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Laparoscopic bariatric surgery
Condition Guide

Weight loss surgery
Minimally invasive bariatric surgery

American Board of Obesity Medicine Certified DiplomateDr. Irshad holds certification from the American Board of Obesity Medicine

Weight-loss (bariatric) surgery helps people with obesity lose a significant amount of weight and improve or resolve conditions like type 2 diabetes, high blood pressure and sleep apnea. Dr. Irshad performs these operations with keyhole techniques, and offers the Sleeve Nissen — a combined procedure for patients who also have bad reflux.

Sleeve / Sleeve Nissen
Procedure
1–3 nights
Hospital stay
Keyhole
Minimally invasive
60–80%
Excess weight lost

What is bariatric surgery?

It’s surgery that reduces the size of the stomach so you feel full sooner and eat less, and it changes the hormones that control hunger. The most common operation is the sleeve gastrectomy. It works best alongside long-term changes to eating and activity.

Who is it for?

  • Adults with a BMI of 40+, or 35+ with weight-related conditions like diabetes or sleep apnea
  • People who haven’t reached their goals with diet and medication
  • Those ready for life-long follow-up and healthy changes

How it works

  • A full assessment by the bariatric team
  • Keyhole surgery to create the sleeve
  • For patients with reflux, a Sleeve Nissen adds an anti-reflux wrap
  • Nutrition and follow-up support afterwards

The Sleeve Nissen

  • Combines a sleeve gastrectomy with a Nissen anti-reflux wrap in one keyhole operation
  • An option at the hospital for patients with morbid obesity and a symptomatic hiatus hernia
  • Evidence shows weight loss equal to the sleeve alone, with far less reflux

Patient tool · Weight loss surgery

BMI & eligibility check — do you meet the usual criteria?

Body Mass Index (BMI) is the starting point bariatric teams use when assessing eligibility for surgery. Enter your height and weight to see your BMI and how it relates to the usual criteria. It is for information only — not a diagnosis or a guarantee of eligibility.

Please enter a valid height and weight.

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Your BMI

BMI is a screening measure and does not account for muscle mass, ethnicity-specific risk, or overall health. Eligibility for surgery is always determined by a full assessment. This tool does not diagnose any condition or replace assessment by your doctor.

Dr. Irshad’s approach

Keyhole bariatric surgery

All procedures are done laparoscopically through small cuts, which means less pain and a quicker recovery. As a diplomate of the American Board of Obesity Medicine, Dr. Irshad treats obesity as a medical condition — combining surgery with medical and nutritional care.

For patients with both obesity and reflux, the Sleeve Nissen treats both at once.

Your recovery, step by step

Before surgery

Most patients follow a special low-calorie “liver-shrinking” diet for about 2 weeks beforehand. This makes the operation safer and easier.

Hospital

Typically 1–3 nights, depending on the procedure.

Weeks 2–3

Most patients return to light activity.

First year

60–80% of excess weight is typically lost — individual results vary.

Long term

Major improvement or remission of type 2 diabetes, high blood pressure and sleep apnea, with ongoing follow-up.

Common questions

Who is a candidate for bariatric surgery?
Candidates usually have a BMI of 40 or higher, or 35 or higher with weight-related conditions such as diabetes or sleep apnea. A full assessment is completed before surgery.
What is the Sleeve Nissen, and who is it for?
It combines a sleeve gastrectomy with a Nissen fundoplication in a single keyhole operation. It’s ideal for people with obesity who also have significant GERD or acid reflux, treating both at the same time.
Does the Sleeve Nissen affect weight-loss results?
No. Published evidence shows it achieves weight loss equal to a sleeve gastrectomy alone while substantially reducing reflux. Most patients lose around 65–75% of their excess weight within 12–24 months, though results vary.
What is eating like after surgery, and will I need vitamins?
Eating returns in stages — clear fluids first, then pureed and soft foods, and gradually back to solid meals over several weeks. Long term you’ll eat much smaller portions and focus on protein first. Because a smaller stomach absorbs fewer nutrients, daily vitamin and mineral supplements are needed for life (such as a multivitamin, vitamin B12, iron and calcium), along with regular blood tests to keep levels on track.
How does surgery compare to weight-loss medications like Ozempic?
Newer GLP-1 medications (such as semaglutide/Ozempic) can produce meaningful weight loss and suit many people, especially those who prefer not to have surgery or need to lose weight before an operation. The trade-offs: the weight tends to return if the medication is stopped, and it’s an ongoing cost. Surgery generally gives larger, more durable weight loss and a higher chance of putting type 2 diabetes into remission. They aren’t mutually exclusive — Dr. Irshad, as a diplomate of the American Board of Obesity Medicine, can help you weigh which path (or combination) fits you best.
Is weight-loss surgery safe?
Modern keyhole bariatric surgery has a strong safety record, and for many people the health risks of untreated obesity are greater than the risks of surgery. As with any operation there are risks — such as bleeding, infection, blood clots, or a leak at a staple line — which are uncommon and are minimised by careful assessment and an experienced team. Dr. Irshad will go through the specific risks and benefits for your situation.
How do I get a referral?
Your family doctor can submit a referral directly. See the referral section for the right form to complete. For private gastric sleeve surgery, you can also contact 360 Sleeve directly (below).

Private sleeve surgery

Gastric sleeve surgery at 360 Sleeve

Dr. Irshad performs gastric sleeve gastrectomy at 360 Sleeve, a private bariatric clinic in Toronto offering keyhole sleeve surgery, flexible financing, and a 6-year aftercare program. The Sleeve Nissen (combined sleeve and anti-reflux repair) is offered at the hospital for patients with morbid obesity and a symptomatic hiatus hernia.

Disclosure: 360 Sleeve is a private clinic where Dr. Irshad performs surgery; gastric sleeve procedures there are private and not OHIP-covered.

Visit 360sleeve.com @360sleeve

Medically reviewed by Dr. Kashif Irshad, MD, MSc, FRCSC · Last updated July 2026

A referral from your family doctor or specialist is all that’s needed to be seen by Dr. Irshad. Find the referral forms and clinic details below.

Referral information →