VERTICAL SLEEVE GASTRECTOMY (VSG)

Please also visit our

[ General Information About Bariatric Surgery ]

The vertical sleeve gastrectomy creates a narrow gastric tube through the excision of most of the stomach. It limits intake and removes most of the ghrelin-producing (hormone of GIT) cells of the gastric mucosa. The procedure permanently reduces the size of the stomach. The procedure is performed laparoscopically. (9)

Gastric sleeve is an irreversible procedure which involves the laparoscopic vertical resection from the upper part of the stomach, called fundus, down to about two inches from the pylorus, the area where the stomach and small intestine meet. To prevent bleeding and leakage, the very first step in this procedure is securing hemostasis (arrest of bleeding) and stapling the seams bilaterally through the area where the cut will be made. When the first step is done, resection will follow. Sutures are made along the area of incision to reinforce the staples previously placed, the resected part will be taken out and the wound will be closed. The gastric sleeve is not a malabsorption procedure. Rather, it is solely a restrictive method and yields weight loss by scheming how much food you can take in. Because this surgery is just a restrictive means, weight loss comes at a slower rate compared to that of a gastric bypass surgery. lthough results come slower, complications present in procedures like those of bypass surgery are eliminated making gastric sleeve still a better choice.

In the context of weight loss surgery, gastric sleeve is the median between gastric band and gastric bypass. Therefore, this method can be a very good first step for patients who want to undergo a gastric bypass but cannot do so due to health problems.  Vertical Sleeve Gastrectomy, is also ideal for the medical tourist patient who has little or no access to a bariatric specialist back at home who could do the required follow up.

Indications

Gastric sleeve resection is typically reserved for people who have a body mass index (BMI) of more than 40, or for those who are not in appropriate physical condition to undergo gastric bypass surgery or other more radical weight loss surgeries.
Gastric sleeve surgery may be appropriate also for people who can't return for the follow-up visits required by gastric banding.

Precautions

Certain lifestyle changes and standard medical follow-up care is required after a vertical sleeve gastrectomy.
People who have had gastric sleeve surgery must:

• Exercise regularly.
• Learn behavior modification techniques.
• Follow very specific dietary instructions, including eating slowly, consuming only small quantities of food at a time, chewing thoroughly and swallowing food only when it is mashed, and not eating and drinking at the same time.

Vertical Sleeve Gastrectomy in Germany

Or center for bariatric surgery is a leading institution with an established track record with this procedure. The bariatric surgeons are able to assess the risks and benefits of each procedure together with you and will, based on your personal requirements, suggest a procedure that is most suitable for you. Please contact us for more information.

References:

1. Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among US children, adolescents, and adults. 1999–2002. JAMA 2004;291:2847–50.
2. Torpy J, Lynm C, Glass RM. Bariatric Surgery. JAMA 2002; 288: 2918
3. Haslam DW, James WP. Obesity. Lancet 2005; 366:1197–209
4. Strychar I. Diet in the management of weight loss. CMAJ 2006 ;174 (1): 56-63
5. Dugan S. Part I. Bariatric surgery. AAOHN Journal
6. Schauer PR, Burguera B, Ikramuddin S, Cottam D, Gourash W, Hamad Get al. Effect of laparoscopic Roux-en Y gastric bypass on type 2 diabetes mellitus. Ann Surg 2003; 238:467–84.
7. Pories WJ. Bariatric Surgery: risks and rewards. J Clin Endocrinol Metab 2008; 93(11):S89–S96
8. Sjöström L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, Dahlgren S, Larsson B, Narbro K, Sjöström CD, Sullivan M, Wedel H. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004;351:2683–93.
9. Buchwald H.  International symposium on gastric banding. Supplement to Surgery for Obesity and Related Diseases.2008. Cambridge, MA: Elsevier; 4:35;pp 71
10. Himpens J, Dapri G, Cadiere GB.A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg 2006;16:1450–6.
11. Kreft JS, Montebelo J, Fogaca KC, Rasere I, Oliveira MR.Gastric bypass: post-operative complications in individuals with and without preoperative dietary guidance. Journal of Evaluation in Clinical Practice2008;14:169–71