Vertical sleeve gastrectomy is a technique of weight-loss surgery that involves altering the size of your stomach so you’ll feel fuller faster, and eat less food. This surgery will require dramatic changes to your daily eating habits and is only recommended for patients who meet certain weight and health criteria. The surgery is a permanent change to your stomach, which means you must carefully consider your options before undergoing this surgical option.
Although specific guidelines may vary from physician to physician, vertical sleeve gastrectomy isn’t for the casual dieter hoping to lose a few pounds. Instead, the procedure requires an assessment that focuses on physical and mental considerations to make sure you can succeed with weight loss following the surgery. While the surgery may change the size of your stomach, it’s up to you to change your eating habits.
Body mass index or BMI is an important measurement to determine if you qualify for the surgery. Vertical sleeve gastrectomy was traditionally reserved for highly obese patients. If you have a BMI higher than 40 or are at least 100 pounds overweight you are considered extremely obese. Today those who are considered just obese or have a BMI of 30.0 to 39.9 may be considered if they have health risk factors, such as diabetes.
You can figure out your BMI by multiplying your weight in pounds by 703, and then dividing the result by your height in inches squared. For example, a 300-lb. person who is 6 feet tall would have a BMI of about 40.7.
BMI alone is not enough to qualify you for the surgery. Your physician will likely order other tests to make sure your body can handle the surgery and ensure your weight isn’t related to a medical condition that can be treated without surgery. These other tests include:
- blood tests such as complete blood count (CBC), red blood cell (RBC) count, white blood cell (WBC) count, platelets, hemoglobin, and hematocrit
- fasting blood glucose
- lipid profile
- serum chemistries such as tests for kidney and liver function
- thyroid test
Your doctor also will consider your age, gender, other medical conditions, and lifestyle habits, such as smoking.
Your surgeon will perform the vertical sleeve gastrectomy while you’re under general anesthesia. This means you’ll be asleep and free of pain during the surgery. Most of the time, the surgery is done in a way that is minimally invasive. This means that your surgeon will use small incisions to insert thin surgical tools and a tiny camera to see inside your stomach.
Your surgeon will use these tools to remove a portion of your stomach. They’ll transform it from a pouch-shaped organ to one that is shaped more like a vertical tube, hence the name of the surgery. Staples will be applied to join together the remaining stomach portions.
In total, the surgery will take anywhere from 60 to 90 minutes, providing you don’t experience any issues during surgery. The procedure is not reversible in the way that some other weight-loss surgery options such as gastric band are.
The vertical sleeve gastrectomy procedure removes an estimated 85 percent of your stomach. Your new, sleeve-like stomach can hold about 2 to 5 oz. of food. Following surgery, your physician will ask you to follow a special diet that allows the stomach to heal.
A few weeks later, you’ll follow a diet that focuses on eating small amounts of healthy foods. Your physician may recommend taking vitamin supplements to ensure you get the nutrients you need.
You’ll likely lose weight over the course of two to three years. The procedure isn’t associated with losing as much weight as gastric bypass because the vertical sleeve is a larger stomach pouch. By following the recommended diet, you also may reverse chronic, weight-related conditions such as asthma, type 2 diabetes, arthritis, high blood pressure, and high cholesterol.
The vertical sleeve gastrectomy is not without side effects. A thorough discussion with your surgeon about what to expect post-surgery is vital to your surgery’s success.
Risks associated with the surgery itself and being under general anesthesia include:
- allergic reactions to the medications used to put you to sleep
- trouble breathing
- blood loss
- blood clots that can travel to the lungs
- stroke or heart attack during surgery (although uncommon, it is a possibility)
- infection or sepsis
Post-surgery, you must work with your surgeon to minimize surgical risks, including:
- stomach irritation
- stomach injury
- nerve damage
- leakage at the stomach stapling site
- scarring that can affect how food moves in your stomach
- vomiting from eating too much food
Providing you don’t experience any immediate post-surgical complications, you can expect to go home two days after the procedure.
Written by: Rachel Nall
Medically reviewed on Jan 13, 2016 by Steve Kim, MD