Gastric Sleeve Surgery in Darien & Bolingbrook, IL

How I perform the robotic sleeve

Nearly every sleeve I do is robotic. I sit at a console a few feet from you and control instruments that bend and rotate like a wrist, with a magnified 3D view inside your abdomen. The robot never moves on its own. It translates my hand movements into smaller, steadier ones. Once you are asleep under general anesthesia:

1. Small incisions. I make four incisions, each under half an inch, and inflate the abdomen with carbon dioxide gas so I have room to work.
2. Free the stomach. I separate the outer curve of the stomach from the tissue and blood vessels that hold it in place.
3. Size the new stomach. A sizing tube goes down through the mouth and rests along the inner curve of the stomach. It acts as a guide so the sleeve is the right width from top to bottom.
4. Staple and remove. I divide the stomach along the tube with a stapler that cuts and seals in one pass. The removed portion, about 80% of the stomach, comes out through one of the incisions.
5. Check the work with a scope. At the end of the operation, while you are still asleep, I pass an endoscope down into the new stomach. I check that there is no bleeding inside, that the sleeve has an even width along its whole length with no twist or kink, and that any hiatal hernia repair sits correctly. Finally I fill the sleeve with air and watch the staple line for leaks. In my own practice I have not had a staple-line leak in the past ten years.
6. Close and wake up. The incisions are closed with dissolvable stitches. Most patients are walking the halls within a few hours.

The operation usually takes about an hour and a half. You go home the next morning in most cases. Surgery takes place at University of Chicago AdventHealth Bolingbrook Hospital, an MBSAQIP-accredited bariatric center recognized as a Blue Distinction Center and center of excellence for bariatric surgery.

What results to expect

Surgeons measure results as a share of your excess weight, meaning the pounds above a healthy weight for your height. If you are 100 pounds over, losing 55% of your excess weight means losing about 55 pounds. Most of the loss happens in the first 12 to 18 months.

Two randomized trials followed sleeve patients for five years. In the Finnish SLEEVEPASS trial, sleeve patients had lost 49% of their excess weight at five years. In the Swiss SM-BOSS trial, they had lost 61% of their excess BMI.^1,2 At ten years, SLEEVEPASS patients were still down 43.5% of their excess weight, with a wide range from person to person.⁵ A large review of earlier studies across all bariatric operations found an average excess weight loss of 61%.⁶ In my own practice, patients typically lose 60 to 70% of their excess weight. Some lose much more, and a few lose less. Your eating habits and follow-up visits matter as much as the operation.

Health changes, not just pounds

The weight loss is the visible part. The health changes are why I do this work.

• Type 2 diabetes. In a U.S. study of 9,710 patients with diabetes, 84% of sleeve patients reached remission at some point in the five years after surgery, and about four in ten of those saw it return within five years.¹⁶ In SLEEVEPASS, 37% of sleeve patients with diabetes were in full or partial remission at five years.¹ In the STAMPEDE trial, sleeve patients cut their average A1c far more than patients on intensive medication alone, and used far less insulin.⁷
• Blood pressure and cholesterol. Across bariatric procedures, high blood pressure resolved in about 62% of patients and improved in 79%. Cholesterol problems improved in 70% or more.⁶
• Sleep apnea. Resolved in roughly 86% of patients in the same review.⁶ Many of my patients retire their CPAP machine within a year.
• Living longer. The Swedish Obese Subjects study followed more than 4,000 people for over a decade. Those who had bariatric surgery had a 29% lower risk of death from any cause than matched patients who did not.⁸

Want a projection built on your own numbers? Try the weight-loss calculator.

Your recovery timeline

Recovery from a robotic sleeve is faster than most patients expect. Here is the protocol I use. Yours may differ a little, and we adjust it to you.

• Day of surgeryYou wake up in recovery, start sipping water, and take your first walk within a few hours.
• Day 1Home the next day, walking on your own and managing stairs. Pain is usually controlled with Tylenol. Week 1 is liquids only.
• First few daysYou can drive once you are off narcotic pain medication, usually within a few days.
• Week 1Most patients are back to work within one week. Lift nothing heavier than 10 pounds for the first 14 days.
• Week 2Puréed, smooth-consistency foods. After two weeks you gradually return to normal physical activity, and to full work duties once cleared.
• Weeks 3 to 6Soft, easy-to-digest foods. Your six-week follow-up visit, where we review your eating, your vitamins and your incisions.
• Week 7 onwardGradual return to solid foods as tolerated, guided by our dietitian and team.
• First year and beyondFollow-up visits with our team and dietitian through the first year, plus blood work. The ASMBS recommends a yearly bariatric visit for life, and so do I.¹⁴

Our post-surgery instructions page has the day-by-day diet and activity guide you will follow.