Vertical Sleeve Gastrectomy
What Is Vertical Sleeve Gastrectomy and Why Is It Performed?
Vertical sleeve gastrectomy (VSG) is a weight loss surgery that consists of removing a majority of the stomach and creating a new stomach about the size and shape of a banana. Bariatric surgeons at the Massachusetts General Hospital Weight Center typically perform vertical sleeve gastrectomy as a minimally invasive procedure for patients with obesity.
VSG is recommended for patients based on the following benefits:
- Average loss of 45% to 85% of excess weight
- Causes increased fullness, decreased hunger
- Improves conditions such as type 2 diabetes and hypertension
- Increased life expectancy
- Positive effects on insulin resistance
- Fewer intestinal complications than other weight loss procedures
To qualify for this procedure, patients must have a Body Mass Index (BMI) of 40 or greater, or a BMI of 35 or greater plus a medical condition such as type 2 diabetes, high blood pressure or sleep apnea. Patients must also have tried other weight loss approaches that did not lead to significant and sustainable weight loss.
How Is Vertical Sleeve Gastrectomy Performed?
During VSG, the surgeon removes a majority of the stomach, creating a new banana-shaped stomach from the remaining component. This procedure decreases the production of ghrelin, the hunger hormone, so patients are less hungry. Additionally, the new stomach processes food faster, creating early feelings of fullness.
At Mass General, VSG is usually performed laparoscopically with a few small incisions. Surgeons use narrow cylindrical tubes called trocars to access the abdominal cavity through small incisions in the upper abdominal wall.
The duration of this procedure ranges from 30 to 60 minutes. After the procedure, you will stay at the hospital for one or two nights. We recommend taking off three to four weeks from work.
What Preparation Is Required Before Vertical Sleeve Gastrectomy?
You may be required to enroll in the Mass General Weight Center’s pre-surgery nutrition program before you can undergo vertical sleeve gastrectomy. All patients scheduled for weight loss surgery are required to lose some weight prior to surgery. Weight loss before bariatric surgery results in a decrease of the size of the liver, commonly known as “shrink the liver” diet. This size decrease in the liver makes the surgery less difficult and faster, reducing postoperative complications. Your Mass General dietitian will create a meal plan specifically tailored to your weight loss goals.
What Happens After Vertical Sleeve Gastrectomy Is Performed?
At the Mass General Weight Center, your care team develops an individualized postoperative program to monitor, guide and support you after the procedure. The program is divided into two phases—Postoperative Adjustment and Lifestyle Modification—each lasting three months.
How Safe Is the Procedure?
Your Mass General Weight Center care team will discuss the benefits (see above) and risks of this procedure, including complications such as:
- Dumping, where food and digestive juices from your stomach move to your small intestine in an uncontrolled, abnormally fast manner. Symptoms include dehydration, sweating and rapid heartbeat. Foods high in carbohydrates lead to this complication
- Gastroesophageal reflux disease (GERD)
Why Mass General?
Mass General is consistently ranked among the best hospitals in the country by U.S. News & World Report. As part of the Mass General Digestive Healthcare Center, the Mass General Weight Center is unique for its expert, multidisciplinary approach to vertical sleeve gastrectomy. Our surgeons, among the most experienced in the region, are accustomed to seeing both local and international patients with multiple medical conditions.
At the Mass General Weight Center, your care team comprises your surgeon, dietitian and psychologist, who meet weekly to coordinate your care. Before and after your surgery, your care team designs an individualized treatment plan for you that promotes long-term weight loss. Mass General experts are available for counseling on nutrition, exercise and behavior modification along with medical management of related diseases.