Success with bariatric surgery continues to improve as surgeons learn more about the disease of obesity and how the body functions. With new information and techniques, doctors are able to offer more options to obese individuals seeking medical help. One of the newest bariatric procedures performed for obesity treatment is Gastric Sleeve Surgery, also known as Vertical Sleeve Gastrectomy (VSG). Gastric Sleeve Surgery involves removing a large portion of the stomach, while keeping both ends of the stomach as well as the small intestine intact.



About the Procedure

The Gastric Sleeve procedure helps with weight loss by reducing the size of the stomach and thereby restricting the amount of food that can be eaten at any one time. During surgery, the surgeon removes about three-quarters of the stomach along the outside curvature. The new stomach is the shape of a thin tube, which spans the original distance from the esophagus to the small intestine. The pyloric valve, the normal outlet which controls the release of food from the stomach to the small intestine, continues to function normally. The surgery also helps to control hunger by removing the upper stomach portion, which is the area that produces the hunger stimulating hormone, ghrelin.

The gastric sleeve is increasingly being performed as a stand-alone procedure, but many times it is considered the first step in a two part process. For patients who are either extremely obese or have so many health problems that they do not qualify for gastric bypass surgery, the gastric sleeve can be performed to help a patient start losing weight. After a few years of weight loss, a patient has usually lost enough weight so that the second step of the process can be completed, usually with the duodenal switch procedure, if further weight loss is desired.

Gastric Sleeve vs. Gastric Bypass

When comparing the gastric sleeve to gastric bypass surgery, there are two primary surgical differences. With gastric sleeve, the natural outlet of the stomach (pyloric valve) is preserved and the small intestine is not cut, rerouted, or bypassed. With gastric bypass surgery, a new stomach outlet (stoma) is created and the small intestine is cut in two - the first portion is bypassed and the last portion is attached directly to the new stomach pouch at the new opening.

The benefits of the gastric sleeve procedure compared to gastric bypass surgery include: digestive system is not bypassed or rerouted and digestion occurs normally, does not cause malabsorption or nutritional deficiencies, less chance of developing ulcers, less complicated procedure, safer for extremely obese and those with many health problems.

Gastric Sleeve vs. Adjustable Gastric Banding

The gastric sleeve and adjustable gastric banding procedures (LAP-BAND or REALIZE Band) both help promote weight loss through restrictive methods, neither method involves changes to the small intestine. They help a patient lose weight by controlling feelings of hunger and limiting meal portions. Although the gastric sleeve is not adjustable or reversible, it also does not involve having a medical device implanted into the body, does not require follow-up appointments for adjusting and filling the gastric band, and food does not get stuck at the opening to the stomach.

Making the Choice

While gastric sleeve surgery offers many benefits, deciding which type of bariatric surgery is the best procedure for you should only be made after an evaluation and discussion with your bariatric surgeon.