Vertical Sleeve Gastrectomy - the Safest Bariatric Surgery

Bariatric surgery is surgery designed to help obese patients lose weight. Patients can choose from several types of bariatric surgery, including gastric bypass, lap banding, vertical sleeve gastrectomy and duodenal switch. Different operations may meet the needs of different patients, but some forms of surgery are riskier than others.

Vertical Sleeve Gastrectomy

Gastric bypass and lap banding are the most popular forms of bariatric surgery but the vertical sleeve gastrectomy (sometimes simply referred to as the sleeve or VSG) is rapidly gaining in popularity. In that operation, surgeons removed about 85% of the patient's stomach. It's called a vertical sleeve gastrectomy because the remaining organ is shaped like a long sleeve. Patients can only eat small amounts of food since they have only a small stomach after surgery. Also, the part of the stomach that is removed is the part that makes a hormone called Ghrelin. It's a hormone that stimulates the appetite, so removing that part of the stomach reduces feelings of hunger.

No Foreign Objects in the Body

When someone has lap band surgery, doctors put a silicon band around the stomach and this limits how much food the patient can eat. The presence of a foreign object in the body carries some risks. The band can develop another leak and then a second surgery must be performed to replace the band. Sometimes the band slips and a second surgery may be required to correct that problem. Patients' bodies may also reject the band since it is a foreign object in the body. When someone has a vertical sleeve gastrectomy, they have no foreign object in the body so they don't have to worry about these potential problems.

No Problems with the Absorption of Nutrients

When patients have gastric bypass or duodenal switch surgery, they do not absorb all the nutrients from their food because a portion of the small intestine is bypassed. This helps them lose weight since they do not absorb all the fat or calories in the food they eat but it also creates a danger of nutritional deficiencies since they don't absorb all the vitamins or minerals from food they eat. When patients have vertical sleeve gastrectomy surgery, though, the intestine is not affected so they are at low risk for nutritional deficiencies.

Early Complications

Early complications of VSG surgery are similar to early complications of other bariatric surgeries like lap banding and gastric bypass. Possible complications include acute respiratory distress syndrome (affecting about .25 percent of patients), postoperative bleeding (affecting about .5 percent) and blood clots (affecting about .5 percent). Another early complication is a leak at the staple line, which is not a risk in lap band patients since the stomach is not cut in that surgery. Some patients experience nausea in the early days after surgery. The mortality rate for VSG patients is about .25, similar to the mortality rate for lap band patients. The mortality rate is lower for lap band patients, however.

Long-Term Complications

Late complications are believed to be rather rare with the vertical sleeve gastrectomy, although until recently the sleeve was not widely performed so it's possible that other late complications will be found to be more common in the future. So far the greatest late complication seems to be insufficient weight loss and/or later regain of weight. Patients lose an average of 60 percent of their excess weight though, more than lap band patients typically lose.

Sources:

Laparoscopic Associates of San Francisco. http://www.lapsf.com/vertical-gastrectomy-weight-loss-surgery.php. Vertical Sleeve Gastrectomy.

AATCO. http://www.obeseinfo.com/vertical-sleeve-risks.htm. Risks of Vertical Sleeve Gastrectomy.

Medical University of South Carolina. http://www.muschealth.com/weightlosssurgery/procedures/laprisks.htm. Risks with Adjustable Gastric Banding.

Thinner Times. http://www.thinnertimes.com/weight-loss-surgery/wls-basics/weight-loss-surgery-comparison.html. Weight Loss Surgery Comparison.

John J. Feng, MD. http://gastricbypasssanfrancisco.com/vertical-gastrectomy-sleeve-san-francisco-ca.htm. Vertical Sleeve Gastrectomy.

Surgery.com. http://www.surgery.com/procedure/gastric-bypass/risks#Information. Gastric Bypass Risks.