The Sleeve Gastrectomy is a restrictive weight loss surgery procedure that causes weight loss by restricting food intake. During the surgery, approximately 85% of the stomach is removed leaving a cylindrical or sleeve shaped stomach with a capacity ranging from about 60 to 150 cc, which will hold about ½ to 1 cup of food at one time.
This procedure generates weight loss solely through reducing the stomach volume and decreasing the appetite. This part of the procedure is not reversible. The nerves to the stomach and the outlet valve (pylorus) remain intact with the idea of preserving the functions of the stomach while drastically reducing the volume
This surgery is an option for those patients that are morbidly obese with a BMI greater than 40, or a BMI between 35-40 with significant comorbidities. The surgery is performed laparoscopically and robotically, and only requires an overnight stay in the hospital.
The average weight loss for this procedure is reported to be 50-60% of the excess weight loss over 2 years. This means, that if you are 100lbs above your ideal body weight, you would expect on average to loose approximately 50-60 pounds. However, individual weight loss will vary based upon how well you follow the post-operative guidelines.
The Vertical Gastrectomy procedure to date has the following names in the medical literature or the internet:
- Vertical Sleeve Gastrectomy
- The Gastric Sleeve
- Greater Curvature Gastrectomy
- Gastric Reduction
- Sleeve Gastrectomy
- Vertical Gastroplasty
- The Sleeve
- The VSG or VG
- Partial Gastrectomy
- Vertical Gastrectomy with Duodenal Switch
- Vertical Sleeve Gastroplasty
- Gastro Sleeve
Advantages of the Vertical Gastrectomy Weight Loss Surgery
- The stomach is reduced in volume but tends to function normally so most food items can be consumed, though only in small amounts.
- Eliminates the upper portion of the stomach that produces the hormones that stimulates hunger (Ghrelin), therefore hunger is often decreased temporarily for a few months.
- No dumping syndrome because the pyloric valve is preserved.
- Does not require adjustments
- Does not induce malabsorption
- Great procedure for Low BMI patients (35-40) with metabolic syndrome (HTN, diabetes type 2, etc.)
- No foreign body or implanted devices.
- Can be performed laparoscopically or robotic in virtually all patients.
- 99% leave the hospital within one day
- Minimizes the chance of an ulcer occurring by decreasing the amount of acid secreted.
- By avoiding the intestinal bypass, the chance of intestinal obstruction (blockage), anemia, osteoporosis, protein deficiency and vitamin deficiency are greatly reduced.
- No adjustment required or foreign body inserted (as in an adjustable gastric band) that may cause obstruction, slippage or erosion.
Disadvantages of the Vertical Gastrectomy Weight Loss Surgery
- Because the stomach is removed, it is not reversible.
- There is a potential for inadequate weight loss or weight regain. While this is true for all procedures, it is theoretically more possible with procedures that do not have an intestinal bypass. Usually this is related to excess snacking and stretching the sleeve by over eating.
- Soft calories such as ice cream, milk shakes, can be consumed \ absorbed and these high calorie foods may slow weight loss.
- This procedure does involve stomach stapling and therefore leaks and other complications related to stapling may occur.
- Reflux may develop after this procedure, if you already have reflux this procedure could cause and increase.
What to Do Before Gastric Sleeve Surgery
Before gastric sleeve resection or any bariatric surgery, smoking increases the risk for infections, pneumonia, blood clots, slow healing and other life-threatening complications after surgery. Ideally, you should permanently quit smoking, but even if you don’t you must quit for at least one month before and one month after bariatric surgery.
Some surgeons require patients to go on special diets in the week(s) before the procedure.
What to Expect After Gastric Sleeve Surgery
A non-reversible procedure, gastric sleeve surgery is performed under general anesthesia and takes about one to two hours. Afterward you will probably stay in the hospital for one or two days; recovery from gastric sleeve surgery may last a few weeks.
The abdomen is often swollen and sore for several days. Your surgeon may prescribe pain medication for the discomfort. Some scarring may occur, but this can be covered with clothing.
Following surgery, you will need to become re-accustomed to eating solid foods. Normally this starts with four weeks on a liquid-only diet, two weeks of semi-solid, pureed foods and then solids.
As far as weight loss goes, most people who have gastric sleeve surgery lose 50 to 80 percent of their excess body weight over the first six months to one year after surgery. Studies have shown that after the gastric sleeve resection procedure people show improvement in diabetes, high blood pressure, high cholesterol and sleep apnea within one to two years. These improvements are comparable with those seen after other weight loss surgeries.
Following recovery, certain lifestyle changes and follow-up care occur; people who have gastric sleeve surgery must:
- Exercise regularly.
- Learn behavior modification techniques.
- Follow very specific dietary instructions for the rest of their lives, including eating very slowly, consuming only small quantities of food at a time, chewing thoroughly and swallowing food only when it is mashed, and not eating and drinking at the same time.