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Gastric Sleeve (Vertical Sleeve Gastrectomy (VSG))

Gastrectomy is a combination of two Latin words: gastro, meaning “stomach,” and -ectomia, which means “to cut out.”

Sleeve gastrectomy is a restrictive surgery that permanently reduces the size of the stomach by about 85 percent. This procedure is helpful for patients who wish to lose weight but have health conditions that make combined restrictive/malabsorptive surgery less safe at this point in time. These patients may want to consider a malabsorptive procedure like duodenal switch (DS) later to lose more weight.

During sleeve gastrectomy (gastric sleeve surgery), the surgeon will remove the larger, rounded part of the stomach.
• The remaining stomach looks like a sleeve (or hose or tube) and holds about 15 percent as much food as the original stomach.
• The surgeon will remove the larger, rounded part of the stomach from the body.
• Unlike gastric bypass, which changes the exit pathway of the stomach, sleeve gastrectomy leaves the exit pathway intact intact.
• It may be a safer and more effective option than gastric bypass for patients with very high BMI, those with medical problems like anemia, Crohn’s disease, osteoporosis, extensive prior surgeries and other complex medical conditions.

• Sleeve gastrectomy may be safer than gastric bypass for patients who have a number of health risks.
• It lowers the risk of marginal ulcers (ulcers that may occur along the reconstructed exit pathway of the stomach) compared to gastric bypass.
• The surgery cuts away the part of the stomach that produces grehlin, a stomach hormone that stimulates hunger.
• Though the stomach is smaller, the entrance and exit openings are left intact, so digestion can go on as normal (no dumping syndrome).
• The body is free of foreign objects like the LAP-BAND®.

• Sleeve gastrectomy is more common in Europe, but most American health insurance carriers still consider it an investigational procedure and do not cover the cost.
• Anytime you have anesthesia or surgery, there is a risk of blood clots, other complications or death.
• Do not smoke. Smoking would put you at high risk for infection, blood clots, slow healing and other life-threatening complications.
• Complications can occur with the stapling, such as leaks or bleeding.
• You may need malabsorptive surgery – intestinal bypass or duodenal switch – in addition to your sleeve gastrectomy in order to lose all the weight you need and want to lose.
• The smaller portion of the stomach may stretch.
• Foods that you eat now may cause discomfort, nausea or vomiting after your surgery.
• Gastric surgery puts you at higher than normal risk of developing gallstones and gallbladder disease.
• You will not lose weight or maintain your weight loss unless you eat a healthy diet and exercise regularly. This is the reason we stress long-term follow-up with our center and your doctor.

It is suggested that surgeons performing sleeve gastrectomy inform patients regarding the lack of published evidence for sustained weight loss beyond 3 years and provide them with information regarding alternative procedures with published long-term (greater than or equal to 5 years) data confirming sustained weight loss and comorbidity resolution based upon available literature at this time.

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