Frequently Asked Questions

Getting Started

  • How quickly can I have my gastric sleeve surgery after deciding to proceed?

    Once you’ve made the decision to move forward with gastric sleeve surgery, we understand the urgency and eagerness to begin your journey towards better health. Our team is committed to facilitating your preoperative process as swiftly and efficiently as possible, without compromising on the thoroughness and quality of your care. For many patients, the journey from decision to surgery can be as short as a few weeks. Our philosophy is centered on doing everything within our power to expedite your preparation while ensuring you are fully informed and ready for the transformation ahead. We strive to balance rapid progression to surgery with the need for comprehensive health evaluations and personalized care, tailoring our approach to meet your unique needs and circumstances.

  • Do I need to stop smoking before surgery?

    Do you have to quit smoking before your surgery? No, you don’t have to, but it’s a good idea to try. Quitting smoking helps your recovery go more smoothly and makes the surgery safer. We understand quitting smoking is hard, and we wouldn’t deny anyone the surgery just because they smoke. However, a lot of our patients see their surgery as a chance to quit smoking for good. We really encourage you to give quitting a shot, even if it’s just for the 30 days before your surgery. And who knows? After those 30 days, you might decide to go another 30. We’re here to help with advice, support, and treatments to make quitting easier, including medications.

  • What steps are involved in preparing for gastric sleeve surgery?

    Preparing for your gastric sleeve surgery involves a comprehensive and supportive process designed to ensure you are fully prepared, both physically and mentally, for your procedure. This extensive preparation includes a detailed medical assessment to minimize surgery risks and optimize outcomes. Our dedicated patient coordinators will be with you every step of the way, facilitating meetings with a team of specialists including the surgeon, a bariatric nurse, and your main coach, the assigned bariatric dietitian. An anesthesiologist will also be part of your care team to discuss the anesthesia aspect of your surgery.

    To establish a thorough health and vitamin baseline, you’ll undergo basic bloodwork and an electrocardiogram. Depending on your specific health needs, additional tests such as gastroscopy or further cardiac evaluations may be required. While comprehensive, our goal is to make this preparation process as streamlined and stress-free as possible, ensuring that you feel ready and confident as you approach your surgery date. Most of our patients find the process straightforward and are able to complete it quickly, thanks to the guidance and support of our expert team.

  • Is it possible to connect with patients who have already had the surgery?

    Yes, indeed! A remarkable aspect of our clinic is the vibrant online community we’ve fostered among our patients. We offer access to a private and exclusive Facebook group that hosts thousands of individuals who have undergone the procedure. This community provides invaluable insights into life after surgery, offering support and sharing personal experiences that can help guide your journey. Additionally, if you’re looking for a more personal connection, we’re happy to connect you with one of our patient ambassadors. These individuals can offer a firsthand perspective on their experiences, including adjustments to daily life and answers to those lifestyle questions you may have in mind.

  • How do I know if I’m eligible for gastric sleeve surgery?

    Determining your eligibility for gastric sleeve surgery is a personalized process, focused on your specific health needs and history. Ideal candidates are those who have battled obesity for a considerable time and have a Body Mass Index (BMI) of at least 30. For a quick and easy way to see if you might qualify, our online eligibility calculator is a helpful tool. Additionally, individuals suffering from obesity-related health issues such as diabetes, high cholesterol, high blood pressure, and sleep apnea may find this surgery particularly beneficial. Gastric sleeve surgery has a significant impact on improving or potentially resolving these conditions, leading to a markedly healthier lifestyle.

  • Will I need to go on a special diet before my surgery?

    Before your surgery, we might ask you to follow a special diet, which includes drinking protein shakes and eating vegetables throughout the day. This isn’t about losing weight before your procedure—the surgery itself will take care of the weight loss. The main goal here is to prepare your body, specifically to make sure your liver is just the right size for the surgery. When we carry extra weight, sometimes our liver can grow a bit too big, which can make it challenging to perform the surgery since the liver sits right above the stomach. By following this diet, your liver shrinks to a more manageable size, allowing us to operate more smoothly. For most people, the diet lasts about two weeks. Sometimes, we might ask you to keep going for a bit longer if we think your liver is larger than usual.Most patients find that after the initial couple of days, they actually start to enjoy the diet. It helps you mentally prepare for your surgery and might even lead to a little unexpected weight loss as a welcome side effect.

Surgery: What to Expect

  • Will I be completely asleep during the procedure?

    Yes, you will be fully asleep under general anesthesia during the procedure. This ensures you’re comfortable and feel no Discomfort while the surgery is performed.

  • How long does the surgery take?

