Surgery day is the moment everything becomes real. After months of consultations, pre-operative tests, dietary preparation, and mental readiness work, you are finally at the point of no return. For most people, it is a mixture of relief, nerves, and a strange kind of calm. We want to walk you through what the day actually looked like for us at Weight Loss Riga in March 2024, because knowing what to expect makes a significant difference to how you experience it.
The Night Before and Morning of Surgery
The pre-operative instructions you receive will specify exactly how long you need to fast before surgery. For gastric sleeve, you will typically be asked to stop eating solid food the night before and stop drinking clear fluids a few hours before your scheduled procedure time. Follow these instructions precisely. Fasting requirements exist to prevent aspiration during anaesthesia, which is a serious risk, and bariatric patients face a slightly higher baseline aspiration risk due to increased abdominal pressure. Your surgical team will not operate if you have not fasted correctly.
The morning itself tends to feel suspended in a strange way. You are not allowed to eat or drink, which gives you less to do, and the combination of hunger, thirst, and nerves produces a particular kind of restless waiting. We found it helped to have everything already packed and prepared the night before so the morning was simply about getting to the clinic without any logistical stress.
Arriving at the Clinic
On arrival you will be checked in, shown to your room, and asked to change into a surgical gown. A nurse will take baseline observations: blood pressure, heart rate, oxygen saturation, and temperature. You will have a pre-operative consultation with your surgeon, who will go through the procedure one more time, answer any last questions, and mark the consent documentation. This is your final opportunity to raise anything not yet mentioned, including any medications you have taken, any new symptoms, or any concerns.
An anaesthetist will visit to conduct their pre-operative assessment. They will review your medical history, any known sensitivities or reactions, and discuss how anaesthesia will be managed for you specifically. In James’s case, he had a pre-flagged adverse reaction to a specific anaesthetic agent. The anaesthetist at Weight Loss Riga was fully briefed on this and had already planned an adjusted protocol before the visit. Do not assume your anaesthetic notes will automatically follow you if you are having surgery abroad. Make sure they have been communicated to the team explicitly.
Going to Theatre
When your slot is ready, you will be transferred to the theatre suite, usually on a trolley or bed. The theatre itself tends to be cooler than you expect and is a busy, functional space with equipment, nurses, the surgical team, and the anaesthetist all preparing simultaneously. The team moves with practiced efficiency and will be talking you through what they are doing as they go.
Anaesthesia is typically administered through the cannula, and most people describe the onset as extremely quick. You will be asked to count or breathe oxygen through a mask, and within seconds you will be unconscious. There is no dramatic transition. You are there, and then you are not.
During the Procedure
Gastric sleeve surgery is performed laparoscopically, meaning through small incisions rather than a large open cut. The surgeon inserts a camera and instruments through several small ports. The stomach is divided along a calibration tube using a surgical stapler, and approximately 75 to 80 percent of the stomach is removed, leaving a narrow sleeve-shaped remnant. The procedure typically takes between 60 and 90 minutes, though this varies.
You will be entirely unaware of the procedure. The anaesthetic team monitors your vital signs, airway, and depth of anaesthesia throughout. Any adjustments needed during the operation are managed by the team in theatre.
Waking Up in Recovery
The recovery room is where you come round from anaesthesia. Waking up from a general anaesthetic is a gradual process rather than a sharp transition. You may be aware of voices before you can open your eyes or respond. Pain, nausea, and confusion are all common in the first minutes and hours after surgery. Recovery room nurses monitor you closely during this period and will manage any immediate symptoms.
James woke up feeling nauseated and disorientated, which was partly a known consequence of his sensitivity to certain anaesthetic agents. The team had anticipated this and had anti-emetics ready. Kirsten came round more smoothly but found the initial pain more significant than expected. Both experiences were within the normal range, and both were managed well by the recovery team.
Once you are stable and your observations are satisfactory, you will be transferred back to your room. The post-operative monitoring phase then begins: regular observations, IV fluids, pain management, and the slow reintroduction of sips of water. The first sip you manage is a significant moment, and it will feel very different to how drinking felt before.
What to Expect Emotionally
The emotional experience of surgery day is something that does not get talked about enough. The combination of relief that the surgery is done, physical discomfort, post-anaesthetic grogginess, and the dawning reality of what has just happened produces a complicated emotional state. Many people cry in recovery without quite knowing why. Some feel euphoric. Others feel frightened or regretful in those first hours. All of these are normal responses to a major physical and psychological event.
What you will not feel on surgery day is any sense of whether it was the right decision. That takes time and distance. Surgery day is just about getting through it, and the team around you is there to help you do exactly that.
Sources
NHS. General anaesthesia. Available at: https://www.nhs.uk/conditions/general-anaesthesia/
NICE. Obesity: identification, assessment and management. Clinical guideline CG189. Available at: https://www.nice.org.uk/guidance/cg189
BOMSS. Guidelines on peri-operative and postoperative biochemical monitoring and micronutrient replacement for patients undergoing bariatric surgery. Available at: https://www.bomss.org.uk/
About this content
This blog is written by James and Kirsten, a couple from the UK who had gastric sleeve surgery together in March 2024.
We started this blog because we couldn't find any sources of content that details before surgery, the surgery and then life post surgery - so we decided to write one ourselves.
Everything on this site is based on our own experience and the research we have done along the way. It is not medical advice. Gastric sleeve surgery is a serious procedure and every patient's journey is different. Please always consult your own bariatric team or GP before making any decisions about your health or treatment.
Some posts on this site may contain featured or sponsored content, or affiliate links. Where this is the case, it will always be clearly stated at the top of the article. Our opinions are always our own.
Publish Date: 16 June 2026 | Last Reviewed: 16 June 2026 | Next Planned Review: 16 December 2027