Vertical sleeve gastrectomy (VSG) is a type of weight-loss surgery in which a portion of the stomach is removed. VSG is a restrictive procedure, meaning it restricts the amount of food you can eat, but does not interfere with the absorption of nutrients the way other types of weight-loss surgery can.
The procedure
VSG is a laparoscopic procedure, a minimally invasive surgery in which the surgeon uses several small incisions rather than one large incision. Using a digital laparoscope to see into the body, the surgeon will remove approximately 60 to 85 percent of your stomach. The part of the stomach that remains resembles a sleeve. To obtain the desired shape, the surgeon uses a device known as a bougie---a flexible rubber tube that is placed into the stomach during the procedure and then removed. The open side of the stomach is closed with titanium staples.
Results
VSG is a relatively new procedure; the earliest versions of the surgery were developed in the late 1990s. There is therefore no long-term data available to determine if the effects of the surgery are long lasting. According to Cornell University, patients typically lose about 40 percent of their excess body weight. Because VSG patients can later undergo other types of weight-loss surgery, such as Roux-en-Y (RNY) gastric bypass, Lap-Band, or duodenal switch, VSG is sometimes used as an "in-between" surgery to help morbidly obese patients lose weight in preparation for a second-stage operation.
Advantages
Laparoscopic surgeon Dr. Mark A. Pleatman believes that VSG is safer than RNY in many ways, because VSG does not reroute the digestive tract. Not only does this make VSG easier to perform, it eliminates the risk of bowel obstruction that can occur with RNY, as well as the risk of vitamin deficiencies. In comparison to the Lap-Band, VSG does not involve the insertion of foreign objects into the body and does not require regular post-surgical adjustments. "The feeling of fullness that you get from the VSG is much more satisfying than the feeling of obstruction or discomfort that you get with the Lap-Band," says Dr. Pleatman. VSG patients also experience lower rates of nausea and vomiting than Lap-Band patients.
Complications
Because the stomach sleeve can stretch out over time, some patients may experience weight regain. About 3 percent of patients experience leaking along the staple line, which can be caused by stapler malfunctions or the wrong choice of stapler size. Dye may be administered during or after the surgery to check for leaks.
Maintenance
Little post-surgical maintenance is required for VSG patients. Although the procedure is purely restrictive, you should take vitamin supplements due to the required low-calorie post-surgical diet. In particular, take vitamin B-12 supplements, as removing such a large portion of the stomach interferes with the body's ability to absorb this vitamin.
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