Vertical Sleeve Gastrectomy: What You Should Know

Vertical Sleeve Gastrectomy – also referred to as the VSG, gastric sleeve, or “Sleeve” – is performed far less frequently than the gastric bypass, but has become increasingly common in recent years and shows similar initial outcomes. Like the gastric bypass and the Lap-Band® procedure, gastric sleeve surgery can be performed laparoscopically, reducing the risk of infection and speeding post-operative recovery time. Unlike these other procedures, however, the VSG is irreversible.

How It Works
The sleeve gastrectromy reduces the size of the stomach and thereby restricts the amount of food a patient can eat. An experienced surgeon will perform the procedure in approximately 45-60 minutes. During the surgery, the doctor will remove 70 to 80 percent of the patient’s stomach and use surgical staples to seal the open edges together, forming a banana-shaped “sleeve” or tube. In addition to restricting the volume of food a patient can consume, the vertical sleeve gastrectomy can also reduce the body’s secretion of grehlin, a hormone that causes hunger, for the first year. Patients often find they do not want to eat as often, which helps promote weight loss.

Patients can expect to spend one night in the hospital and be back to work with no restrictions in two to four weeks. Gastric sleeve patients lose approximately 50-70 percent of their excess weight during the first year after surgery, which is comparable to gastric bypass patients. Unlike a gastric bypass, however, a sleeve gastrectomy will not cause dumping syndrome, because the surgery preserves the pyloric valve, which regulates food intake into the stomach.

Weight-loss generally levels off after the first year or two, and it is not uncommon for patients to regain up to 20 pounds. Unfortunately, at this time, there are not enough long-term studies to demonstrate the weight loss durability of the gastric sleeve procedure.

Possible Complications
The mortality rate within the first 30 days after surgery is very low, about 0.5 percent, which is comparable to the gastric bypass. Short-term complications following a vertical sleeve gastrectomy also are similar to those of the gastric bypass and include blood clots, leakage along the suture lines, and wound infection. Long-term complications can include stricture, GERD, ulcers, gallstones, staple line disruption, weight re-gain, and nutritional deficiencies.

The dietary guidelines following the sleeve gastrectomy are similar to those prescribed for gastric banding or gastric bypass patients. Patients can avoid nutritional complications by continually adhering to the vitamin and mineral supplement regimen prescribed by their bariatric surgeon. An experienced weight loss surgeon generally will check a patient’s vitamin levels every six months for the first two years and annually thereafter.

As with any weight loss surgery procedure, life-long follow-up with your doctor and regular participation in a weight loss surgery support group will help you lose more weight and keep it off for goods. If you are considering a sleeve gastrectomy or other weight loss surgery procedure, be sure to consult with an experienced bariatric surgeon before making your decision.

8 Responses

  1. Cheryl

    I have set up an appt to descuss the sleeve gastrectomy. I am shocked at the price of this surgery. it was quoted at $16,600.00. Is that a fair price? I truely need it but am afraid I can’t come up with that amount. Any sugestions?
    thank you

  2. Nancy Donovan

    when will medicare cover the gastric sleeve…
    we are all waiting waiting waiting for the news….
    they are supposed to make a decision by friday the 29th….

  3. Nancy Donovan


  4. Tiffany

    I was going to get the Sleeve, but after going for all the tests and having only 1 more appt left, I was told that the Sleeve, was NOT covered by Medicare??? So I am really confused?? I have Medicare & Medicaid and I Live in Illinois. Is there something I am missing???

  5. Harry Stewart

    It is my understanding that although the Laparoscopic Gastric Sleeve (LGS) surgery has been approved for Medicare (conditions A, B, C), it still hasn’t been approved for the region that covers Maryland. I also understand that there should be a decision for this area by the end of October. Is there any indication as to which way the deciding committee will rule? I am morbidly obese, have high blood pressure, have OSA, and other co-morbidity issues. I have reviewed the various options, and only feel comfortable with the LGS procedure. I do not want the high potential maintenance of the lap-band (Dr agrees), and I feel the life-time restrictions relating to the gastric by-pass are beyond my comfort zone. I’m hoping to hear (relatively soon) of a positive response for the Maryland area.

  6. Tonia

    i had the sleeve gastrectomy done on November 16th of 2012 and i was wondering if anyone knew how many stitches or staples are involved inside my stomach? i know there is no exact number but when someone asks me how many staples and how many stitches i dont know what to tell them and it is aggrivating. i keep forgetting i had the surgery and i am pulling my internal stitches. how long does it normally take for them to heal inside? anyone got an answer or a best guess for me??? PLEASE!

  7. Annie

    Sleeve surgery in Mexico is very affordable.
    The doctors have a lot of experience with the Sleeve Gastrectomy and even train the US doctors in this procedure. I am having mine for $4700.00. That includes all of my lab work, medication, days in the hospital and 3 days at the Marriott. There are other affordable options.