Vertical Sleeve Gastrectomy—Laparoscopic
(Sleeve Gastrectomy—Laparoscopic; VSG—Laparoscopic)
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.
|Copyright © Nucleus Medical Media, Inc.
Reasons for Procedure
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 40
- BMI 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 reduction
- Improvement in many obesity-related conditions
- Improved movement and stamina
- Enhanced mood and self-esteem
Complications are rare. But no procedure is completely free of risk. Complications may include:
- Stitches or staples may loosen
- Pouch stretches or leaks
- Reaction to anesthesia
- Blood clots
- Nausea, vomiting
Long-term complications include vomiting and developing
Factors that may increase the risk of complications include:
- Recent or chronic illness
- Increased age
- Heart or lung disease
- Bleeding or clotting disorders
Discuss these risks with your doctor.
What to Expect
Prior to Procedure
You may have the following:
- Physical exam and review of medical history
- Blood test and other tests
- Meetings with a registered dietitian
- Mental health test and counseling
Prior to the procedure:
Talk to your doctor about any medications, herbs, and dietary supplements you are taking. You may be asked to stop taking some medications up to one week before the procedure, like:
Anti-inflammatory medications, such as ibuprofen and naproxen
- Blood thinners
- Anti-platelet medications
Before the procedure:
- You may be given antibiotics.
- You may be given laxatives or an enema.
- Arrange for a ride to and from the hospital. Arrange for help at home.
- The night before, eat a light meal. Do not eat or drink anything after midnight.
will be given through an IV. It will block pain and keep you asleep through surgery.
Description of the Procedure
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.
Immediately After Procedure
The breathing tube and catheter will be removed.
How Long Will It Take?
About two hours
How Much Will It Hurt?
Anesthesia will prevent pain during surgery. Pain medication will be given after surgery.
Average Hospital Stay
The usual length of stay is 2-3 days.
At the Hospital
- 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 problems
- Wear elastic surgical stockings or boots to promote blood flow in your legs
- Get up and walk
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.
- Take walks daily.
- Your doctor may recommend that you meet with a therapist to help you deal with emotional changes after surgery.
- Follow your doctor’s instructions.
You should be able to return to normal activities in 2-3 weeks.
For good nutrition:
clear liquid diet
for about one week.
- Begin with 4-6 small meals per day. A meal is two 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
Contact your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
- Pain that you cannot control with the medications you have been given
- Blood in the stool
- Pain, burning, urgency, or frequency of urination, or persistent bleeding in the urine
- Persistent nausea and/or vomiting
- Severe abdominal pain
- Pain and/or swelling in your feet, calves, or legs
- Cough, shortness of breath, or chest pain
In case of an emergency, call for medical help right away.
American Society for Metabolic and Bariatric Surgery
Weight Control Information Network
Canadian Obesity Network
Weight Loss Surgery
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http://www.ebscohost.com/dynamed. Updated December 2, 2013. Accessed December 8, 2013.
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http://health.ucsd.edu/specialties/surgery/bariatric/weight-loss-surgery/gastric-sleeve/Pages/default.aspx. Accessed December 8, 2013.
Laparoscopic sleeve gastrectomy. Cleveland Clinic website. Available at:
http://weightloss.clevelandclinic.org/Sleevegastrectomy.aspx. Accessed December 8, 2013.
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.
Sleeve gastrectomy. Yale New Haven Health website. Available at:
https://www.greenhosp.org/upload/docs/FactSheets/English/bariatrics%5Fsleeve.pdf. Updated May 2011. Accessed December 8, 2013.
Weight loss surgery. North Shore Medical Center website. Available at:
http://nsmcweightloss.org/web/surgical%5Fprocedures.aspx. Accessed December 8, 2013.