Vertical Sleeve Gastrectomy.Vertical Sleeve Gastrectomy, also known as sleeve gastrectomy, is a surgery that reduces the size of the stomach and makes it into a narrow tube.
The Vertical Sleeve gastrectomy (VSG) is a restrictive and hormonal procedure.
During the procedure approximately 60-85% of the stomach is removed, creating a “sleeve” or tubular stomach. This procedure can be used on its own, or as a first stage of a two stage procedure. The procedure is done by laparoscopy. Because part of the stomach is removed, this procedure is not reversible.
During Sleeve gastrectomy, the right side of the stomach is completely removed. This leaves a sleeve or tubular shaped stomach. The remaining volume is about 60-110 cc.
No reconnection needs to be made with the intestines. No foreign object is implanted in the body.
The stomach functions as before, but the quantity of food that can be taken is considerably restricted. The nerves of the stomach and the outlet valve of the stomach stay intact (pylorus), in contrary to other surgical procedures. Hence dumping syndrome is not a problem.
Patients can expect to lose about 60-80% of excess body weight in 12-24 month time.
The advantages are that the stomach still functions fairly normally. A feeling of saturation is achieved by eating a smaller meal. Also, as the greater curvature of the stomach is removed, fewer hormones are produced. This hormone (ghrelin) makes a person feel hungry. It may be used as the first stage operation of a two-stage procedure.
Disadvantages are that it is only a restrictive procedure. I may worsen gastro esophageal reflux. Patients might have difficulty in obtaining funding for the second stage procedure if needed.
Serious Gastric Sleeve Complications
The most common serious complications include.
1. Staple line leaks – 2% of patients on average experience staple line leaks.
2. Bleeding – 1.2% of patients.
3. Stenosis/Strictures – 0.6% of patients.
Minor Gastric Sleeve Side Effects
Gastro-oesophageal reflux disease (GERD) is a common minor complication, with about 1 out of 5 patients experiencing it after 1 year. However, the prevalence of GERD plummets to about 3% after three years.
Gastric Sleeve Surgery Mortality Rate
The relatively simple gastric sleeve surgery procedure also has an extremely low mortality rate of 0.19%.