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Weight Loss Options

Sleeve Gastrectomy

The Vertical Sleeve Gastrectomy (VSG) is the newest surgical procedure available to help severely over weight patients lose weight. The Vertical Sleeve Gastrectomy (VSG) is the restrictive portion of the Duodenal Switch Procedure. The duodenal switch procedure is usually reserved for the super obese, i.e. patients who weigh in the 450 to 600 pound range. In these patients, this risky procedure was typically done in two stages. The first stage involves removing a large portion of the stomach, changing the stomach into a narrow tube. The remaining stomach is similar in size and shape to a banana. Every individual and outcome is different, however, the majority of patients who underwent this procedure lost a majority of their excess body weight and many never required the second stage of the procedure. Similar success has been seen in patients undergoing the procedure with lower BMIs as well.

Bariatric Surgeons began performing the Vertical Sleeve Gastrectomy (VSG) as a standalone procedure in the US in 2001. The last 3 years has seen a rapid rise in the number of VSG procedures performed at bariatric centers across the US. Recently a number of bariatric surgery centers have published their experience with the (VSG) Vertical Sleeve Gastrectomy surgery. Several centers have performed over 1000 (VSG) procedures. Weight loss seen in (VSG) Vertical Sleeve Gastrectomy patients both short and long term is very encouraging. Excess weight loss approaching 80% at 2 years follow (VSG) is commonly seen. This is similar weight loss seen in patients having Gastric Bypass over the same time interval. Patients undergoing the Vertical Sleeve Gastrectomy have been noted to experience more weight loss and a faster rate of weight loss compared to patients who underwent the LAP-BAND® procedure. Please note, weight loss varies based on the individual. To see which option is best for you, we suggest speaking with one of our specialists. Patients who had the (VSG) also experience improvement or resolution in their comorbidities similar to the Gastric Bypass and LAP-BAND® .

The Vertical Sleeve Gastrectomy (VSG) is a restrictive procedure requiring no intestinal transection or re-routing. This makes the VSG much safer than the gastric bypass. Approximately 70% of the stomach is removed. The remaining tubular stomach can only hold about 80 cc of fluid or around 5 bites of solid food. Patients can only eat small amounts of food before feeling full, similar to the LAP-BAND® procedure. Unlike the Lap-Band® procedure, no adjustments are required so fewer follow-up visits are required.

Since a portion of the stomach is removed, the procedure is considered non-reversible. Risks particular to the Vertical Sleeve Gastrectomy include bleeding from the staple line (1.4%), staple line leak (2.4%), stricture formation, pouch dilation (2.8%), and GERD (chronic heart burn) symptoms (4.7%). Long term results (>5 years) are not yet available.

Who should consider the (VSG) Vertical Sleeve Gastrectomy Procedure:
  • Patients considering the Gastric Bypass or Duodenal Switch surgeries but are  concerned about the complications or side effects related to intestinal rerouting  (anastomotic leaks, vitamin and mineral malnutrition).
  • Patients considering the LAP-BAND® with higher BMIs (BMI > 50).
  • Patients with chronic diseases requiring long term steroid use.
  • Patients who have difficulty meeting the close follow-up requirements of the LAP-BAND® .

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