Concierge bariatric surgery · UK
Gastric sleeve, done properly — by a consultant bariatric surgeon.
The UK’s most common weight-loss operation, done through a full NICE NG246 pathway — with a proper MDT before surgery and lifelong follow-up after. Sleeve or bypass compared honestly.
Why patients choose us
- 01
A consultant bariatric surgeon, in a high-volume centre
Not a general laparoscopist and not an occasional case. A named upper-GI/bariatric surgeon at a unit that does sleeves every week.
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Sleeve vs bypass, honestly compared
For some people a Roux-en-Y bypass is the better operation. We say so before you commit to a sleeve — especially if you have reflux, Barrett’s or diabetes.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private gastric sleeve costs in the UK.
Indicative ranges across our partner units. NHS-funded surgery is available through the NICE NG246 pathway if you meet criteria — we help either way.
In short
A laparoscopic sleeve in our network: £8,000–£14,000, home in one to two nights.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Laparoscopic sleeve gastrectomy (self-pay) | £8,000–£14,000 | 45–90 min GA | 1–2 night stay |
| Robotic-assisted sleeve gastrectomy | £11,000–£16,000 | 60–120 min GA | 1–2 night stay |
| Pre-op MDT workup (dietician/psychology) | £600–£1,500 | 2–4 appointments | 4–6 weeks |
| Two-year follow-up package | £1,200–£2,500 | Ongoing | Every 3–6 months |
| Revision surgery (sleeve to bypass/SADI) | £12,000–£20,000 | 90–180 min GA | 2–3 night stay |
| Consultation only | £250–£450 | 45 min | Same visit |
Prices vary by unit, by whether the operation is laparoscopic or robotic, and — importantly — by what is included. A good quote covers MDT workup, the operation, the hospital stay and at least one to two years of follow-up. We confirm a firm figure within one working day.
The problem
The right operation, the right unit, the right follow-up.
Bariatric surgery is a decision for the next thirty years, not for next month. Too many people are booked into a sleeve when a bypass would suit them better — or into surgery at all when a Tier 3 pathway has not been done.
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Not sure if it is even the right step?
We check your BMI against NICE NG246, ask about what you have already tried, and are honest if a GLP-1 or endoscopic option would fit better first.
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Sleeve or bypass?
A real conversation about reflux, diabetes, nutrition and long-term risk — not a script from whichever operation the surgeon does most.
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Worried about the aftercare?
We insist on a unit with a proper MDT and structured follow-up. A sleeve is a procedure; the follow-up is the treatment.
The journey
From enquiry to lifelong follow-up — what happens, in order.
One team from first message through Tier 3 workup, surgery and every review — for as long as you need it.
Phase 1 · Before your operation
MDT workup and preparation
Phase 2 · Surgery and hospital stay
One to two nights in hospital
Phase 3 · After
Staged diet, lifelong follow-up
- 01
Before
You tell us what is going on
A short, confidential form. BMI, obesity-related conditions, what you have tried, whether you are on GLP-1 medication.
- 02
Before
MDT workup — Tier 3 then Tier 4
Dietician, psychology and endocrinology assessment per NICE NG246, followed by consultation with the bariatric surgeon and anaesthetist.
- 03
Before
Two to four weeks of liver-shrinkage diet
A very-low-energy diet (Optifast, Slimfast or similar) shrinks the left lobe of the liver and makes the operation safer. Stop smoking at least six weeks before.
- 04
Surgery
Admission and anaesthetic
Arrival, consent and a chat with the surgeon and anaesthetist. General anaesthetic, VTE prophylaxis, warming and antibiotic cover.
- 05
Surgery
The operation itself
45 to 90 minutes, laparoscopic or robotic. 70–80% of the stomach is removed along the greater curve over a 36–40Fr bougie. Staple line is checked for leaks.
- 06
Surgery
One to two nights in hospital
Sips of water the same evening, mobilise day one, discharge day one or two on an ERAS pathway. No routine drain, no NG tube.
- 07
After
Diet progression and lifelong follow-up
Liquid two weeks → puree two weeks → soft two weeks → solid. Protein-first, small bites, lifelong multivitamin, iron, B12 and vitamin D. Reviews at 6 weeks, 3, 6, 12 months then annually.
Typical end-to-end: 8–12 weeks from enquiry to surgery. Full recovery: 6–8 weeks. Follow-up: lifelong.
When it helps
When a gastric sleeve is the right operation.
The NICE NG246 criteria we work through with you — plus the one situation where the sleeve is usually the wrong choice.
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BMI ≥40 with Tier 3 tried
You have completed a Tier 3 non-surgical programme — behavioural, dietetic and often medical (GLP-1 RA) — without adequate response.
