Vertical Gastrectomy (VG)



Also Known as Vertical Sleeve Grastrectomy

Another restrictive surgical weight loss procedure, the Vertical Gastrectomy procedure (also called Vertical Sleeve Gastrectomy, Sleeve Gastrectomy, Greater Curvature Gastrectomy, Parietal Gastrectomy, Gastric Reduction and even Vertical Gastroplasty) is performed by approximately 15 surgeons worldwide. It was originally conceived of by Dr. Johnston in England as an open procedure, and has been further refined laproscopically. It is now utilized in the United States, Germany and Belgium. It generates weight loss by restricting the amount of food (and therefore calories) that can be eaten by removing 85% or more of the stomach without bypassing the intestines or causing any gastrointestinal malabsorption. This surgery creates a small, thin, tube-like stomach approximately 2 ounces in size, usually smaller than the stomach pouch that Duodenal Switch patients have (see Laparoscopic Duodenal Switch).

The Vertical Gastrectomy is a significant improvement over older gastroplasty ("stomach stapling") procedures for a number of reasons:
  • 1) Rather than creating a pouch with silastic rings or polypropylene mesh (plastic devices), the Vertical Gastrectomy actually resects or removes the majority of the stomach. The portion of the stomach that is removed is responsible for secreting Ghrelin, which is a hormone that is responsible for appetite and hunger. By removing this portion of the stomach rather than leaving it in-place, the level of Ghrelin is reduced to near zero, actually causing you to lose your appetite.
  • 2) The removed section of the stomach is actually the portion that "stretches" the most, thereby drastically reducing the holding capacity once it has been removed. Not only is your appetite reduced, but very small amounts of food make you feel extremely full.
  • 3) Finally, by not having to place plastic rings or mesh around your stomach to create a new pouch, the problems that are associated with these items are eliminated (infection, obstruction, erosion, and the need for synthetic materials). This procedure significantly restricts the volume of the food that can be consumed. It is recommended for higher risk patients, patients 50 years old or older, or patients with a BMI of 50 or above. It has been developed to minimize postoperative complications and risks. Since there is no malabsorption or rearrangement of the intestinal tract, vitamin deficiencies or nutritional problems are minimal.

    The Vertical Gastrectomy is routinely performed Laparosopically, even in patients weighing as much as 660 pounds. The procedure generally takes about 60-90 minutes to perform and the hospital stay is 1-2 days. Patients must consume liquids only for 2 weeks after surgery, but by 4-6 weeks after the operation, patients should be able to eat regular healthy foods with little difficulty.
  • The Vertical Gastrectomy is a reasonable solution to morbid obesity BMI  greater than 60Kg/M2). It can usually be done laparoscopically in patients weighing over 500 pounds. The stomach restriction that occurs allows these patients to lose more than 100 pounds and in many patients more than 200 pounds. This weight loss allows significant improvement in health and effectively "downstages" a patient to a lower risk group. Once the patients BMI is lower (35-40) they can return to the operating room for the "second stage" of the procedure, which can either be the Duodenal Switch, Roux-en-Y gastric bypass or even a LapBandŽ.

     

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