Vertical Sleeve Gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach, following the major curve. The open edges are then attached together (often with surgical staples) to form a sleeve or tube with a banana shape. The procedure permanently reduces the size of the stomach. The procedure is performed laparoscopically and is not reversible.
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Why choose the Vertical Gastrectomy?
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Vertical Sleeve Gastrectomy is a new bariatric procedure that offers an excellent alternative to both gastric bypass and adjustable gastric banding. Perhaps the biggest advantage of the Vertical Sleeve Gastrectomy lies in the fact that it does not involve any bypass of the intestinal tract so that patients do not experience the complications of intestinal bypass including intestinal obstruction, osteoporosis, anemia, vitamin deficiency and protein deficiency.
This procedure is also known by other names like vertical gastrectomy, vertical gastroplasty, vertical gastronomy, greater curvature gastrectomy, parietal gastrectomy, gastric reduction, and sleeve gastroplasty. Related to the long-standing 'duodenal switch' procedure, this particular form of bariatric surgery is in fact a vertical sleeve gastrectomy to which a duodenal switch (intestinal bypass) is added.
Important facts about the Vertical Sleeve Gastrectomy:
- The portion of the stomach that produces the hormone that stimulates hunger (Ghrelin) is removed.
- The stomach is reduced in volume but tends to function normally.
- No dumping syndrome because the pylorus is preserved.
- Minimizes the chance of an ulcer occurring so the use anti-inflammatory drugs such as aspirin, Motrin, Aleve and ibuprofen should not be a problem.
- No intestinal bypass and therefore little chance of nutritional deficiencies.
- Most of our patients with BMI between 30-50kg/M2 achieve their goal weights within 9-12 months after surgery.
- Safer alternative for high body weight (>400 pound) or medically high-risk patients.
- No foreign body or implanted devices.
- Can be done Laparoscopically in virtually all patients.
- 99% leave the hospital within one day.
Patient Considerations for Gastric Sleeve Surgery
- Safer option for individuals with BMI greater than 60 to undergo two-stage process of gastric sleeve followed up with duodenal switch or gastric bypass after partial weight loss
- Option for patients concerned about long-term side effects of weight loss surgery that involves rerouting and bypassing a portion of the small intestine, such as intestinal obstruction, ulcers, anemia, osteoporosis, protein deficiency, and vitamin deficiency
- Restrictive weight loss option for patients who are not comfortable having a medical device implanted into their body as with the LAP-BAND or REALIZE Band
- Surgical weight loss option for patients with health problems or complex medical issues that may prevent them from having other types of weight loss surgery, such as anemia, Crohn’s disease, anti-inflammatory drug use, or extensive prior surgery
- Revision option for gastric band patients experiencing problems with their band but who do not want to convert to a bypass type of operation
- Promotes weight loss by restricting amount of food that can be eaten at any one time
- Reduces hunger since it removes the part of the stomach that produces the hunger stimulating hormone ghrelin
- Digestion occurs normally as the digestive system is not altered
- Does not cause malabsorption or nutritional deficiencies as it does not involve rerouting or bypassing the small intestine
- Less chance of developing ulcers than with gastric bypass surgery
- Dumping syndrome not likely to occur as the stomach outlet (pyloric valve) remains intact, unlike gastric bypass surgery
- Less complicated procedure than gastric bypass or duodenal switch surgery
- Can usually be performed laparoscopically on extremely obese patients
- Does not require a gastric band being implanted into the body
- Does not require adjustments or fills as with a LAP-BAND or REALIZE Band
- Safer than a combined restrictive/malabsorptive weight loss surgery for patients who have many health problems
- May be converted to gastric bypass or duodenal switch if necessary for additional weight loss
- Expected excess weight loss for stand-alone procedure is 60 to 70% at two years
Advantages of Gastric Sleeve Weight Loss Surgery
Disadvantages of Gastric Sleeve Weight Loss Surgery
- As it is a purely restrictive weight loss procedure, inadequate weight loss or weight regain is more likely than with a procedure involving intestinal bypass
- With time, new smaller stomach pouch may stretch (also occurs with gastric bypass surgery)
- Although the gastric sleeve helps control hunger and limit amount of food that can be eaten at any one time, weight loss will not occur without a healthy, low-calorie diet and regular exercise (same as with other purely restrictive procedures such as LAP-BAND and REALIZE Band)
- If performed as the first part of a two-stage process, a second malabsorptive weight loss surgery such as the duodenal switch will need to be performed at a later time
- The surgery is not reversible as a portion of the stomach is permanently removed
- Leaks or bleeding may occur along the stomach stapling edge
- Procedure may not be covered by some insurance companies
- All surgery and anesthesia involves some level of risk including bleeding, blood clots, infection, pneumonia, or complications
- Lack of published data for long-term weight loss results
Vertical Sleeve Gastrectomy Support
VerticalSleeveTalk.com
VerticalSleeveTalk was launched February 2009 and has quickly grown to be the most popular online community dedicated to the Vertical Sleeve Gastrectomy Surgery (VSG). VerticalSleeveTalk's audience consists of potential and post-op Gastric Sleeve patients. VerticalSleeveTalk offers it's members discussion forums, online support groups, member blogs, Gastric Sleeve Surgeon reviews, photo galleries containing before and after pictures, live member chat rooms with audio and video plus many other useful features.
- Vertical Sleeve Gastrectomy
- The Sleeve
- The Gastric Sleeve
- The VSG or VG
- Greater Curvature Gastrectomy
- Parietal Gastrectomy
- Gastric Reduction
- Vertical Gastroplasty
- Vertical Gastronomy
Gastric Sleeve Weight Loss Surgery - Diet Restrictions
The gastric sleeve procedure will help a person control their hunger and limit the amount of food they can eat at any one time. As with all surgical weight loss programs, however, weight loss ultimately depends on adopting a new lifestyle, healthy diet, and regular exercise. The surgery itself does not require many food restrictions as the stomach continues to function normally, but for weight loss to occur high-calorie and high-fat foods and drinks must be avoided and daily calories must be limited. Many bariatric surgeons recommend eating five small, healthy meals a day with no snacking in-between meals.
Following surgery, patients will need to follow a liquid diet for about two weeks while the body heals. The diet will slowly progress from soft to solid foods. At about 4 to 6 weeks after surgery, most patients will usually be able to eat a regular solid diet. During the first 1 to 2 years after surgery, when most weight loss is expected to occur, the diet is limited to 600 to 800 calories a day. Once goal weight is achieved, most patients are able to eat about 1000 to 1200 calories a day.
The Vertical Gastrectomy procedure to date has the following names in the medical literature or the internet: