Laparoscopic Sleeve Gastrectomy (VSG)

Laparoscopic Sleeve Gastrectomy Overview

Laparoscopic Sleeve Gastrectomy surgery (VSG) is one of the newer bariatric operations. It can be performed as a stand-alone procedure for those who have relatively less weight to lose, who are older, or who are at higher risk for more extensive surgeries. It can also be part of a staged operation, converting to a Duodenal Switch or Roux-en-Y Gastric Bypass for additional weight loss. Weight loss rates average 55-70% of excess body weight, and can be even higher for those who are otherwise healthy, relatively young and able to exercise.

Laparoscopic Sleeve Gastrectomy is the only bariatric procedure involves no malabsorption (difficulty absorbing nutrients common in other procedures) or foreign body issues (introduction of an internal device such as a Lap Band). Because of the simplicity of the operation, there is also a very low risk of requiring additional surgery in the future.

Weight loss is restrictive and takes place because the stomach is reduced to about 60cc in volume (compared to 1,000 to 2,000cc for a normal stomach). Patients feel full after a very small amount of food, are satisfied with less and, as a result, lose weight. Hunger also diminishes because the body has a reduced capacity to produce ghrelin, a naturally occurring hormone that induces a feeling of hunger.

VSG preserves the pylorus, a valve that regulates the emptying of the stomach. The result is a more normal feeling of fullness as food slowly trickles out. When food quickly empties out of the stomach it can result in complications known as dumping and marginal ulcers, which are more common with other procedures. Symptoms include nausea and diarrhea.