
Sleep apnea
Nonalcoholic fatty liver disease
Osteoarthritis
Heart disease
Dyslipidemia (high cholesterol or triglycerides)
Have made serious attempts at diet and exercise without achieving or maintaining significant weight loss
Are prepared to make lifelong changes in eating habits and lifestyle
Do not have conditions that would make surgery excessively risky
Have realistic expectations about the results of bariatric surgery
Are committed to long-term follow-up care
Understand the procedure and its potential risks and benefits
Have been cleared by psychological evaluation for bariatric surgery
Do not have untreated mental health conditions that would interfere with post-surgical adherence
Are not dependent on alcohol or illicit drugs
For adolescents: have reached physical maturity (typically age 13+ for girls, 15+ for boys)
Have no active gastrointestinal ulcers or severe reflux disease that would contraindicate sleeve gastrectomy
Are not pregnant or planning pregnancy within the first 18 months after surgery
Can demonstrate a history of obesity for at least 3-5 years
Our approach to gastric sleeve surgery combines surgical excellence with comprehensive care throughout your weight loss journey. The procedure begins with thorough preoperative assessment including nutritional, psychological, and medical evaluations to ensure you're well-prepared for surgery and the necessary lifestyle changes that follow. What sets us apart is our use of the advanced DaVinci robotic surgical system combined with our multidisciplinary team approach that provides support before, during, and long after your procedure to maximize your success.
The surgery is performed using the DaVinci robotic platform, which offers significant advantages over traditional laparoscopic techniques. The robot's articulating instruments provide enhanced dexterity and range of motion beyond what human hands can achieve, allowing for more precise tissue handling and staple line creation. The system's high-definition 3D visualization gives our surgeon unprecedented views of the surgical field with 10x magnification, enabling meticulous dissection and identification of critical structures.
Using the DaVinci system, we make 4-5 tiny incisions (typically 8mm or smaller) in the abdomen, resulting in minimal scarring compared to traditional approaches. After accessing the abdominal cavity, we carefully divide the attachments along the greater curvature of the stomach and insert a sizing tube to guide the creation of your new stomach. Using specialized surgical staplers with robotic precision, we remove approximately 80% of the stomach, leaving a narrow, banana-shaped "sleeve" that typically holds about 100-150 ml (compared to the original 1.5-liter capacity).
Our distinctive robotic approach includes:
Unprecedented surgical precision that ensures a perfectly uniform staple line
Enhanced 3D visualization allowing for meticulous tissue handling
Reduced tissue trauma leading to less post-operative pain and faster recovery
Careful testing of the staple line during surgery to ensure there are no leaks
Precise technique that preserves the pyloric valve and normal digestive pathway
Attention to the angle of His (where the esophagus meets the stomach) to reduce reflux risk
Meticulous staple line reinforcement to minimize bleeding and leak risk
Minimal scarring with significantly smaller incisions
The robotic advantage translates to patient benefits including:
Reduced post-operative pain
Lower risk of complications
Shorter hospital stay (often just overnight)
Faster return to normal activities
Minimal scarring for improved cosmetic results
Reduced risk of post-operative hernia
Throughout your care journey, our comprehensive program includes:
Detailed nutritional counseling before and after surgery
Psychological support for the emotional aspects of significant weight loss
Customized exercise plans developed with our exercise physiologists
Regular follow-up visits to monitor progress and address any concerns
Support groups led by bariatric professionals
Long-term monitoring for nutritional deficiencies with appropriate supplementation
This integrated approach combining robotic-assisted surgical excellence with comprehensive care ensures not just successful weight loss but sustained health improvement, addressing the physical, nutritional, and psychological aspects of obesity management for comprehensive, long-term success.
Immediate Post-Procedure (1-3 days)
Expect a hospital stay of just 1 day for most patients due to the minimally invasive robotic approach
Experience significantly less post-operative pain compared to traditional laparoscopic techniques
Begin with clear liquids as directed by your surgical team, typically within hours of surgery
Work with nursing staff to ensure adequate hydration
Receive instruction on proper breathing exercises to prevent lung complications
Begin walking within hours of surgery to prevent blood clots and promote recovery
Manage discomfort with prescribed pain medication, which is typically minimal following robotic surgery
Experience some shoulder pain from residual CO2 gas used during surgery
Understand the importance of not overextending yourself despite feeling well
Meet with the dietitian to review your post-operative diet progression
Receive detailed discharge instructions about medications, diet, and activity
Learn to recognize signs of potential complications requiring immediate attention
Understand the importance of maintaining proper hydration (typically 64 oz. daily)
Prepare for your first follow-up appointment, typically scheduled 1-2 weeks after surgery
Short-Term Recovery (1-4 weeks)
Return to normal activities more quickly than with traditional surgical approaches
Resume light physical activity within days rather than weeks
Experience minimal discomfort at your small incision sites
Follow the prescribed diet progression:
Clear liquids (days 1-2)
Full liquids (days 3-14)
Pureed foods (weeks 3-4)
Focus on protein intake, aiming for 60-80 grams daily through protein shakes and supplements
Take all prescribed vitamins and minerals as directed
Avoid carbonated beverages, caffeine, alcohol, and straws
Sip water continuously throughout the day to maintain hydration
Begin taking small sips (1-2 oz.) at a time, allowing 30 minutes to consume 8 oz.
