This stomach-restrictive surgery is one of the most popular surgeries we perform.
The sleeve gastrectomy, also known as the gastric sleeve or vertical sleeve gastrectomy (VSG), is a very popular surgical weight loss option because it allows patients to enjoy a wider variety of foods than is typical with other weight loss surgeries. With this operation, nearly 90 percent of the stomach is removed. Stomach function remains normal because all of the key components of the stomach are preserved. Anatomy is not altered in any other way and there is no intestinal bypass.
How It Works
For this operation, the surgeon permanently removes the stretchy outer and upper 90 percent of the stomach, leaving a small, vertically-oriented tubular stomach. The remaining stomach is shaped like a banana or "sleeve" and is approximately 6-7 inches long with a half inch diameter. Stomach capacity is reduced from about a quart (1,000 ml) to roughly 3 ounces (100 ml). Depending on the size of the tube that is created, patients generally report feeling full after eating 2-4 ounces of solid food.
Because all of the important structural elements of the stomach and intestines are preserved, such as the antrum, the pylorus and the nerves that control stomach function, the result is a much smaller stomach that functions very similar to normal. This allows patients the ability to enjoy a relatively normal diet (in much smaller quantities) without side effects like "dumping" syndrome. Weight loss is achieved by restricting the amount of food that can be consumed. With this operation there is no intestinal bypass or malabsorption.
Removal of the outer portion of the stomach almost completely removes the tissue that produces ghrelin, the hunger stimulating hormone, and patients typically report a significant decrease in hunger and food consumption. Studies have reported ghrelin levels remain low in sleeve patients throughout a 5-year follow-up period (1).
- Approximately 65% excess weight loss (EWL) has been reported. (2, 3) (Excess weight is the amount of weight over what is considered the “ideal body weight” for a person’s height [Current Weight – Ideal Weight = Excess Weight]. The percentage of excess weight loss (%EWL) is the percentage of weight loss from this excess weight.)
- Improvement/resolution in all major co-morbidities has been documented, including type 2 diabetes, sleep apnea, hypertension, high cholesterol and depression.
- There is very little risk of "dumping" syndrome—which occurs when a patient consumes sugar or carbohydrates, or eats too quickly, causing nausea, cramping, diarrhea, sweating, vomiting and heart palpitations. Preservation of the pyloric valve provides for a more physiologic emptying of solid foods from the stomach enabling people to tolerate normal foods and reducing dumping syndrome.
- This is a pill-friendly operation. NSAIDS and Aspirin are well tolerated.
- An excellent option for patients with Crohn's disease or other intestinal conditions, and patients who are on immuno-suppressants.
- A relatively low-maintenance surgery that is a great option for patients with an active lifestyle, busy professionals who travel often, or those considering future pregnancy.
- This operation typically provides fast and predictable weight loss and is a great option for those who are seeking weight loss in preparation for an orthopedic procedure, such as knee replacement.
Jamie, Sleeve Gastrectomy