    The duration of the surgery varies for each individual. With a highly experienced bariatric surgeon, the surgery itself often takes less than 30 minutes. When considering the time needed to administer anesthesia before the surgery and for you to comfortably awaken afterward, the total time spent in the operating room is typically between 45 to 60 minutes.

  • Can gastric sleeve surgery be reversed if needed?

    Gastric sleeve surgery is designed to be a permanent solution for weight loss and improved health. During the procedure, a significant portion of the stomach is removed, including the stretchy part that allows for expansion. As a result, the surgery is not reversible in the traditional sense.

    However, it is important to note that in rare and unusual circumstances, gastric sleeve surgery can be converted to another type of weight loss procedure, such as a gastric bypass or duodenal switch. These situations are exceedingly uncommon.

    In fact, the permanence of gastric sleeve surgery is one of its key advantages, as it allows for sustained weight loss and long-term improvements in health. By removing the stretchy portion of the stomach, the procedure helps to reduce hunger and promote a feeling of fullness, making it easier for patients to maintain a healthy diet and lifestyle.

  • How does gastric sleeve surgery work?

    In gastric sleeve surgery, the stretchy part of the stomach is removed to form a smaller, sleeve-like shape. This new, smaller stomach (the size of a small banana) lets you feel full after eating less food. Additionally, the surgery removes the part of your stomach that produces a hunger-causing hormone called ghrelin, significantly reducing your hunger and cravings. 

  • How is the gastric sleeve procedure performed?

    The surgery is done laparoscopically, which means we make a few small incisions in your abdomen and use slender instruments and a special camera to carry out the procedure. This method is less invasive and helps with a quicker recovery.

  • How safe is gastric sleeve surgery?

    When performed by experienced medical professionals, the gastric sleeve procedure is considered quite  safe. In fact, it carries a lower complication rate than other common surgeries like gallbladder removal and hip replacement. The risks associated with gastric sleeve surgery are generally far less than the risks associated with obesity and its related health conditions. Every surgery carries some level of risk, but with the right team and care, we minimize those risks to ensure the best possible outcome for you.

  • What does the recovery process look like?

    Recovery from this surgery is generally swift. Most patients find they’re able to go back to work about a week after the procedure. However, a few may need up to two weeks, depending on how they feel. Recovery isn’t so much about dealing with pain or needing to stay in bed, but more about managing fatigue and giving yourself time to mentally adjust to returning to work. Remarkably, patients are usually up and moving within hours after surgery. We’ve seen many of our patients who are business owners or executives start handling work tasks remotely as soon as three days post-surgery. For those who have the flexibility to take more time off, we can provide documentation for a longer recovery period of 4 to 6 weeks. This extended time is not just about physical healing but also allows for a smoother transition to new eating habits and lifestyle changes.

  • What happens to the part of the stomach that’s removed?

    The portion of the stomach that is removed during the surgery is sent to a laboratory for a detailed examination under a microscope by a pathologist. 

  • How does gastric sleeve compare to gastric bypass?

    The gastric sleeve and gastric bypass are both effective surgical weight loss procedures, but they differ in approach and outcomes and overall impact on your body. 

    The gastric sleeve procedure is straightforward—it involves removing the stretchy part of the stomach to form a smaller, tube-like shape. This reduction in stomach size helps limit your food intake and helps you feel full sooner. Additionally, the procedure leads to a decrease in the production of ghrelin, the hormone responsible for hunger, which helps in reducing appetite and cravings.  Importantly, the gastric sleeve does not alter the digestive tract, maintaining a more natural flow of food.

    In contrast, gastric bypass is a more complex procedure that not only reduces stomach size but also involves modifying the digestive system by cutting, rearranging, and reattaching the intestines to a newly created stomach pouch. This alteration results in decreased food intake and may significantly impact the absorption of micronutrients.

    Each procedure has distinct advantages and potential drawbacks. The choice between gastric sleeve and gastric bypass typically depends on individual health profiles.

Life After Surgery

  • Are vitamins and supplements necessary after surgery?

    Yes, vitamins and supplements are necessary after surgery. Since you’ll be eating less, it’s important to ensure you’re still getting all the essential micronutrients. Think of it as an insurance policy for your health. The regimen is quite straightforward—most patients take a bariatric multivitamin in the morning and two or three calcium chews with vitamin D in the afternoon. It’s really no big deal and easy to manage.

  • Can I still enjoy meals and dine out?

    Dining out is often the focal point of many social events. This habit won’t change much after you have weight loss surgery, but your portion sizes definitely will. Whether you are going to a big chain restaurant or stopping at a convenience store for a snack, eating out after bariatric surgery is certainly possible as long as you continue to focus on making healthy choices to ensure that you are meeting your daily protein goal. Remember, now that you’ve had bariatric surgery, it may be helpful to try to share a meal with a friend, ask for a box ahead of time, or order off the kids menu to help you to watch portion sizes.