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BMI ≥35 with a co-morbidity
Type 2 diabetes, hypertension, sleep apnoea, severe joint disease or fatty-liver disease that would improve with weight loss.
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BMI ≥30 with new-onset T2DM
Updated NICE NG246 (2023) permits earlier bariatric referral for people of any ethnic background with recent-onset type 2 diabetes.
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Very high BMI (>50)
A sleeve is often the safer first step at very high BMI, with the option of converting to bypass or SADI later if needed.
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GLP-1 plateau or intolerance
Weight regain after stopping semaglutide/tirzepatide, or side effects that make medication impossible to continue.
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Preference over bypass
No anastomosis, no internal-hernia risk, fewer long-term nutritional problems — a valid reason to choose a sleeve when either operation would work.
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Fit for a general anaesthetic
Anaesthetic assessment confirms you are fit for laparoscopic surgery under GA, with acceptable cardiorespiratory reserve.
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Red flag: severe GORD or Barrett’s
A sleeve makes reflux worse. Significant GORD or Barrett’s oesophagus usually points to a Roux-en-Y bypass instead — we say so before you book.
Procedure options
A sleeve is not the only option.
What each bariatric option actually involves — and which fits which person.
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Laparoscopic sleeve gastrectomy
The standard UK operation. 70–80% of the stomach removed along the greater curve, creating a narrow tube. Predominantly restrictive with useful hormonal (ghrelin) effect.
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Robotic-assisted sleeve
Same operation, delivered through a robotic platform. Marginal benefits in some hands, higher cost — worth discussing but not superior in every case.
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Roux-en-Y gastric bypass
The alternative bariatric operation. Better for severe GORD, Barrett’s and stronger for type 2 diabetes remission. More complex, higher long-term nutritional risk.
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Single-anastomosis (SADI-S)
A staged option after a sleeve for people who have not lost enough weight, or a primary option at very high BMI. Powerful but with a higher nutritional footprint.
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Endoscopic sleeve gastroplasty
A no-cut alternative done through the mouth with sutures. Smaller weight loss, no scars, faster recovery — worth considering at lower BMI or when surgery is refused.
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Gastric bypass revision
A previous sleeve that has stretched or is causing intractable reflux can be converted to a Roux-en-Y bypass in a planned revision operation.
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Gastric balloon (bridge)
A six- or twelve-month balloon can be used as a bridge to surgery at very high BMI, or as a lower-commitment option in its own right.
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Consultation only
An honest discussion of whether a sleeve is the right operation for you — no obligation, and often the most valuable appointment we arrange.
Our vetted UK network
A small panel of bariatric units, we picked them.
Consultant bariatric surgeons and high-volume units across London and major UK cities. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every bariatric unit in our network.
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Consultant upper-GI / bariatric surgeons, not general laparoscopists
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High-volume units with a full MDT (dietician, psychology, endocrinology)
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NICE NG246 pathway followed — Tier 3 workup before Tier 4 surgery
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Lifelong follow-up in place, not a one-off operation and goodbye
Safety and outcomes
What can go wrong — and what usually does.
A gastric sleeve is one of the safest major abdominal operations in a high-volume unit — 30-day mortality is around 0.1–0.3%. The complications worth knowing about, and the ones that matter years later, are set out below.
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Staple-line leak (1–2%)
The most feared early complication, usually near the top of the sleeve (angle of His). Managed urgently with CT, drainage, sometimes a stent or revision surgery. Rare, but the reason for a high-volume centre.
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Bleeding and blood clots
Bleeding 1–3%; VTE 1–2% despite prophylaxis. Early mobilisation, LMWH and TED stockings reduce risk but do not eliminate it.
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Sleeve stenosis (1–3%)
A narrowing or twist that causes vomiting and food intolerance. Usually treated with endoscopic dilation; a small number need revision.
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Reflux and heartburn (20–30% long term)
A sleeve tends to worsen GORD. Some people need long-term PPI; a proportion eventually convert to a Roux-en-Y bypass for control.
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Nutritional deficiency — lifelong supplements
Iron, B12, vitamin D and calcium deficiency are common without lifelong multivitamin, iron, B12 and vitamin D supplementation. Less than after bypass, but still lifelong.
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Gallstones (~25%)
Rapid weight loss brings on gallstones in around a quarter of people. Some units offer prophylactic ursodeoxycholic acid; a minority need cholecystectomy later.
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Weight regain (10–20% typical)
Sleeve dilation and lifestyle drift cause modest regain in most people after a few years. Diet, exercise, GLP-1 top-up or revision surgery are the options.
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Pregnancy, alcohol and mental health
Wait 12–18 months before pregnancy. Alcohol is absorbed faster and addiction-transfer is a real risk. Mental-health support is part of a good bariatric pathway.
