Sleeve Gastrectomy


In the Sleeve Gastrectomy procedure, also called the Vertical Sleeve Gastrectomy (VSG), 70-80% of the stomach is surgically removed, resulting in a sleeve or banana-shaped tube. The procedure is normally performed laparoscopically using small instruments inserted into tiny incisions in the upper abdomen. By limiting the size of the stomach, the amount of food you can eat is restricted. The procedure also prompts hormonal changes that help relieve conditions associated with obesity.

The Vertical Sleeve Gastrectomy is relatively new as a standalone weight loss surgical procedure.  It is the first part of the Biliary Pancreatic Diversion with Duodenal Switch (BPDDS, DS) operation for the super obese patient (BMI > 50).  There are instances where the VSG may be the best option when:
 

  1. The patient desires a restrictive operation without a foreign body.
  2. A stand-alone weight loss surgical procedure for a patient with a BMI < 50 who does not want their intestine bypassed is desired.
  3. A staged operation for patients with excessively high surgical risk and BMI is desired.  Staging procedures may reduce the risk of complications for the patient.
Advantages
  • Metabolic Procedure
  • Patients can expect to lose 50% of their excess body weight at one year, depending on their starting BMI.
  • Good appetite control
  • Low risk of weight regain (~25%)
Risks
  • Long term studies lacking.
  • Irreversible
  • Less effective for BMI greater than 50
  • Can worsen GERD (Reflux)
Recovery

Patients can expect to spend one to two nights in the hospital for a Sleeve Gastrectomy procedure. Pain and nausea are typically easily controlled with oral medication. Before discharge from the hospital, most patients are able to have their drain removed, and all patients will undergo a lower extremity venous doppler to evaluate for blood clots in their veins. 

Activity is progressed slowly and patients may return to a sedentary job after about two weeks.  Patients can expect an excess weight loss of about 50% of their excess weight with this procedure on average.