  • What about excess skin?

     Some, but not all patients, may have excess skin after surgery. Whether this occurs depends on a host of factors, including, the patient’s weight prior to surgery, the amount of excess weight loss, the patient’s age and genetics. For patients with concerns of excess skin, plastic surgery after the gastric sleeve can be a highly effective option. We typically recommend that patients wait 12-18 months from their surgery to ensure that their weight has stabilized.

  • Will there be dietary restrictions?

    There aren’t strict dietary restrictions after surgery, but you will need to adjust how you eat because your stomach will be significantly smaller. We’ll guide you on how to make the most of this new, smaller “real estate” by prioritizing protein Over other foods. The aim is not to keep you on a restrictive diet but to help you eat normally and take control of your relationship with food.

  • How fast will I lose weight?

    You’ll likely begin to lose weight shortly after your surgery, with the most noticeable drop in the first few weeks and months. Generally, patients lose about 50% of their excess weight within the first six months, depending on how much they weighed before the surgery. The total weight loss journey typically spans 12 to 18 months. The heavier your starting weight, the quicker you might see initial results. It’s not uncommon for patients to lose between 15 to 30 pounds within just the first few weeks post-surgery. The process of weight loss starts right away for most individuals.

  • What can I expect in terms of success rates following gastric sleeve surgery?

    Gastric sleeve surgery has been shown to be highly effective in helping patients achieve significant and lasting weight loss, as well as improvements in overall health and quality of life. On average, patients can expect to lose between 60-70% of their excess body weight within the first year following surgery. This transformational weight loss can lead to a reduction or even complete resolution of many obesity-related health conditions, such as type 2 diabetes, high blood pressure, and sleep apnea.

    Long-term studies have demonstrated that the majority of patients are able to maintain a substantial portion of their initial weight loss over time. The success of gastric sleeve surgery is primarily determined by the effectiveness of the procedure itself and the quality of the aftercare program. Our comprehensive aftercare program is the key to helping patients achieve and maintain their weight loss goals, as obesity is a complex medical disease that requires ongoing professional support and management. By providing regular follow-up appointments, monitoring, and expert guidance, our dedicated team of healthcare professionals ensures that patients remain accountable and adherent to the post-operative guidelines. This structured support system is critical to maximizing the chances of long-term success and allowing patients to fully benefit from the significant health improvements associated with sustained weight loss. The aftercare program is designed to empower patients and provide them with the tools they need to effectively manage their medical condition, rather than placing undue emphasis on individual lifestyle factors.It is important to note that individual results may vary, and the success of the surgery is influenced by a variety of factors, including a patient’s starting weight, overall health, and adherence to post-operative guidelines. However, with dedication and support from our experienced team, patients can expect to achieve significant and life-changing results following gastric sleeve surgery.

    We encourage you to discuss your specific goals and concerns with your program advisor, who can provide personalized information and guidance based on your unique situation. Our team is committed to supporting you every step of the way as you embark on your journey towards improved health and wellness.

Long-Term Considerations

  • How many scars will I have?

    The surgery is performed laparoscopically and typically involves 5 tiny incisions. 4 of these incisions are about 5mm (the width of a pea). One of the incisions is approximately 15mm (less than the width of a loonie ).

  • Will my other health conditions improve?

    Yes, Most people see Dramatic improvements in obesity-related health conditions after surgery. Conditions like diabetes, obstructive sleep apnea (OSA), High blood pressure (Hypertension), high cholesterol (dyslipidemia), polycystic ovary syndrome (PCOS), joint pain, and urinary incontinence, to name a few,  typically improve dramatically or, in Many cases, ay even resolve completely. 

  • What are the potential long-term effects of gastric sleeve surgery that I should be aware of?

    Gastric sleeve surgery has been shown to provide numerous long-term benefits for patients, including significant improvements in overall health and quality of life. Many obesity-related conditions, such as diabetes, high blood pressure, high cholesterol, sleep apnea, PCOS, and fertility issues, can be greatly reduced or even resolved following the procedure. Furthermore, studies have indicated that the surgery can potentially extend a patient’s lifespan by 5 to 9 years and lower the risk of various cancers and possibly even dementia.

    While the vast majority of patients experience positive outcomes, it is important to be aware of a few potential long-term effects. A small percentage of patients may develop heartburn post-operation, which can be effectively managed with the use of antacids. Additionally, some patients may require ongoing supplementation of certain vitamins and micronutrients to maintain optimal health. For example, women with heavy menstrual periods who lose significant amounts of blood may benefit from additional iron supplements to prevent anemia.

