Vertical Sleeve Gastrectomy (VSG) is a restrictive weight loss surgery offered by the East Valley bariatric surgeons at The Bridges Center and surgeons worldwide. The procedure is generally considered safe for patients with a high BMI; it is also offered as an alternative to the LAP-BAND® System for obese patients with a lower BMI.
VSG leads to weight loss by restricting the stomach size. During the procedure, 85% or more of the stomach is removed. A smaller stomach means patients must eat smaller portions, thereby consuming fewer calories, which leads to weight loss.* One benefit of VSG is that there is no intestinal bypass in this procedure, so patients do not have to worry about the risk of gastrointestinal malabsorption. (Malabsorption can occur in patients who undergo Roux-en-Y gastric bypass or biliopancreatic diversion with duodenal switch.)
How It Works
In the procedure, which can be done in either our Phoenix or Mesa bariatric facility, the surgeon restricts the stomach by dividing it vertically and stapling it. The majority of the stomach is resected, leaving behind a small stomach shaped like a slender banana that can hold just a few ounces of food. All other components of the digestive system are left in tact, including the pylorus (the opening from the stomach that connects to the duodenum). Only the size and shape of the stomach are altered in this procedure. Because of this, patients avoid potential long-term complications that can occur in procedures that dramatically alter how food moves through the digestive system.
Vertical sleeve gastrectomy is a laparoscopic procedure, meaning the entire operation is performed through just two to five small incisions in the abdomen. The surgeon is able to see inside the abdomen with the aid of a small camera, which passes through these incisions and relays back a live video feed. The entire procedure takes just 60 to 90 minutes or less.
What Results Can I Expect?
Patients who undergo vertical sleeve gastrectomy can expect several benefits…
- Weight loss. Weight loss is, of course, the top priority for patients at The Bridges Center. Patients who are highly motivated, have a successful operation and apply the education provided by the health care team at The Bridges Center may achieve significant weight loss, losing weight that is comparable to the results seen in other bariatric procedures.*
- Reduced appetite. The portion of the stomach that is resected during VSG is responsible for secreting a hormone known as Ghrelin. Ghrelin is responsible for sensations of appetite and hunger. Many patients report a significant reduction in appetite and hunger following vertical sleeve gastrectomy, a phenomenon that does not occur in other weight loss procedures like adjustable gastric banding. Some studies suggest that appetite slowly returns in the years following VSG; still, other studies have demonstrated significantly lower appetites (several years post-op) in patients who have undergone VSG compared to patients who have undergone adjustable gastric banding.
- Satisfaction with small meals. Because stomach size is drastically reduced in VSG, patients are satisfied with small meals. Very small meals can quickly create a sense of lasting fullness.
Is Vertical Sleeve Gastrectomy Right for You?
Vertical Sleeve Gastrectomy may be a good option for patients with an especially high BMI, including patients who weigh over 500 lbs. In these cases, VSG may be used as a “first stage” procedure, helping the patient to lose 100 lbs. or more, reducing their overall risk level.* (In many cases, such as these, the procedure can still be done laparoscopically.) Once the patient’s BMI is reduced to a manageable range of 35-40, he or she could be a candidate for a “second stage” procedure, such as adjustable gastric banding, Duodenal Switch or Roux-en-Y gastric bypass. Your East Valley weight loss surgeon at The Bridges Center can tell you more.
Obese patients with a lower BMI may also consider VSG. This procedure may be right for you if…
- You are concerned about potential long-term side effects that may develop as a result of an intestinal bypass (including, for example, protein and vitamin deficiencies, obstructions, ulcers, osteoporosis and anemia).
- You are concerned about introducing a foreign body to the abdomen (i.e. an adjustable gastric band) or will be unable to follow through with the regular physician maintenance a band requires.
- You are unable to have other procedures because of pre-existing medical conditions.
- You need to take NSAIDs (e.g. ibuprofen) on a frequent basis.
What Benefits Are Associated With VSG?
Vertical sleeve gastrectomy offers a number of benefits as a surgical weight loss option:*
- Because the procedure reduces the stomach size without altering how the stomach functions, most foods are okay to consume. Portion size is the main concern.
- Reduced appetite because of the removal of stomach tissue that produces Ghrelin, the hunger-stimulating hormone
- No or very little “dumping syndrome” because the pylorus is not affected in the procedure
- Lower chance of stomach ulcers, protein and vitamin deficiencies, obstructions, osteoporosis and anemia. Vitamin deficiencies are quite rare. However, because of the restricted stomach’s size, your physician may recommend a multivitamin after surgery.
- High rate of effectiveness as a “first stage” procedure for patients with BMI > 55
- Good successes with patients who have a lower BMI of 30-35
- Good option for patients who, because of a pre-existing condition that increases risk of complications, cannot have an intestinal bypass procedure
- No foreign objects introduced to the body
- Can be done laparoscopically, even in high BMI patients
Vertical sleeve gastrectomy is not right for everyone. Disadvantages of VSG include:
- The possibility of little weight loss or regaining weight is sometimes higher among patients who undergo this procedure (compared to patients who have an intestinal bypass procedure).
- Patients who undergo VSG may experience slower rates of weight loss if they consume “soft calories,” such as ice cream or milk shakes.
- Unlike adjustable gastric banding, this procedure is irreversible.
- Some insurance providers consider VSG “investigational.”
What Risks Are Associated With Sleeve Gastrectomy?
For patients with a high BMI, this procedure is typically part one of two. While a two-part procedure can be more effective for weight loss, having to undergo two procedures means undergoing the potential risks, complications and recovery twice. Patients should also be aware that leaking and staple-related complications are possible, as this procedure does require stapling the stomach. Your weight loss surgeon and health care team at The Bridges Center will provide extensive educational materials about VSG and the potential risks and complications prior to surgery.
What Happens After Vertical Sleeve Gastrectomy?
In the first several weeks after surgery, patients typically consume water and liquid protein drinks. After two to four weeks of this diet, thicker food items are slowly introduced into the diet. After a couple months of soft foods, many patients are able to return to normal foods.
Life After Vertical Sleeve Gastrectomy
Your health care team at The Bridges Center will work with you to develop a post-VSG diet plan to achieve your weight loss goals. A fairly standard VSG diet in the months following surgery is low in calories (~500 calories/day), high in protein (70gm/day), low in fat (30gm/day), and low in carbohydrates (40gm/day). Patients gradually increase their daily caloric intake throughout the first year, usually landing somewhere between 900 and 1500 calories per day. Caloric intake will depend on age, gender and activity levels.
Vertical Sleeve Gastrectomy In Phoenix & Mesa, AZ
To learn more about vertical sleeve gastrectomy and whether it’s right for you, we invite you to attend a weight loss webinar or seminar at The Bridges Center. Learn about…
- Obesity and its health risks
- The Bridges Center’s proven program
- Our professional health care team
- Weight loss surgery options in Phoenix and Mesa, AZ
To register for a seminar, call 602-251-8828 or select the link below.