The first week following a gastric sleeve, or Vertical Sleeve Gastrectomy (VSG), is the most intense period of immediate recovery and adjustment. This surgical procedure involves removing a large portion of the stomach, creating a narrow, sleeve-shaped pouch that restricts the amount of food you can consume. The initial seven days are a period of significant physical and metabolic change as your body begins to heal and adapt. Successfully navigating this first week by strictly adhering to medical instructions sets the foundation for your long-term health. This practical roadmap outlines the physical, dietary, and emotional expectations for the first seven days post-operation.
Managing Pain and Incision Care
Immediate post-operative discomfort after VSG involves two types of pain. The first is localized soreness around the small abdominal incisions used for the laparoscopic procedure, which improves within the first few days. The second is referred pain, often felt in the shoulder or upper back, caused by residual carbon dioxide gas used during surgery. Walking helps accelerate the clearance of this gas as it is slowly absorbed by the body.
Pain management relies on a strict schedule of prescription medication, taken only in liquid or chewable forms to avoid irritating the new stomach pouch. Follow your surgeon’s instructions precisely and do not wait for pain to become severe, as maintaining a steady level of medication is more effective. For incision care, the small wounds should be kept clean and dry, gently patting them after showering. Monitor the sites for signs of infection, such as excessive redness, increased warmth, or any unusual discharge, and report these to your medical team immediately.
The Strict Liquid Diet Phase
The first week is defined by the Phase 1, or clear liquid, diet, designed to allow the staple line on the stomach to heal without stress. Consuming only thin liquids prevents pressure buildup in the newly formed stomach sleeve, which is necessary for avoiding a serious complication called a leak. Acceptable options include:
- Clear broth.
- Sugar-free gelatin.
- Sugar-free popsicles.
- Water.
Protein intake is a primary focus; prioritize protein-rich clear liquids, such as specialized bariatric protein water or diluted protein shakes, to support healing and prevent muscle loss. All beverages must be non-carbonated, non-caffeinated, and sugar-free, as carbonation can cause painful gas, and sugar can lead to discomfort.
Sip liquids slowly, taking frequent, small sips throughout the day rather than drinking large volumes at once. Avoid using a straw, which introduces air into the stomach and causes painful bloating.
Activity Levels and Hydration Goals
Movement is actively encouraged immediately following surgery to prevent complications. Frequent, short walks are mandatory, starting on the day of surgery, as they are the most effective way to promote circulation and prevent blood clots. Gentle movement also helps the body absorb the residual gas, reducing the referred shoulder pain.
A major goal during the first week is meeting your daily hydration quota, as dehydration is a common cause of readmission. Most programs target a minimum of 64 ounces of non-carbonated fluids per day, though this can be difficult to achieve with the small stomach capacity. Track your fluid intake meticulously and watch for signs of dehydration, such as dark urine or extreme fatigue. Strenuous activity is strictly prohibited, and you should avoid lifting anything heavier than 10 to 15 pounds for the first few weeks to protect the abdominal incisions.
Emotional Adjustment and Warning Signs
The physical trauma of surgery, combined with hormonal shifts and the sudden change in diet, often leads to an emotional low, sometimes referred to as the “sleeve blues.” It is common to experience fatigue, mood swings, or feelings of sadness as the initial excitement wears off and the reality of the lifestyle change sets in. Recognizing that these emotional fluctuations are a normal part of the adjustment is important, and patients should utilize support systems or contact their surgical team if the feelings become overwhelming.
Warning Signs
While managing expected discomfort, remain vigilant for specific warning signs that indicate a serious complication. Contact your surgeon or seek emergency care immediately if you experience any of the following:
- A fever above 101.5°F.
- Severe, persistent nausea or vomiting that prevents fluid intake.
- Shortness of breath.
- Calf pain or swelling, which could signal a blood clot.
- Pain that worsens significantly instead of gradually improving.