The vertical sleeve gastrectomy(VSG) is a type of surgery which removes 80 to 85 percent of the stomach. The vertical sleeve is a new technique being used to help obese individuals lose weight. It reduces the size of the stomach to a small pouch which is the size and shape of a banana. The technique was pioneered in 1999 in San Francisco, California by doctors at a weight loss centre.
VSG is done with the aid of a laparoscope which is a camera. This enables the surgeon to monitor the abdomen as he performs the surgery. A very thin surgical instrument is inserted through 2 to 3 tiny cuts in the belly.
A good candidate for surgery is a person who is about 100lbs above their ideal weight. A patient who is too heavy is required to lose some weight before surgery is performed. This surgery is not performed on patients who have esophageal motility disorders. The vertical sleeve has been performed on persons who have been diagnosed with sleep apnea, diabetes and heart disease.
The sleeve as a weight loss solution is a fairly new type of surgery so there is not enough data to determine long term side effects. The problems that can occur with the vertical sleeve are poor nutrition and vomiting which are the effect of having a smaller stomach. Other problems involve the blockage of the bowels which can result because of long term scarring.
It takes up to 2 to 3 years to lose all the weight after the procedure. It is a much slower process than the gastric bypass surgery. The weight loss is more balanced which does not cause the appearance of drastic weight loss.
With the vertical sleeve gastrectomy, the pyloris is kept intact, so sleeve patients do not have problems with food dumping. The stomach continues to function as it would because there is no change to the intestinal tract. The area of the stomach that produces the hunger hormone ghrelin however is removed.
Patients are required to stay on a special diet for six weeks after surgery. Immediately following surgery only liquids should be consumed. This evolves to a puree diet then a regular diet. There is no special long term diet, but there are some recommendations which are small portions, eating for about 20 minutes or until full, no fluids with meals and protein with every meal.
The typical down time for this surgery is three weeks. This is a non reversible procedure and it is subject to the same complications that apply to all gastrectomy surgeries. Vertical sleeve gastrectomy is now an accepted weight loss alternative that insurance companies pay for.