Get the most out of your Gastric Sleeve

You are a suitable candidate for bariatric surgery – a procedure that will change your life. Gastric sleeve surgeries are one of the most commonly performed bariatric procedures.

During a gastric sleeve procedure, a large part of the stomach is removed. The intestinal tract is not altered. The new, smaller stomach that remains after the procedure is shaped like a banana and can hold about 100 ml to 150 ml of food. You will only be able to eat a tenth of the amount that you are used to. Due to your reduced stomach, you will feel full after eating just a small amount of food, so you lose weight as a result of eating less. You will also feel less hungry. This is because the part of the stomach that has been removed is responsible for the production of the ‘hunger hormone’ ghrelin.

However, the procedure is only an aid to losing weight. It is said that about 80% of weight loss in the year following the procedure is the result of the surgery, and 20% is the result of changing your eating and exercise habits. After a year, these percentages are reversed. This means that changing your behaviour is very important and should take place within a year of the surgery.

Preventing long-term weight gain

Unfortunately, it is possible for patients to start gaining weight again over time. This is usually due changes in eating and exercise habits without you noticing. Eating too much or too fast can cause the new, reduced stomach to stretch (dilation). If this keeps happening for a longer period of time, the passage of food becomes progressively quicker and easier. You then feel full less quickly and are more likely to overeat. Slowly but surely, this can cause the lost weight to be regained.

Banded Gastric Sleeve

Fitting a MiniMIZER Ring as part of the gastric sleeve procedure can prevent unwanted weight gain in the long term. It helps you to maintain the necessary lifestyle changes. This variation on the conventional procedure is also called a banded gastric sleeve.

What is a MiniMizer Ring?

The MiniMIZER Ring is a certified surgical implant. It is made of medical-grade silicone, a material that is tolerated by the body. After the stomach has been made smaller during the gastric sleeve procedure, the surgeon fits the MiniMIZER Ring loosely around the upper part of the reduced stomach. The ring is secured so that it cannot move out of place.

How does the MiniMizer Ring work?

Because the MiniMIZER Ring is positioned loosely around the reduced stomach,
it has the effect of slowing down the passage of food. As a result, you feel full more
quickly and stop eating sooner. In this way, the ring supports you in changing
your eating habits and makes them easier to maintain.

Results of Banded Gastric Sleeve Surgery

Better weight loss

Counteracting weight gain

People who have a gastric sleeve lose on average 60%–70%(2) of their excess weight. Studies show that people with a MiniMIZER Ring around their reduced stomach lose even more weight. Three years after the surgical procedure, they will have lost on average 27%(2) more of their excess weight than people who had a conventional gastric sleeve surgery. And on average, they will have lost 50%(2) more weight five years after the procedure.

After an initial period of weight loss, it is possible for weight gain to occur sometime after a gastric sleeve procedure. At more than five years following the procedure, around half of the people with a conventional gastric sleeve will have gained weight again. This happens very gradually. Some people gain so much that they need a second procedure. With a banded gastric sleeve, just 2% of people will have gained weight again at more than five years after the procedure.

What are the possible side effects of a MiniMizer Ring?

  • Regurgitation can be a possible side effect of the MiniMIZER Ring. If this occurs shortly after the procedure, it may be because the stomach is still slightly swollen. This may constrict the passageway into the stomach slightly. In the days following after the procedure, the swelling will go down by itself.
  • If you continue to regurgitate sometimes later on, there is no need to worry right away. Regurgitation can also be a result of the way the ring works. The ring slows down the passage of the food you eat, so it is very important to adjust your eating habits and diet to accommodate this change. Take small bites, chew well and pause between bites. If you do not do this, you may experience some regurgitation.
  • If the regurgitation continues even after you have changed your eating habits and diet, it is possible to loosen the MiniMIZER Ring or even remove it. However, this does require keyhole surgery.
  • One extremely rare complication is band erosion. Band erosion means that the MiniMIZER Ring starts to push(grow) its way into the stomach wall as a result of friction. In cases of complete band erosion (migration), the ring actually ends up inside the stomach. Often, patients do not notice that this has happened. They may only notice that they are able to eat more again. Should band erosion occur, the gastroenterologist will remove the MiniMIZER Ring by means of a gastroscopy.


1. Banded Versus Nonbanded Sleeve Gastrectomy, A Randomized Controlled Trial With 3 Years of Follow-up. Jodok M. Fink, MD,Y Andrea Hetzenecker, MD, Gabriel Seifert, MD, Mira Runkel, MD, Claudia Laessle, MD, Stefan Fichtner-Feigl, MD, and Goran Marjanovic, MD
2. Banded Sleeve Gastrectomy: Better Long-Term Results? A Long-Term, Cohort Study Until 5 Years Follow-Up in Obese and Superobese Patients. Luc Lemmens & Jelmer Van Den Bossche & Hinali Zaveri & Amit Surve
3. The mini-gastric bypass: experience with the first 1,274 cases. R. Rutledge
4. Laparoscopic Silastic Ring Mini-Gastric Bypass (SR-MGBP): Up to 11-Year Results from a Single Centre. Laila Sheikh & Lyn A. Pearless & Michael WC Booth
5. Weight regain after Mini Gastric Bypass. Nidhi Khandelwal, Jaydeep Palep
6. Banded Gastric Bypass: Better Long-Term Results? A Cohort Study with Minimum 5-Year Follow-Up. Luc Lemmens
7. Ten Years Experience of Banded Gastric Bypass: Does It Make a Difference? William Awad & Alvaro Garay & Cristián Martínez
8. Banding the Pouch with a Non-adjustable Ring as Revisional Procedure in Patients with Insufficient Results After Roux-en-Y Gastric Bypass: Short-term Outcomes of a Multicenter Cohort Study. Abel Boerboom & Edo Aarts & Volker Lange & Andreas Plamper & Karl Rheinwalt & Katja Linke & Ralph Peterli & Frits Berends & Eric Hazebroek