Laparoscopic Vertical Sleeve Gastrectomy

How is it done?

Vertical sleeve gastrectomy, also known as parietal gastrectomy or just Sleeve gastrectomy consists of an operation that aims, if performed alone, to be restrictive in nature. It is performed by laparoscopy. The VSG procedure is often utilized as a first-stage bariatric procedure to reduce surgical risk in high-risk patients by induction of weight loss and this may be its most useful application at the present time (BMI > 60 kg/m2). During this procedure, we create a small, banana-shaped stomach by removing about 85% of the stomach as shown at left. The sleeve is larger than the gastric pouch created during Roux-en-Y Gastric Bypass. The actual surgery takes about 50 minutes.

Weight loss following sleeve gastrectomy results from eating less because of the much smaller stomach. Removing the part of the stomach that produces the hunger hormone (Ghrelin) or some other unidentified factor(s) also contributes to the weight loss.

Weight regain or a desire for more weight loss in very obese patients may require additional surgery in 1-2 years time, such as gastric bypass.

What Are the Benefits?

Preliminary studies show that patients after VSG lose 50-60% of their extra weight in the first 2 years after the surgery.

More recent research shows that VSG is a viable alternative for those patients who feel the gastric bypass is “too much” surgery.

In addition to this weight loss, if you have any of these conditions, they will improve or resolve after the surgery:

  • Type 2 Diabetes
  • High blood pressure
  • Sleep apnea
  • Abnormal lipids/cholesterol
  • Asthma
  • Low back pain
  • Weight-bearing arthritis of the hips, knees, ankles, and feet
  • Skin fold dermatitis
  • Urinary stress incontinence
  • Acid reflux
  • Metabolic Syndrome

Finally, the health benefits gained with gastric bypass surgery can reduce your risk of death by as much as 89% compared to staying morbidly obese. For more details please explore the section “Reasons why to opt for Weight Loss Surgery”.

What are the situations where this surgery should not be done?

  • Lung disease requiring oxygen therapy
  • Extremely limited mobility
  • Untreated psychiatric disorders and substance abuse or narcotic dependency
  • Endocrine disorders such as Cushing’s Syndrome and Prader Willi Syndrome
  • Psychological instability
  • Drug or alcohol abuse
  • Inability to cope with the changes in diet and life modification after surgery
  • Refusal to be assessed by psychologist or psychiatrist

Complex medical conditions increase the risk of surgery and are considered on a patient-by-patient basis.