Robot Assisted Laparoscopic Sleeve Gastrectomy
Medically reviewed by Drugs.com. Last updated on Jun 30, 2025.
What do I need to know about robot assisted laparoscopic sleeve gastrectomy (RALSG)?
RALSG is surgery to remove most of your stomach through small incisions in your abdomen. The remaining stomach forms a tube or sleeve. You will feel full faster and have a decreased desire for food. RALSG is done with a machine that is controlled by your surgeon. The machine has mechanical arms that use small tools to help perform the surgery.
What do I need to know before I have RALSG?
- You will work closely with a dietitian before and after surgery. Your dietitian will talk to you about nutrition and what you should eat and drink before and after surgery. You may need to follow a very low-calorie, low-carbohydrate, or liquid diet for 2 weeks before surgery. This will help you lose weight and make the surgery safer for your liver.
- Your surgeon will talk to you about self-care and follow-up activities you will need after surgery. You will need to take vitamins and come in to have your progress checked.
- If you have diabetes, your diabetes medicine needs may change after surgery. This depends on the medicine you take and if you have type 1 or type 2 diabetes. Do not change your diabetes medicine unless directed. Your providers will help you set schedules for checking your blood sugar levels and taking your medicine.
- Your medicine needs may change if you are taking medicine for hypothyroidism (low thyroid hormone level). Your healthcare providers will monitor your TSH levels and make medicine changes if needed. Do not change your thyroid medicine unless directed.
- Your surgeon will talk to you about family planning. If you are female, it is important that you do not get pregnant for 12 to 18 months after surgery. Then your pregnancy will need to be monitored for your safety and your baby's safety. Your provider will tell you how much weight is safe for you to gain during pregnancy. Your provider will help you create healthy meal plans so you get the right nutrition. If you want to prevent pregnancy, healthcare providers will help you choose the right kind of birth control. You may not be able to use birth control pills because you may not be able to absorb them fully after surgery.
How do I prepare for surgery?
- Your surgeon will tell you how to prepare. You may be told not to eat or drink anything after midnight on the day of your surgery. Arrange to have someone drive you home when you are discharged.
- Tell your surgeon about all medicines you currently take. Your surgeon will tell you if you need to stop any medicine for the surgery, and when to stop. Your surgeon will tell you which medicines to take or not take on the day of surgery.
- Tell your surgeon about any allergies you have, including to anesthesia or medicines. You may be given an antibiotic to help prevent a bacterial infection. You may also be given blood thinner medicine to help prevent blood clots.
- Your surgeon will tell you if you need any tests before your surgery, and when to have them. You may need to have an upper endoscopy before surgery. This is a procedure to look inside your esophagus and stomach. This will check for any problems and help your surgeon plan your surgery.
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What will happen during surgery?
- You will be given general anesthesia to keep you asleep and free from pain during surgery. Your surgeon will make several small incisions in your abdomen. Your abdomen will be filled with carbon dioxide to lift the muscles away from your organs. This helps your surgeon see your stomach and nearby organs better.
- Surgical tools are attached to the arms of the robot. Your surgeon will guide the arms to place a laparoscope and other tools inside your abdomen. A laparoscope is a long, thin tube with a light and camera on the end. Your surgeon will then use the arms to remove most of your stomach. The remaining stomach will be stapled to create a small tube or sleeve.
- Your surgeon will then remove the tools from your abdomen. Your incisions will be closed with stitches or medical glue and covered with bandages.
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What should I expect after RALSG?
- You will be taken to a recovery room until you wake up. Healthcare providers will monitor you for any problems. You will then be taken to your hospital room. You may need to stay in the hospital for 1 to 2 days. You will be helped to walk around after surgery to help prevent blood clots.
- A nasogastric (NG) tube may be put into your nose and down into your stomach during surgery. The NG tube helps prevent vomiting and may help your intestines start to work. The NG tube is usually removed soon after surgery.
- Your surgeon will tell you when you can eat and drink. You may be given ice chips at first. Then you will get clear liquids such as water, broth, or juice. You will be told when you can start to eat soft foods.
What are the risks of RALSG?
You may bleed more than expected or develop an infection. Organs near the surgery area may be damaged. During surgery, you may need 1 large incision instead of several small incisions. A leak may develop along the staple line where it is holding your sleeve closed. This leak can cause a severe infection. You may have nausea, vomiting, or heartburn. You may not lose as much weight as you expect. You may develop a life-threatening blood clot.
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