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Vertical sleeve gastrectomy

How it works

Vertical sleeve gastrectomy is surgery to help with weight loss. A large portion of your stomach is removed from your body. The smaller stomach limits the amount of food you can eat by making you feel full after eating small amounts of food. If you eat or drink too much or too fast, you will throw up or have pain.

Since most of your stomach will be removed, you may not feel as hungry all of the time.

In the past, this surgery was most often done on people who were too heavy to safely have other types of weight-loss surgery. However, it is now the most common weight-loss procedure for all bariatric patients. For some people who have this surgery, particularly the most heavy people, a second weight-loss surgery, called the duodenal switch may be needed at some time in the future.

What happens during surgery?

You will receive general anesthesia before this surgery. This will keep you asleep and pain-free during the surgery.

The surgery is done using a tiny camera that is placed in your belly. This type of surgery is called laparoscopy. The camera allows your surgeon to see inside your belly. This is how the surgery is performed:

  • Your surgeon will make 5 to 6 small cuts (incisions) in your belly.
  • Through these small cuts, the surgeon will place a camera and the instruments to perform the surgery.
  • The surgeon can see inside your belly by looking at the TV monitor that is connected to the camera.
  • The surgeon will remove most (about 70% to 80%) of your stomach from your body.
  • The remaining stomach will be a long vertical tube or banana-shaped stomach.

This surgery takes about one to one and a half hours.

What to expect after surgery

Most patients will go home one to two days after surgery.

You should be able to drink clear liquids on the day after surgery. You will be on a liquid diet for a week or two after surgery, then will advance to a pureed diet.

The weight will usually come off more quickly over the first 4 to 6 months, and then more slowly over the rest of the first year. You will have lost most of your weight by the time a year has passed.

Life after bariatric surgery will be different. It is a good idea to talk with your health care provider about what weight loss will feel like, what you can eat and drink, and what you should do to stay healthy. People may treat you differently after you have lost weight.

Things to consider

Here are some things you should know about this type of surgery:

  • Weight loss with this surgery may not be as great as after gastric bypass surgery.
  • The sleeve will enlarge as time goes by, and you will be able to eat more food after several months to a year. It will be important to plan when to eat and how much to eat.
  • Some people may develop heartburn or reflux symptoms after a sleeve gastrectomy, and you may need medicine to treat it. If you have severe reflux before surgery, it may be better to consider having a gastric bypass instead.
  • Some people with the most weight will need a second surgery (duodenal switch) once they have lost some of their weight.
  • In order to prevent weight regain after sleeve gastrectomy surgery, you will need to follow a diet and exercise program for the rest of your life.

Talk with your doctor about which procedure is best for you.

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Review Date: 1/30/2018

Reviewed By: John E. Meilahn, MD, Bariatric Surgery, Chestnut Hill Surgical Associates, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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