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Weight & Wellness Program
Vertical Sleeve Gastrectomy

 

  The Procedure 

Advantages of Vertical Sleeve Gastrectomy

Serious Risks Immediately After Surgery

Long-Term Risks After Surgery


Weight & Wellness Program Home 

Surgical Services Home 

 

Weight & Wellness Program
12 Andover Road
Portland, ME 04102
Map Directions

Phone: 207-761-5612
Toll Free: 1-866-268-9274
Fax: 207-253-6073

The Procedure

Vertical Sleeve Gastrectomy surgery works in one way: it is restrictive. Commonly referred to as the “sleeve” procedure, this surgery is restrictive because 60-70% of the stomach is permanently removed. Most people feel satisfied after eating a very small amount of food. The result is weight loss due to eating less and feeling full more quickly.

The vertical sleeve gastrectomy begins by placing a guide down into the stomach through to the small intestines. A banana-shaped tube is created by cutting the stomach and securing it with staples. This is the restrictive potion of the operation. The remainder of the stomach is removed from the body permanently. This procedure will take approximately 1-2 hours in the operating room. Patients can plan on staying in the hospital for about 2 days after surgery. Most patients return to work or usual daily activities in 2-3 weeks.

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Advantages of Vertical Sleeve Gastrectomy

The advantages of laparoscopic vertical sleeve gastrectomy are significant. Many patients experience an improvement in medical conditions, a decrease in prescription medications, and an increase in quality of life. On average, a patient will lose 50-60% of his or her excess body weight (the amount of weight over their ideal body weight) within the first 18-24 months. The majority of the weight loss occurs in the first six months. After five years some weight gain is normal. On average, patients regain 10-15% of the weight they initially lost. Maintaining long term weight loss depends on a patient’s commitment to a healthy lifestyle and diet changes.

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Risks of Vertical Sleeve Gastrectomy Surgery

There are risks involved with having any surgery. The risks associated with having vertical sleeve gastrectomy surgery can be divided into immediate risks and long term risks.

Serious Risks Immediately After Surgery

Leak – Immediately after surgery the stomach is closed by staples. The stomach heals together, but initially there is a chance that the food and saliva will leak into the abdominal cavity, potentially causing a serious infection. This problem usually requires immediate medical attention.

Pulmonary Embolism – This occurs when blood clots form in the large veins of the legs and pelvis, break loose and travel to the heart and lungs. We administer a gentle blood thinner while in the hospital, but the best way to prevent a pulmonary embolism is to get up and walk.

Death – Rarely, death may occur due to a complication of the operation, usually a leak or pulmonary embolism. Those patients who have serious complications from their obesity (such as severe heart or pulmonary disease or poorly controlled diabetes) may have greater difficulty recovering from any operative complications.

Bleeding – Patients occasionally receive a blood transfusion after surgery. This is usually for postoperative bleeding that stops on its own, but reoperation can be necessary to stop more serious bleeding.

Atelectasis/Pneumonia – It can be uncomfortable to take deep breaths and cough immediately after surgery. When patients fail to do so, portions of their lungs tend to collapse (atelectasis). This can cause fevers, a fast heart rate and can lead to pneumonia. The best way to avoid this complication is to breathe deeply, cough, and walk.

Infection – Infection can occur after surgery. Patients should report any fevers to the program nurse. Incision site infections occur occasionally. Keeping the sites clean will allow them to heal without infection.

Nausea - Some patients feel nauseated for weeks or even a few months after surgery. Medication is available for this problem but it cannot always correct the nausea. Fortunately the nausea usually resolves on its own. Regardless of nausea, you must drink 64 ounces of fluid a day.

Vomiting – Vomiting is expected during the first few months after surgery. It is often difficult to explain or to prevent. It can happen when overeating or eating too fast. It is important that you do not force yourself to vomit.

Adhesions/Small Bowel Obstruction – Adhesions are scar tissue inside the abdomen. Small bowel obstruction means there is a blockage in the intestines. Vomiting is a common symptom associated with small bowel obstruction.

Pain – Vertical sleeve gastrectomy is a major abdominal surgery. You will be given a prescription for narcotics. Pain is normal at incision sites and sometimes in the shoulder area. If pain is not relieved by pain medication or gets worse, you should call the Weight & Wellness Program immediately.

Anastomotic Stricture – In the first 1-2 months patients may develop a narrowing (stricture) as scar tissue heals. This narrowing causes vomiting that will gradually get worse over a few days or week. A stricture can usually be easily fixed. The surgeon will give you a sedative and then will stretch out the stricture using an endoscope.

Reoperation – Our surgeons do not hesitate to re-operate on patients who are not progressing well the first few days after surgery. Complications that are detected early, before a patient gets critically ill, can more often be easily managed without a major setback.

Long Term Risks After Surgery

Dumping Syndrome – Few people who have vertical sleeve gastrectomy experience "dumping syndrome" after eating sweet, sugary, or fatty foods. Symptoms of dumping syndrome include gas, cramping, diarrhea, and sweating. Usually sugars are digested slowly in the stomach and are passed into the small intestine. Because your stomach is bypassed the sugars are instead being flushed rapidly into the small intestine, causing the symptoms of dumping syndrome. Although dumping syndrome is unpleasant, it is not dangerous and usually goes away in about one hour.

Gallstones - During any period of rapid weight loss, some people may form stones in their gallbladder. Gallstones usually present with pain on the right side of the abdomen that radiates through to the back. If a patient already had gallstones before surgery, the surgeon may remove the gallbladder at the time of surgery. This decision is made on an individual basis and will be discussed with the surgeon before the operation.

Calcium Deficiency – Calcium is not absorbed well after vertical sleeve gastrectomy surgery and it will be necessary to take two daily calcium supplements.

Vitamin B12 Deficiency – This vitamin may be poorly absorbed after vertical sleeve gastrectomy surgery, therefore it will be necessary to take a daily pill, a weekly nasal spray or a monthly injection to prevent deficiency.

Iron Deficiency – This problem is more common in menstruating women, but can occur in any patient. If a patient is iron deficient, a daily supplement may be indicated. Any patient who has vertical sleeve gastrectomy should have their iron levels monitored through regular laboratory testing.

Other Vitamin Deficiencies – Vitamin deficiencies can cause serious and permanent nerve damage. It is essential to take a daily multivitamin.

Dissatisfaction With The Operation – Not everybody achieves his or her desired weight loss results. Others lose weight but don't like the diet restrictions. A vertical sleeve gastrectomy surgery cannot be reversed.

Vertical Sleeve Illustration

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