Attend your follow-up appointment for a wound check and diet advancement
Gradually increase walking distance daily
Avoid lifting more than 10-15 pounds for 2-3 weeks (shorter restriction than with traditional surgery)
Experience continued improvement in surgical discomfort
Monitor incision sites for proper healing, which typically occurs faster with smaller robotic incisions
Begin to notice significant changes in hunger and satiety cues
Track food and fluid intake carefully
Report any persistent nausea, vomiting, or inability to stay hydrated
Avoid non-steroidal anti-inflammatory drugs (NSAIDs)
Expect rapid weight loss during this period, often 2-4 pounds per week
Return to work as early as 1-2 weeks after surgery, depending on job requirements
Long-Term Recovery (1-6 months)
Continue advancing your diet according to the program guidelines:
Soft foods (months 1-2)
Regular, healthy foods with appropriate texture (months 3+)
Learn to eat mindfully with small bites, thorough chewing, and stopping at the first sign of fullness
Practice separating liquids from meals (typically no liquids 30 minutes before and after meals)
Establish regular eating patterns with 3 small, protein-focused meals daily
Begin a structured exercise program as cleared by your surgeon, typically after 3-4 weeks (earlier than with traditional approaches)
Attend regular follow-up appointments to monitor weight loss progress
Have laboratory tests to check for nutritional deficiencies
Continue taking recommended vitamin and mineral supplements
Participate in support group meetings
Adjust to significant body changes, both physical and emotional
Learn to recognize and manage "head hunger" versus physical hunger
Establish sustainable eating habits for long-term success
Monitor for proper hydration and protein intake
Experience continued weight loss, typically 8-12 pounds per month during this period
Begin to notice improvement or resolution of obesity-related health conditions
Work with the bariatric team to address any challenges or plateaus
Appreciate the minimal scarring from your robotic procedure as incisions continue to fade
Long-Term Expectations
Expect to lose approximately 60-70% of excess body weight within 12-18 months
Weight loss typically stabilizes around 18-24 months post-surgery
Maintain regular follow-ups with the bariatric program:
Every 3 months during the first year
Every 6 months during the second year
Annually thereafter
Continue lifelong vitamin and mineral supplementation, typically including:
Multivitamin
Calcium citrate with vitamin D
Vitamin B12
Iron (for menstruating women)
Undergo regular laboratory testing to monitor for nutritional deficiencies
Expect significant improvement or resolution of many obesity-related conditions:
Type 2 diabetes (70-80% resolution)
Hypertension (70% improvement or resolution)
Sleep apnea (80% improvement or resolution)
Joint pain (70% improvement)
Improved fertility and reduced pregnancy complications
Maintain healthy eating habits and regular physical activity for lasting results
Some weight regain (5-10%) after 2 years is normal and not considered failure
Possibility of excess skin depending on amount of weight lost and individual factors
Potential for body contouring procedures after weight stabilization if desired
Lifetime commitment to the bariatric program for optimal long-term success
Continued focus on psychological adaptation to significant body changes
Most patients report substantial improvement in quality of life and self-esteem
Annual check-ups remain important for long-term success monitoring
Nearly invisible scarring thanks to the small incisions used in robotic surgery
Common Side Effects
Surgical discomfort for 1-2 weeks, typically less pronounced than with traditional surgery
Temporary food intolerances, especially to dense proteins or dry foods
Hair thinning or loss during the rapid weight loss phase (typically resolves after 6-12 months)
Fatigue during the initial rapid weight loss period
Change in bowel habits (usually temporary)
Minor acid reflux or heartburn
Temporary difficulty tolerating cold temperatures
Feeling of restriction when eating too quickly or taking too large of bites
Nausea when overeating or not chewing adequately
Temporary taste changes
Mild dehydration requiring conscious effort to maintain fluid intake
Development of food preferences or aversions
Temporary menstrual irregularities in women during rapid weight loss
Dizziness from rapid movement (orthostatic hypotension)
Psychological adjustment to rapid body changes
Less Common Complications
Staple line leak (occurs in <1% of patients with robotic approach, lower than traditional techniques)
Bleeding requiring transfusion or reoperation (<1% with robotic precision)
Stenosis or narrowing of the sleeve (1%)
Severe or persistent gastroesophageal reflux disease (GERD)
Wound infection requiring antibiotics or drainage (reduced risk with smaller robotic incisions)
