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A Long narrow vertical pouch (about 2-3 oz) is created by stapling off and removing 85% of the stomach. This procedure, like the lap band is a purely restrictive procedure. The VSG significantly restricts the volume of food that can be eaten. There is no rerouting of the intestines thus the VSG produces no malabsorption of nutrients or dumping.

While the VSG is considered a new procedure, it has been performed for several years. The VSG was originally used as a "first-stage" procedure in patients with a very high BMI and/or with serious co-morbidities. The VSG would be performed on the patient with the expectation that a second procedure (either the Roux en Y gastric bypass or the Duodenal Switch) would be performed after the patient has lost enough weight so that the second procedure could safely be performed. It was discovered that many patients did well with the VSG alone and did not need the second procedure.

There is no rerouting of the intestines, and no new connections need to be made. This makes the VSG safer, easier, and faster to perform. The lack of rerouting eliminates the late risk of bowel obstruction from internal hernia that comes with the gastric bypass operation. Finally, the lack of rerouting also reduces the risk of vitamin and mineral deficiencies. Another advantage is that the operation can be easily converted to another procedure such as gastric bypass, duodenal switch, or even LapBand.

Advantages of the Vertical Sleeve Gastrectomy

• Over 80% of type II diabetes cases are resolved.
• Hypertension is improved or resolved in many patients.
• With the VSG there is no foreign body to break, slip, or erode.
• Unlike the Adjustable Gastric Band there is nothing to be adjusted.
• You don't need to worry about getting follow-up care if you move to another city.
• The feeling of fullness that you get from the VSG is much more satisfying than the feeling of obstruction or discomfort that you get with the Adjustable Gastric Band.
• Few patients vomit after the VSG, while many patients continue to have vomiting episodes long after they have their LapBANDs placed.
• Can be performed on patients that otherwise do not qualify for gastric bypass, such as those with anemia, Crohn's disease, etc.
• As with every type of bariatric surgery, the overall quality of life for patients improves greatly. A great deal of excess weight is lost, and patients experience resolution of co-morbidities, and improved appearance, social opportunities, and economic opportunities.
  

What to Expect After Surgery

Patients are usually released from the hospital after 24 hours and can return to normal activities in 1 to 2 weeks. Patients can expect to lose 60%-70% of excess weight loss at about 2 years. You will follow a liquid diet immediately after surgery. Your diet will progress to full liquids, pureed or blended foods, soft foods then finally to a diet of solid foods.