Vertical sleeve gastrectomy (VSG) is a weight-loss surgery that reduces the size of the stomach and restricts the amount of food a person can eat. Fellowship-trained surgeons at our Bariatric and Metabolic Surgery Center have performed hundreds of these procedures. VSG has changed the lives of many people who were unable to reach a healthy weight through nonsurgical methods.
Our surgeons use minimally invasive laparoscopic techniques whenever possible. As a result, patients recover faster and have reduced scarring after surgery.
What Is Vertical Sleeve Gastrectomy?
VSG is a procedure in which doctors remove a large portion of the stomach. People typically lose 50 to 60 percent of their excess weight within two to five years after surgery. VSG is a procedure in which doctors remove a large portion of the stomach. People typically lose 50 to 60 percent of their excess weight within two to five years after surgery. The generally-adopted timeline for weight loss after VSG is:
- First 2 weeks: Patient will lose about one pound per day, around 15 pounds total
- First 3 months: Patient will lose roughly 40% of excess weight
- First 6 months: Patient will lose roughly 50% excess weight
- Full year: Patient will lose 60% excess weight
Because VSG greatly reduces stomach size, you will need to eat smaller meals. The surgery does not change the way your body processes food, meaning the digestive tract still absorbs all calories and nutrients. However, creating a smaller stomach does help regulate ghrelin, an appetite-stimulating hormone, which may reduce hunger.
The benefits of a vertical sleeve gastrectomy include:
- Curbed appetite
- No risk of dumping syndrome
- Positive effect on most obesity-related disease such as heart disease and diabetes
- Effective long-term weight loss
At the same time, there are disadvantages or risks of a sleeve gastrectomy:
- Patients will lose less weight than a gastric bypass procedure
- Inflamed symptoms of gastroesophageal reflux disease (GERD)
- Surgical side effects such as bleeding and infection
- Difficulty absorbing nutrients from food
Who Should Consider Bariatric Surgery?
Patients that are severely obese may find that vertical sleeve gastrectomy is the best weight-loss option for them. If you have a BMI of 40 or higher and have tried other non-surgical weight loss methods to no long-term success, you would be a prime candidate for the procedure. In addition, conditions such as diabetes, heart disease, sleep apnea and high blood pressure may also make you a fitting candidate.
Preparing for a Vertical Sleeve Gastrectomy
The preparatory period for a vertical sleeve gastrectomy could potentially last multiple months. There are physical and mental aspects of preparation that need to be closely considered. The objective of this preparation is to ensure that the procedure will be a success and that the patient will experience long-lasting results.
In terms of the mental preparation for this procedure, there are several evaluations that will be conducted. A psychological evaluation will determine whether a patient is mentally prepared for the surgery and life after surgery. In addition, there is also nutritional counseling sessions that will ensure the patient is prepared to commit to a significant change in their dietary habits for a lifetime post-surgery.
From a physical standpoint, there are several steps a patient needs to take in the long term and the immediate term. It is often advised that a patient lose some excess weight before the surgery to ensure that the surgery is safe. In addition, any patient that smokes cigarettes should quit at least several months prior to the surgery. This is a lifetime commitment and should also be supplemented with counseling. In the immediate term, a patient should stop taking any kind of blood-thinning medication such as aspirin or ibuprofen, and they do not eat or drink anything 8 hours before surgery.
The VSG Procedure
To perform this surgery, one of our highly skilled surgeons:
- Removes 85 percent or more of the stomach
- Leaves the sphincters (the muscles that help move food in and out of the stomach) in place
- Creates a new stomach in the shape of a tube out of the remaining section of stomach
The surgery takes about 1.5 to 3.5 hours, and patients can expect an overnight stay in the hospital. The procedure cannot be reversed.
A Minimally Invasive Approach
Our surgeons use laparoscopy, a minimally invasive surgical technique, in nearly all patients undergoing VSG to reduce the risk of complications. To perform laparoscopic surgery, doctors make several small incisions in the abdomen, rather than the large incision used in open surgery. These small incisions provide access for surgical tools, including a laparoscope, a thin tube with a small camera to view the procedure.
Minimally invasive surgery promotes:
- Faster healing
- Faster return to normal activities
- Less scarring
- Lower risk of surgical complications
Life After Vertical Sleeve Gastrectomy
After your surgery has been completed, there is a general recovery timeline that you will aim to follow. In the first several weeks, you will be on a liquid-only diet as your body begins to process the changes to your digestive system and your stomach heals. The specific timeline for recovery will vary by person, but the progression goes from liquid-only to pureed foods, slowly transitioning to soft foods and then finally introducing small portions of regular food.
It is important to remain in steady contact with your physician and the bariatric team to monitor your progress. It is common for patients to become deficient in certain vitamins and nutrients, and a custom-tailored regimen of nutritional supplements will ensure you have enough calcium, vitamin D, B-12, iron and various other crucial vitamins and minerals.
After one full year, you should expect to have the majority of the weight-loss objective achieved, roughly 50-60% of your excess weight. From that point forward, it is up to you to make sure that weight isn’t regained slowly over time. It is common for the gastric sleeve to dilate over time, thus allowing for a larger appetite. Part of the long-term weight loss plan is to adhere to a strict diet and exercise routine that will instill natural healthy habits and maintain your new goal weight.
Refer a Patient
If you are a doctor who wants to refer a patient to Cooper, please call 856.673.4500.