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by EBSCO Medical Review Board

Vertical Sleeve Gastrectomy—Laparoscopic

(Sleeve Gastrectomy—Laparoscopic; VSG—Laparoscopic)

Definition

Vertical sleeve gastrectomy (VSG) is surgery to decrease the structure and size of the stomach.
The Stomach
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This surgery involves re-shaping the stomach to reduce the amount of food it can hold.
Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure

This surgery is done to make the size of the stomach smaller. This will make a person feel full quickly. This will promote weight loss in people who are obese. It is done when other methods have not been helpful.
In addition to helping a person lose weight, this surgery may also:
  • Improve physical function
  • Lower high blood pressure
  • Lower blood glucose levels
  • Lower cholesterol levels
  • Lower the risk of heart disease
  • Reduce sleep apnea

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Blood clots
  • Stitches or staples that loosen
  • Pouch stretches or leaks
  • Lasting nausea and vomiting
  • Gallstones
  • Heart attack
Things that may raise the risk of problems are:
  • Smoking
  • Drinking alcohol
  • Chronic diseases, such as diabetes

What to Expect

Prior to Procedure

The bariatric surgery team will meet with you to talk about:
  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Specialists you may need to see, such as a registered dietitian
  • Tests that will need to be done before surgery, such as mental health counseling

Anesthesia

You will be given general anesthesia . You will be asleep.

Description of the Procedure

Several small incisions will be made in your abdomen. Gas will be pumped in to inflate your abdomen and make it easier to view the stomach. A thin, lighted tool with a tiny camera will be inserted through an incision. A monitor will be used to view the images. Other tools will be inserted into other incisions. Staples will be used to divide the stomach vertically. The new stomach will be the shape of a slim banana. It can only hold 10% of what a normal adult stomach can hold. The rest of the stomach will be removed. Staples or stitches will be used to close the incisions. A bandage will be placed over the area.
In some people, the doctor may need to switch to open surgery.

How Long Will It Take?

About 2 hours

Will It Hurt?

Pain and swelling are common in the first week. Medicine and home care can help.

Average Hospital Stay

The usual length of stay is 2 to 3 days. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Hospital
After the procedure, the staff may:
  • Give you pain medicine.
  • Use a small thin tube with a camera to look down your throat and into your stomach to check for any problems
  • Give you clear liquids
  • Encourage you to begin walking
  • Teach you how to use an incentive spirometer to prevent breathing problems
  • Give you compression stockings to promote blood flow to your legs
Your bowels will work more slowly than usual. Chewing gum may help speed the process of your bowel function returning to normal.
During your stay, the hospital staff will take steps to lower your risk of infection, such as:
  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered
There are also steps you can take to lower your risk of infection, such as:
  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions
At Home
It will take a few weeks for the incision and muscles to fully heal. Physical activity will be limited during this time. You will need to ask for help at home and delay your return to work.
Dietary changes, regular exercise, and counseling will need to be part of your recovery and lifelong weight loss plan.

Problems to Look Out For

Call the doctor if you are not getting better or you have:
  • Signs of infection, such as fever and chills
  • Redness, swelling, excessive bleeding, or discharge from the incision
  • Pain that you cannot control with medicine
  • Pain and swelling in your feet, calves, or legs
  • Lasting nausea or vomiting
  • Blood in your stool
  • Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
  • Cough
  • Shortness of breath
  • Chest pain
  • New or worsening symptoms
If you think you have an emergency, call for medical help right away.

RESOURCES

American Society for Metabolic and Bariatric Surgery
https://asmbs.org
National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov

CANADIAN RESOURCES

HealthLink BC
https://www.healthlinkbc.ca
Weight Loss Surgery
https://weightlosssurgery.ca

References

Bariatric surgery. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/nutritional-disorders/obesity-and-the-metabolic-syndrome/bariatric-surgery. Accessed September 27, 2021.
Bariatric surgery in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/bariatric-surgery-in-adults. Accessed September 27, 2021.
Gastric sleeve or sleeve gastrectomy. UC San Diego Health website. Available at: https://health.ucsd.edu/specialties/surgery/bariatric/weight-loss-surgery/gastric-sleeve/Pages/default.aspx. Accessed September 27, 2021.
Gastric sleeve surgery. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/departments/bariatric/treatments/gastric-sleeve. Accessed September 27, 2021.
Weight-loss (bariatric) surgery. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/weight-management/bariatric-surgery. Accessed September 27, 2021.
Weight management procedures. North Shore Medical Center website. Available at: https://nsmc.partners.org/weight%5Fmanagement/procedures. Accessed September 27, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Marcin Chwistek, MD
  • Review Date: 07/2021
  • Update Date: 09/27/2021