Vertical Sleeve Gastrectomy
Vertical sleeve gastrectomy has gained worldwide popularity as an effective bariatric surgery procedure with fewer side effects and complications than original bypass procedures.
In 1985, Doug Hess, M.D., developed the concept for the sleeve procedure at the same time he developed the duodenal switch. Subsequent research has demonstrated that the sleeve procedure, which involves reshaping the stomach into a tube, is an effective weight loss surgical procedure on its own, without the intestinal bypass that is done in the duodenal switch.
The Vertical Gastrectomy is a significant improvement over older gastroplasty (stomach stapling) procedures for a number of reasons:
- The procedure removes the area of the stomach that produces a hormone responsible for hunger.
- The procedures does not use plastic rings or mesh around the stomach, eliminating the risks of infection, obstruction, or erosion that can happen with synthetic materials.
- Vertical Sleeve Gastrectomy – How It Works
- Who Is a Candidate?
- Vertical Sleeve Gastrectomy Benefits
- Considerations and Risks
- Where Vertical Sleeve Gastrectomy is Offered
Vertical Sleeve Gastrectomy – How It WorksIn gastric sleeve surgery, a large section of the stomach is removed, along with most of the cells producing the hunger hormone, Ghrelin. This part of the procedure is not reversible. The remaining small section of the stomach is stapled, leaving a 1-2 ounce tube-shaped pouch. Gastric sleeve surgery causes weight loss by restricting the amount of food and calories that can be consumed before feeling full. Because it does not modify the intestines, it does not alter digestion and absorption of nutrients, outside of restricting the amount of food consumed.
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Who Is a Candidate for Vertical Sleeve Gastrectomy?
- BMI 35 and above
- Can be done on those with very high BMI, 55 and above
- Diabetes for less than 3 years
- May be right for those age 50 or older
- Alternative to the LAP-BAND procedure for lower weight individuals
- Safer procedure for a high-risk patient
- May be performed on patients too heavy for other weight loss surgeries, leaving the option for a second surgery once some weight has been lost
- May be right for patients who are taking medications for diseases that are unlikely to improve with weight loss (such as mental illness or rheumatoid arthritis)
Benefits of Vertical Sleeve Gastrectomy
- Average excess weight loss is 40-90%
- 1-2 hour procedure with overnight hospital stay
- Recovery time ranges from a few days to a few weeks
- Patients report early and lasting fullness
- Intestines stay intact – no malabsorption or dumping syndrome
- Quicker return to eating normal foods, in smaller portions
- The nerves to the stomach and the outlet valve (pylorus) remain intact, preserving the functions of the stomach.
Considerations and Risks of Vertical Sleeve Gastrectomy
- Removal of a portion of the stomach is permanent.
- Potential complications may include leaks, reflux and inadequate weight loss.
- Complications may be minimized or avoided by ensuring the creation of the correct size pouch, reinforcement of staple line with sutures, and repairing any hiatal hernias that may be present.
- Remaining pouch may expand over time, leading to regaining weight and warranting additional stomach removal.
- Insurance companies may limit approval of this procedure; however coverage is expanding.
Sutter Health LocationsThe following facilities offer vertical sleeve gastrectomy procedures.
Alta Bates Summit | Oakland/Berkeley
California Pacific Medical Center | San Francisco
Memorial Medical Center | Modesto
Mills-Peninsula Health Services | Burlingame
Palo Alto Medical Foundation | Palo Alto, Mountain View
Sutter Pacific Medical Foundation | San Franciso, Marin
Sutter Medical Center of Santa Rosa | Sonoma, Napa, Lake
Sutter Medical Center, Sacramento | Sacramento
Sutter Roseville Medical Center | Roseville
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