Vertical sleeve gastrectomy (VSG) is a surgery to decrease the size of the stomach.
This surgery involves re-shaping the stomach to reduce the amount of food it can hold.
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Body mass index
(BMI) determines if a person is
or obese. A normal BMI is 18.5-25. This surgery is an option for people with:
BMI greater than 40BMI 35-39.9 and a life-threatening condition or severe physical limitations that affect employment, mobility, and family life
If lifestyle changes are made, the benefits of VSG include: Weight reductionImprovement in obesity-related conditionsImproved mobility and staminaEnhanced mood and self-esteem
Complications are rare. But no procedure is completely free of risk. Complications may include: Stitches or staples may loosenPouch stretches or leaksBleedingInfectionReaction to anesthesiaHeart attackBlood clotsNausea, vomiting
Long-term complications include vomiting and
Factors that may increase the risk of complications include: SmokingRecent or chronic illness (eg, kidney, heart, or lung disease)DiabetesOld ageBleeding or clotting disorders
Discuss risks with your doctor.
You may have the following done: Physical exam and review of medical historyBlood test and other tests to check your healthAttempts to lose weight (about 10%) through medically-approved dietsMeetings with a registered dietitianMental health test and counseling
Prior to the procedure:
Talk to your doctor about your medicines, herbs, and dietary supplements. You may be asked to stop taking some medicines up to one week before the procedure, like:
or other anti-inflammatory drugs
Blood thinnersYou may be given antibiotics.You may be given laxatives or an enema.Arrange for a ride to and from the hospital.The night before, eat a light meal. Do not eat or drink anything after midnight.
will be given through an IV (needle) in your hand or arm. It will block pain and keep you asleep through the surgery.
A nurse will place an IV line in your arm to give you fluids and medicines. The doctor will place a breathing tube through your mouth and into your throat. This will help you breathe during surgery. You will also have a catheter placed in your bladder to drain urine.
The doctor will make an 8-10 inch incision to open the abdomen. Surgical staples will divide the stomach vertically. The new stomach will be the shape of a slim banana. The rest of the stomach will be removed. Your new stomach can hold 50-150 milliliters (mL) of food, about 10% of what a normal adult stomach can hold.
Staples or stitches will be used to close the incision.
The breathing tube and catheter will be removed.
Anesthesia will prevent pain during surgery. You will be given pain medicine after surgery.
The usual length of stay is 4-6 days. If there are any problems, you will need to stay longer.
The doctor may use a small tube with a camera to look down your throat and into your stomach to check for problems.You will receive nutrition through an IV at first, but slowly start eating again.
While in the hospital, you may be asked to: Use a device called an incentive spirometer to prevent breathing problemsWear elastic surgical stockings or boots to promote blood flow in your legsWalk
For a smooth recovery: Ask your doctor about when it is safe to shower, bathe, or soak in water.Do not drive or lift anything heavy for at least two weeks or until advised by your doctor.Walk every day.Your doctor may recommend that you meet with a therapist if you have emotional ups and downs.Follow your doctor’s instructions.
Return to normal activities in 2-3 weeks.
For good nutrition:
clear liquid diet
for about one week or as advised by your doctor.
You will begin with 4-6 small meals per day. A meal is two ounces of food.Progress from soft, pureed foods to regular foods.Solid food must be well-chewed.Get enough protein.Do not eat too much or too quickly.Avoid high-calorie foods.
by drinking fluids before or after meals.
Contact your doctor if any of the following occurs: Signs of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or discharge from the incision sitePain that you cannot control with the medicines you have been givenBlood in the stoolPain, burning, urgency, or frequency of urination, or persistent bleeding in the urinePersistent nausea and/or vomitingSevere abdominal painPain and/or swelling in your feet, calves, or legsCough, shortness of breath, or chest pain
In case of an emergency, call for medical help right away.
Laparoscopic sleeve gastrectomy. Baylor College of Medicine website. Available at:
http://debakeydepartmentofsurgery.org/home/content.cfm?proc_name=Laparoscopic+Sleeve+Gastrectomy&content_id=272. Updated November 2010. Accessed November 22, 2010.
Walsh J. Sleeve gastrectomy as a stand alone bariatric procedure for obesity. California Technology Assessment Forum website. Available at:
http://www.ctaf.org/UserFiles/File/2010%20Oct/Vertical%20Sleeve%20Gast%20final%20draft.pdf. Updated October 2010. Accessed November 22, 2010.
Last reviewed November 2012 by Daus Mahnke, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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