The first 24 hours after gastric sleeve surgery are unlike anything else in the experience. You have just had a major operation and your body is simultaneously dealing with the anaesthetic, the surgical trauma, a stomach that is now a fraction of its former size, and the beginning of what will become a very different relationship with food. It is intense, uncomfortable, and at times frightening. It is also something you will get through, one hour at a time.
We had our surgery at Weight Loss Riga in March 2024. This is what those first 24 hours actually looked like.
The Recovery Room
You will not remember going to sleep and you will not experience the surgery. The first thing you will be aware of is sound before vision, voices in the recovery room before you can open your eyes or speak. This is normal and disorienting in equal measure.
In recovery, nurses monitor your vital signs continuously: oxygen saturation, heart rate, blood pressure, and respiratory rate. You will have an oxygen mask or nasal cannula in place, a urinary catheter, one or more drains coming from the surgical site, and an IV line delivering fluids and medications. The combination of tubes and monitors is intimidating if you are not expecting it, but each is there for a specific clinical reason.
Pain in the immediate post-operative period varies enormously between individuals. James found the pain manageable but the nausea significant. Kirsten found the pain more prominent initially but the nausea less so. Both are within the normal range. Do not try to manage pain stoically in recovery. Tell the nurse your pain level and let them give you what is prescribed. Uncontrolled pain slows recovery and makes breathing shallower, which increases respiratory complications.
Back in Your Room: The First Few Hours
Once you are stable, you will be transferred back to your room. The first few hours involve a lot of lying still, dozing, and trying to find a comfortable position. Rolling to one side typically requires both arms and conscious effort.
Shoulder tip pain is something neither of us was fully prepared for. It comes from the carbon dioxide gas used to inflate the abdomen during laparoscopic surgery. As the gas disperses over the first day or two, it can cause referred pain in the shoulder and upper chest that feels nothing like abdominal pain and can be alarming if you do not know to expect it. Walking helps it to disperse faster. It resolves on its own.
You will not be offered food in these first hours. Ice chips or small sips of water may begin once the surgical team is satisfied with your recovery, typically a few hours post-op. That first sip will feel strange. Your stomach is swollen and tender from surgery and the sleeve is very small. Even a tiny amount of liquid can feel like too much. Sip very slowly and stop when your body tells you to.
Getting Out of Bed
Early mobilisation is a key part of post-bariatric recovery. Getting out of bed on the day of surgery or very early the following morning is standard practice in most bariatric units. It reduces the risk of deep vein thrombosis (DVT), helps the trapped gas to move, and aids respiratory function.
The first time you stand up will likely be with nursing assistance. Nurses will show you how to support your abdomen and transfer from lying to sitting and then to standing in a way that minimises strain on the surgical site. It hurts less than you expect once you are upright, and the sense of achievement is immediate.
You will be wearing compression stockings and will likely have received a blood-thinning injection (low-molecular-weight heparin) to reduce DVT risk. DVT prevention is taken seriously after bariatric surgery because the combination of a major operation, abdominal pressure changes, and reduced mobility creates elevated risk.
Monitoring and Warning Signs
The nursing team will check your observations regularly throughout the first 24 hours. A raised heart rate (tachycardia) that persists without obvious explanation is one of the most important early warning signs of a complication such as a staple line leak. If you feel your heart racing persistently, particularly in combination with feeling unusually unwell, tell the nurse immediately.
Pain that is significantly worsening rather than gradually improving, pain that feels different in character from expected post-operative discomfort, or severe pain in the upper left abdomen specifically, should all be reported to your medical team promptly.
Emotionally, It Is a Lot
We both experienced unexpected emotional responses in the first 24 hours. For Kirsten, it was anxiety around her Crohn’s disease and whether the surgery would trigger a flare. For James, it was a sharp awareness of how much he had put his body through, combined with the strange vulnerability of hospital dependency. Neither of us had talked about those feelings beforehand, and we found it harder to process alone than it would have been if we had simply acknowledged to each other that surgery day and the day after can be emotionally raw.
If you feel frightened, uncertain, or emotional in those first hours, that is not weakness or a sign you made the wrong decision. It is a completely normal response to a major life event. Let the nursing team know how you are feeling, as well as how much pain you are in.
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: 20 June 2026 | Last Reviewed: 20 June 2026 | Next Planned Review: 20 December 2027