    These potential long-term effects are generally minor and can be easily managed under the guidance of your healthcare team. The overwhelming benefits of gastric sleeve surgery, such as improved health, increased longevity, and enhanced quality of life, far outweigh these considerations for most patients. We encourage you to discuss any concerns you may have with your program advisor, who can provide further information and support as you make your decision.

  • Can I have children after surgery?

     Yes, you can certainly have children after your surgery. However, it’s best to wait until your weight has stabilized and your body is receiving adequate nutrients to support both you and your baby’s development. For safety and to ensure the best outcomes, current guidelines suggest waiting 12-18 months after the surgery before trying to conceive. This time frame allows your body to adjust fully to the changes and ensures an optimal environment for pregnancy.

  • Where is the procedure performed?

    Your gastric sleeve surgery will be performed in a private, state-of-the-art surgical facility in Toronto, Ontario. Your comfort, care and safety are our primary considerations. From the bright and welcoming waiting room to the spacious operating theatre, and finally the comforting recovery room, we are equipped for your complete care. The facility is fully accredited by the College of Physicians and Surgeons of Ontario. Our expert surgical team, which includes specialized recovery room nurses and board-certified anesthesiologists, utilize the leading devices, technology, and equipment to ensure your safety throughout this life-changing procedure.

  • When can I resume gym activities after surgery?

    You can go back to the gym whenever you feel physically up to it. Many patients begin light cardio exercises like brisk walking within the first week after surgery. By the end of the first week, activities such as jogging and biking can typically be added. However, it is recommended to wait about 6 weeks before starting any strength training with weights to give your body enough time to heal and adjust after the surgery.

  • What happens to the surgical staples used during the procedure?

    Patients often have questions about the surgical staples used during the operation. These staples are small and made of titanium, and they stay in your body permanently without causing any health issues. They are safe and do not interfere with MRI scans or airport security systems. Within a week post-surgery, scar tissue will form around the staples, rendering them invisible during an abdominal examination. Surgical staples have been a critical tool since the 1960s, and their technology has greatly advanced over the years. These staples are essential for the safety and effectiveness of not only this surgery but also many other types of operations, including appendectomies and bowel surgeries. Their safety and functionality have been extensively researched and proven.

About the Surgery

  • How much time do I need to take off of work?

    Most patients are back to their “normal selves” in about a week or less (similar to gallbladder surgery). However, if possible, we suggest patients take 2-4 weeks off from work to focus on adjusting to their new stomach and lifestyle.

  • How long will I be in hospital?

    Patients are monitored for about 24 hours after surgery.

  • Is this procedure like a “lap band”?

    No. This procedure is quite different from a lap-band. It does not involve placing any foreign materials into your body. The gastric sleeve results in numerous hormonal and biochemical changes within your body to help curb your appetite and keep your body from storing fat. The gastric sleeve has become the most commonly performed procedure in North America and has essentially replaced the old lap-band procedure.

Our Program & How We Work

  • Is the gastric sleeve covered by OHIP?

    This is an extremely important question. The Sleeve Clinic is a private, boutique bariatric surgery clinic specializing in the gastric sleeve surgery. It is not covered by OHIP. The Ontario Ministry of Health and Long Term Care (MOHLTC) does cover a different procedure, called: “gastric bypass” in patients with a BMI >40 or BMI>35 with specific obesity-related health conditions. The MOHLTC will only cover a gastric sleeve if:
    1) there is severe scar tissue from a previous surgery that prevents surgeons from performing a gastric bypass
    2) the patient has a BMI>60 and/or
    3) the patient has certain pre-existing medical conditions that make a gastric bypass excessively risky (e.g., ulcerative colitis, chronic steroid use, etc.).

    For more information, please read our guide on “What To Know Before Undergoing Gastric Sleeve Surgery.

  • Why do I need such an extensive workup before surgery?

    We take your success extremely seriously. If you’ve finally reached the point that you realize that a gastric sleeve is the only solution for you, then it is absolutely critical that you do this the right way. Our process has been designed and honed to ensure that you get through the surgery safely and achieve excellent weight loss results. Now is not the time to cut corners. A few extra weeks of preparation will make all the difference in the world. Our workup takes approximately 4-6 weeks. Sometimes a bit less. Sometimes a bit more.

  • Will Dr. Gmora be involved in my care once the surgery is complete?

    If you know anything about Dr. Gmora you know that he is extremely hands on. He personally reviews each patient’s progress on a frequent basis and actively manages individual issues with his clinical team.

  • Do you offer payment plans or financing options?

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