Vertical Sleeve Gastrectomy (VSG)
The vertical sleeve gastrectomy, like the adjustable gastric band is classified as a restrictive weight loss surgery. The surgeon removes about 85% of the stomach leaving a long tube like shape or “sleeve”. The new stomach can hold about 60 to 150 cc’s of food or 2 to 3 oz. The Gastric Sleeve surgery, like the DS surgery leaves the pylorus or outlet valve of the stomach intact. While the shape of the stomach is drastically changed, its function is preserved. Patients need to understand that unlike some of the other forms of surgery, the vertical sleeve gastrectomy is not reversible.
The new stomach continues to function normally resulting in fewer restrictions of foods which patients can consume after surgery, albeit that the quantity of food eaten will be considerably reduced. Many patients see this as being one of the great advantages of the sleeve gastrectomy. Additionally the removal of the majority of the stomach also results in the elimination of much of the hormones produced within the stomach which stimulate hunger.
One big advantage of the gastric sleeve lies in the fact that it does not involve bypassing and of the intestinal tract, thus patients do not suffer the possibility of complications from the intestinal bypass such as intestinal obstruction, anemia, osteoporosis, vitamin deficiency and protein deficiency. This surgery is also suitable for patients who are already suffering from anemia, Crohn's disease and a variety of other conditions that would place them at high risk for surgery involving intestinal bypass.
Another advantage of the vertical sleeve gastrectomy is that it is one of the few surgeries which can be performed laparoscopically in patients who are extremely overweight. This fact makes this surgery attractive to high BMI and high risk patients.
One of the disadvantages of the vertical sleeve gastrectomy surgery is that it does not always produce the same reduction in weight as the gastric bypass. In the long term, the vertical sleeve gastrectomy can result in weight regain. This is true of any form of purely restrictive surgery.
Because the procedure requires stapling of the stomach the possibility of leakage and of other complications directly related to stapling, though rare, can occur. In addition, as with any surgery, patients run the risk of additional complications such as post-operative bleeding, small bowel obstruction, pneumonia, infection and blood clots.
The risk of encountering any of these complications is however extremely small and varies from about 0.5 and 1%. Having said this, the risk of death from this form of surgery is about 0 .25% is extremely small. The fact still remains that the overall risk of remaining obese is much higher than doing nothing at all.
As a general rule the vertical sleeve gastrectomy is best suited to individuals who are either extremely overweight or whose medical condition would rule out other forms of surgery. The vertical sleeve gastrectomy is also commonly used for high risk and/or high BMI patients as a first stage procedure. Patient will often undergo the gastric sleeve procedure, lose weight thus improving their overall condition, and then have the intestinal bypass portion of the surgery performed at a later date. Please contact us for additional details.
