What is a Vertical Sleeve Gastrectomy?

Vertical sleeve gastrectomy (VSG) is a surgical procedure that is done to reduce the size of the stomach with the hope of achieving weight loss in the obese patient. This procedure can be done on even the most obese patients who weigh in excess of 500 pounds (about 227 kg), even if they don't qualify for other gastric bypass surgeries. Vertical sleeve gastrectomy is minimally invasive and often only requires a one-night stay in the hospital.

During a vertical sleeve gastrectomy procedure, a surgeon removes about 85 percent of the stomach. The procedure is performed while the patient is under a general anesthetic. Several small incisions are made in the abdomen and a laparoscope — a cable with a camera at the end — is inserted. The laparoscope is used to view the stomach and determine placement of surgical staples. Generally, the remaining incisions will be used to insert other instruments necessary for the procedure.

Two rows of staples are inserted vertically along the length of the digestive tract from the lower end of the esophagus to the upper edge of the pylorus. The pyloric area contains the round sphincter muscle that controls release of the contents of the stomach into the small intestine. Keeping the pyloric sphincter in place generally reduces complications and can improve the quality of life for the patient.

After the staples are inserted, the moon-shaped portion of the stomach is removed. The new stomach is now a long tube that will function as a stomach but will only hold small amounts of food. A patient will typically feel full after only eating a fraction of what he or she ate before.

A vertical sleeve gastrectomy procedure is not without risks. There is a risk of bleeding or infection from the placement of the staples — if any leaks occur, they will need to be repaired by a surgeon. Any infection could be serious and would need to be treated with antibiotics. A vertical sleeve gastrectomy is not a reversible procedure because most of the stomach will be removed. The tube portion that remains could expand, thus the patient needs to eat only small amounts of food to prevent this expansion.

There also is a risk that the goal of the surgery will not be met and the patient will not lose weight. A patient typically needs to be diligent about diet by eating the proper foods for good nutrition. It also can be important for the patient to receive an appropriate amount of exercise on a regular basis.