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Red flags after surgery
Tachycardia, fever, severe abdominal pain, breathlessness or a swollen calf in the first weeks are not normal — call the unit or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever unit did the operation, the discharge summary tends to follow the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and operation performed
Why the operation was done — BMI, co-morbidities, NICE criteria met — and confirmation that a sleeve gastrectomy was performed.
- 02 Technique
Bougie size, staple line, leak test
The bougie calibration (typically 36–40Fr), where the staple line started from the pylorus, whether it was oversewn, and the result of the intra-operative leak test.
- 03 Findings
Liver, hiatus and any incidental findings
Notes on the left lobe of the liver, whether a hiatus hernia was found or repaired, and any incidental findings such as gallstones.
- 04 Impression
Diet plan, supplements, follow-up dates
Read this first: the staged diet, the lifelong supplement regime, when to resume medication, and when your first review appointments are.
Recognised by major UK insurers
Bariatric surgery cover varies by insurer and by policy. Many mainstream policies exclude weight-loss surgery; others cover it once NICE criteria are met. We confirm cover before booking.
Frequently asked
Everything we get asked about the gastric sleeve.
Quick answers on NICE eligibility, sleeve vs bypass, weight loss, reflux and lifelong supplements.
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Am I eligible for a gastric sleeve under NICE NG246?
The updated NICE NG246 (2023) supports bariatric surgery at BMI ≥40, or ≥35 with an obesity-related condition (type 2 diabetes, hypertension, sleep apnoea, severe joint disease), or ≥30 with recent-onset type 2 diabetes. A Tier 3 non-surgical programme — including dietetics, psychology and, where appropriate, medication such as a GLP-1 receptor agonist — must have been tried first.
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Sleeve or bypass — which is better?
Neither is universally better. A sleeve is simpler, has no anastomosis (so no leak from a join, no internal-hernia risk), fewer long-term nutritional problems and is often preferred at very high BMI. A Roux-en-Y bypass is stronger for type 2 diabetes remission and much better for people with significant reflux or Barrett’s oesophagus. It is a shared decision — we walk you through both.
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How much weight will I actually lose?
On average 25–30% of total body weight at 12–24 months, settling to around 20–25% at ten years. Most people regain 10–20% from their lowest weight. Type 2 diabetes goes into remission for around 50–60% early, dropping to 35–45% at ten years. Results depend heavily on follow-up and lifestyle.
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How much does a private gastric sleeve cost in the UK?
Roughly £8,000–£14,000 for a laparoscopic sleeve, or £11,000–£16,000 robotic-assisted. Prices should include the pre-op MDT workup, hospital stay and follow-up — check exactly what is included. We confirm a firm figure within one working day.
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What is the pre-op liver-shrinkage diet?
A very-low-energy diet (typically 800–1,000 kcal/day using Optifast, Slimfast or similar shakes and soups) for two to four weeks before surgery. It shrinks the left lobe of the liver so the surgeon can lift it out of the way safely, and reduces operative bleeding. It is compulsory, not optional.
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How long is the recovery and time off work?
Most people are home in one to two nights on an ERAS pathway. Office work in two to four weeks, avoid heavy lifting for six weeks, gradual return to full exercise over eight to twelve weeks. Driving usually restarts at two weeks once you can perform an emergency stop pain-free.
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Do I really need lifelong vitamin supplements?
Yes. A daily multivitamin, iron (especially for menstruating women), vitamin B12 and vitamin D and calcium are lifelong after a sleeve. It is less than after a bypass, but it is not optional. Annual blood tests are part of good follow-up.
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What if I get bad reflux after a sleeve?
Around one in four to one in three people have significant reflux after a sleeve. Most is controlled with a daily PPI. If it becomes intolerable, or if Barrett’s develops, conversion to a Roux-en-Y bypass is the definitive answer. This is why we screen for reflux and hiatus hernia before choosing a sleeve.
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Can I get pregnant after a sleeve?
Yes, and fertility often improves — but wait 12–18 months so weight and nutrition are stable. Pregnancy needs specialist input on supplementation, glucose testing (a standard OGTT is not always tolerated) and monitoring of the baby’s growth.
Related treatments
Looking for something else?
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Gastric bypass surgery
Roux-en-Y bypass — the alternative bariatric operation.
Learn more -
Gastric band surgery
Adjustable band — a reversible restrictive option.
Learn more -
Gastric balloon
Non-surgical bridge or lower-commitment option.
Learn more -
Endoscopic sleeve gastroplasty
A no-cut alternative done through the mouth.
Learn more -
Duodenal switch (SADI-S)
Powerful bariatric option for very high BMI or revision.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more