This procedure is now the number one Bariatric procedure in the world, with an average EWL of 60 – 70%. Other names for this operation are vertical sleeve gastrectomy (VSG) or gastric sleeve resection of the stomach. It originated as part of another surgical procedure, called a biliopancreatic diversion with duodenal switch, where the sleeve resection was performed first as part of this procedure. Gradually it became clear that, for a number of clients, this first procedure was in itself sufficient, and so this procedure has been launched independently. This procedure was finally adopted in 2008 and has been recognized as a fully-fledged operation.
It consists of the complete longitudinal division of the stomach line beginning about 5 cm from the pylorus and proceeding to the Angle of His, then the separated part of the resected stomach is removed. It is a restrictive operation, preventing the stomach from receiving large portions of food. The removal of gastric fundus reduces levels of the hormone ghrelin, which is released precisely in this area. This hormone is responsible for hunger and following the surgery, clients consistently indicate significantly lower feelings of hunger, which positively affects food intake. This favourable metabolic effect is probably also involved in changes in the duodenal secretion of hormones, especially GLP-1, having a positive effect on insulin resistance.
The cost of higher efficiency is higher morbidity. In this type of operation, complications are described as early and late. Early complications include bleeding/leakage from the resection margin and late complications include leakage with fistula or abscess formation requiring reoperation and long-term treatment. From a surgical point of view, these complications are kept to a minimum by using a modern endo-stapler (Ethicon), with three rows of staples. Most surgeons (including ours) construct along the established 36Fr bougie. It must be emphasized that unlike gastric banding this operation is irreversible!
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Vertical sleeve gastrectomy is the preferred procedure of our surgeons. Results are similar to the bypass without the added complications of nutritional deficiencies.
It is suitable for patients of BMI of 35 and above. Patients should consider the sleeve if:-
- A BMI of 35 and above
- Are comfortable with a permanent procedure which removes part of the stomach
- Struggle with eating large portions of food
- Prefer sugary foods (many patients suffer from dumping syndrome which can be a deterrent)
- Would like the added benefit of reduction of hunger due to removal of fundus gland
- Are more likely to ‘push’ portion sizes as stomach has less chance of dilation
- Have struggled to stick to dietary regimes in the past
Do I Qualify??
Are you suitable for surgery?
If you need some advice on which medical procedure would be most appropriate for you or have any other questions, please complete the contact form or call Amanda on 07551958653
A medical form needs to be filled in to send to our surgeon to see if you qualify for surgery. Please fill it in and provide as much detail as possible. Once we have received this form we can usually confirm your surgery within 48 hours.