Vertical sleeve gastrectomy (VSG) is surgery to decrease the size of your 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) is used to determine if a person is
or obese. A normal BMI is 18.5 to 25. This surgery is an option for people with:
BMI over 40BMI 35-39.9 and a life-threatening condition or physical limitations that affect employment, movement, and family life
If lifestyle changes are made, the benefits of VSG include: Weight reductionImprovement in many obesity-related conditionsImproved movement and staminaEnhanced mood and self-esteem
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like: Stitches or staples may loosenPouch stretches or leaksBleedingInfectionReaction to anesthesiaHeart attackBlood clotsNausea, vomiting
Long-term complications include vomiting and developing
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as: SmokingDrinking
Chronic diseases, such as
You may have the following: Physical exam and review of medical historyBlood test and other testsMeetings with a registered dietitianMental health test and counseling
Leading up to your procedure: Talk to your doctor about your medications, herbs, and dietary supplements. You may be asked to stop taking some medications up to 1 week before the procedure.Do not start any new medications, herbs, or supplements without talking to your doctor.Arrange for a ride to and from the hospital.Arrange for help at home as you recover.You may be given antibiotics.You may be given laxatives and/or an enema to clear your intestines.The night before, eat a light meal. Do not eat or drink anything after midnight unless told otherwise by your doctor.Shower or bathe the morning of your surgery.
will be given through an IV. It will block pain and keep you asleep through surgery.
An IV line will be placed in your arm to give you fluid and medications. A breathing tube will be placed 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.
Several small cuts will be made in your abdomen. Gas will be pumped in to inflate your abdomen, making it easier for the doctor to see. A laparoscope and surgical tools will be inserted through the incisions. A laparoscope is a thin, lighted tool with a tiny camera. It sends images of your abdominal cavity to a monitor. Your doctor will operate while viewing the monitor.
Surgical staples will be used to 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 mL (milliliters) of food—about 10% of what a normal adult stomach can hold. Incisions will be closed with staples or stitches.
In some cases, the doctor may need to switch to open surgery.
The breathing tube and catheter will be removed.
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
The usual length of stay is 2-3 days.
A small tube with a camera may be used to look down your throat and into your stomach to check for problems.You will receive nutrition through an IV, but then slowly start eating again.
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 legsGet up and walk daily
During your stay, the hospital staff will take steps to reduce your chance of infection, such as: Washing their handsWearing gloves or masksKeeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as: Washing your hands often and reminding visitors and healthcare providers to do the sameReminding your healthcare providers to wear gloves or masksNot allowing others to touch your incision
Be sure to follow your doctor’s
instructions. You will need to practice lifelong healthy eating and exercising habits. After your surgery: Do not lift anything heavy for at least two weeks.You may have emotional changes after this surgery. Your doctor may refer you to a therapist.You will meet regularly with your healthcare team for monitoring and support.
For good nutrition:
clear liquid diet
for about 1 week.
Begin with 4-6 small meals per day. A meal is 2 ounces of food.Your diet will 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.
Call your doctor if any of these occur: Signs of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
, shortness of breath, or chest pain
Worsening abdominal painBlood in the stoolPain, burning, urgency or frequency of urination, or persistent bleeding in the urinePersistent nausea and/or vomitingPain and/or swelling in your feet, calves, or legs; sudden shortness of breath or chest painNew or worsening symptoms
If you think you have an emergency, call for emergency medical services right away.
Bariatric surgery. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated November 3, 2014. Accessed December 4, 2014.
Bariatric surgery for severe obesity. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
http://win.niddk.nih.gov/publications/gastric.htm. Updated June 2011. Accessed December 4, 2014.
Gastric sleeve. University of California, San Diego Health System website. Available at:
http://health.ucsd.edu/specialties/surgery/bariatric/weight-loss-surgery/gastric-sleeve/Pages/default.aspx. Accessed December 4, 2014.
Laparoscopic sleeve gastrectomy. Cleveland Clinic website. Available at:
http://weightloss.clevelandclinic.org/Sleevegastrectomy.aspx. Accessed December 4, 2014.
Sleeve gastrectomy. Virginia Mason Medical Center. Bariatric Surgery Center of Excellence website. Available at:
https://www.virginiamason.org/SleeveGastrectomy. Updated October 2010. Accessed December 8, 2013.
Weight loss surgery. North Shore Medical Center website. Available at:
http://nsmcweightloss.org/web/surgical_procedures.aspx. Accessed December 4, 2014.
Last reviewed December 2014 by Michael Woods, 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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