Sleeve gastrectomy is a restrictive and metabolic procedure, performed either as a primary surgery or as part of a staged procedure with the duodenal switch. The amount of food a 
patient consumes is reduced, and anatomy alterations result in metabolic changes. This leads to a decrease in hunger and an increase in metabolism. The sleeve gastrectomy is a primarily restrictive procedure, but does have a metabolic component.
1. The stomach is divided creating a narrow tube with a stapling device. This limits the amount of food that can be eaten (restrictive), and with combined hormone changes patients feel full and satisfied from small meals.
2. The excess stomach is removed.
Virtually all sleeve gastrectomy procedures are performed with a minimally invasive laparoscopic technique. Most patients leave the hospital the day after surgery.