Nutritional deficiencies despite supplementation
Gallstone formation during rapid weight loss
Small bowel obstruction from adhesions
Incisional hernia at port sites (significantly reduced with robotic approach)
Persistent nausea or vomiting
Gastroparesis (delayed stomach emptying)
Port site infection requiring antibiotics or intervention
Venous thromboembolism (blood clots)
Dumping syndrome (less common than with gastric bypass)
Persistent abdominal pain requiring evaluation
Conversion to open procedure (extremely rare with robotic approach)
Development of or worsening of depression during adjustment period
Excessive weight loss or malnutrition
When to Seek Immediate Medical Attention
Persistent vomiting or inability to tolerate fluids for 24 hours
Severe abdominal pain that is getting worse rather than better
Fever over 101°F (38.3°C)
Heart rate over 120 beats per minute at rest
Shortness of breath or difficulty breathing
Chest pain or rapid breathing
Severe, uncontrolled diarrhea
Excessive bleeding from incision sites
Increasing abdominal distension or bloating
Drainage of pus or foul-smelling fluid from an incision
Calf pain, swelling, or redness (potential blood clot)
Severe, persistent nausea
Jaundice (yellowing of skin or eyes)
Dark, tarry stools or bright red blood in stool
Persistent hiccups that don't resolve
Increasing redness, warmth, or drainage at incision sites
Confusion or extreme lethargy
Severe heartburn unrelieved by medications
From your first consultation through your complete recovery, we provide:
Thorough evaluation and explanation of your condition
Clear discussion of all treatment options, including non-surgical alternatives when appropriate
Detailed pre-operative instructions to help you prepare
Compassionate care during your hospital stay or outpatient procedure
Comprehensive follow-up care and support during recovery
Ongoing availability to address questions or concerns
We understand that facing head and neck surgery can be intimidating, but you don't have to navigate this journey alone. Our team is committed to providing expert care with a personal touch, ensuring you feel supported, informed, and confident every step of the way.
Your health and wellbeing are our highest priorities, and we're honored to be part of your care team.
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All our laparoscopic procedures are performed by our highly trained surgical team using state-of-the-art equipment and techniques.
We're committed to providing you with the most advanced, minimally invasive options because we believe you deserve:
Less pain after surgery
Shorter hospital stays
Faster return to work and activities you enjoy
Smaller, less visible scars
Lower risk of complications
Better overall outcomes
Dr. Richard Nguyen is a board-certified General Surgeon with over 20 years of surgical expertise and fellowship training in Minimally Invasive and Bariatric Surgery from Vanderbilt University. Since establishing his practice in San Jose in 2007, he has pioneered innovative surgical techniques, including single-incision laparoscopic procedures and mastery of the da Vinci Robotic Surgical System. Beyond his acclaimed bariatric surgery practice, he has earned national recognition for his specialized expertise in both non-mesh and advanced mesh hernia repairs, while also serving as a critical approach surgeon for anterior spine access procedures. Dr. Nguyen combines technical precision with personalized care across multiple premier facilities throughout the South Bay Area.
I would refer Doctor Nguyen to anyone, in fact I have and they have all had the same experience as me. He is truly great. I owe all my success to Doctor Nguyen and I thank him for all the work he has done for me and continues to do so. He is extremely amazing, and I am very grateful to him.
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At 50, I now have a life I had only dreamed of a year before. My body tells me if I am done eating. This surgery is a tool that I have used to the fullest. It is not an easy way out. It still took work. But I honestly know that I would not be living this amazing new life if I didn’t step forward to embrace this life-saving surgery.
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Dr. Nguyen has changed my life completely. I feel so much better and I also feel like I’ve got control of my life again…I had high blood pressure, diabetes and cholesterol. I took at least 5 different medications for the past 30 years. NOW, after surgery I take no medications only vitamins!
Wondering which surgical procedure might be right for your condition? We're here to help you understand your treatment options and develop a personalized surgical plan. Contact our office today to schedule a consultation.
Your path to improved health may be more achievable than you think—with advanced surgical techniques leading to faster recovery, reduced complications, and a significantly enhanced quality of life.