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Vertical Sleeve Gastrectomy—Open

(Sleeve Gastrectomy—Open; VSG—Open)

by Cynthia M. Johnson, MA

Home | Health Information Center | Procedure & Surgery Fact Sheets | Article

Definition

Reasons for Procedure

Possible Complications

What to Expect

Problems to Look Out For

En Español

Definition

Vertical sleeve gastrectomy (VSG) is surgery to decrease the structure and size of the stomach.

The Stomach

This surgery involves re-shaping the stomach to reduce the amount of food it can hold.

Reasons for Procedure

This surgery is done to make the size of the stomach smaller. This will make a person feel full quickly. This will promote weight loss in people who are obese. It is done when other methods have not been helpful.

In addition to helping a person lose weight, this surgery may also:

Improve physical function
Lower high blood pressure
Lower blood glucose levels
Lower cholesterol levels
Lower the risk of heart disease
Reduce sleep apnea

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

Excess bleeding
Problems from anesthesia, such as wheezing or sore throat
Infection
Blood clots
Stitches or staples that loosen
Pouch stretches or leaks
Lasting nausea and vomiting
Gallstones
Heart attack

Things that may raise the risk of problems are:

Smoking
Drinking alcohol
Chronic diseases, such as diabetes

What to Expect

Prior to Procedure

The bariatric surgery team will meet with you to talk about:

Anesthesia options
Any allergies you may have
Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
Fasting before surgery, such as avoiding food or drink after midnight the night before
Whether you need a ride to and from surgery
Specialists you may need to see, such as a registered dietitian
Tests that will need to be done before surgery, such as mental health counseling

Anesthesia

You will be given general anesthesia. You will be asleep.

Description of the Procedure

A long incision will be made in the abdomen. Staples will be used to divide the stomach vertically. The new stomach will be the shape of a slim banana. It can only hold 10% of what a normal adult stomach can hold. The rest of the stomach will be removed. Staples or stitches will be used to close the incision. A bandage will be placed over the area.

How Long Will It Take?

About 2 hours

Will It Hurt?

Pain and swelling are common in the first week. Medicine and home care can help.

Average Hospital Stay

The usual length of stay is 4 to 6 days. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Hospital

After the procedure, the staff may:

Give you pain medicine.
Use a small thin tube with a camera to look down your throat and into your stomach to check for any problems
Give you clear liquids
Encourage you to begin walking
Teach you how to use an incentive spirometer to prevent breathing problems
Give you compression stockings to promote blood flow to your legs

Your bowels will work more slowly than usual. Chewing gum may help speed the process of your bowel function returning to normal.

During your stay, the hospital staff will take steps to lower your risk of infection, such as:

Washing their hands
Wearing gloves or masks
Keeping your incisions covered

There are also steps you can take to lower your risk of infection, such as:

Washing your hands often and reminding visitors and staff to do the same
Reminding staff to wear gloves or masks
Not letting others touch your incisions

At Home

It will take a few weeks for the incision and muscles to fully heal. Physical activity will be limited during this time. You will need to ask for help at home and delay your return to work.

Dietary changes, regular exercise, and counseling will need to be part of your recovery and lifelong weight loss plan.

Problems to Look Out For

Call the doctor if you are not getting better or you have:

Signs of infection, such as fever and chills
Redness, swelling, excessive bleeding, or discharge from the incision
Pain that you cannot control with medicine
Pain and swelling in your feet, calves, or legs
Lasting nausea or vomiting
Blood in your stool
Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
Cough
Shortness of breath
Chest pain
New or worsening symptoms

If you think you have an emergency, call for medical help right away.

RESOURCES:

American Society for Metabolic and Bariatric Surgery
https://asmbs.org

National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov

CANADIAN RESOURCES:

HealthLink BC
https://www.healthlinkbc.ca

Weight Loss Surgery
https://weightlosssurgery.ca

References:

Bariatric surgery. Merck Manual Professional Version website. Available at:
...(Click grey area to select URL)
Accessed September 27, 2021.

Bariatric surgery in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/bariatric-surgery-in-adults. Accessed September 27, 2021.

Gastric sleeve or sleeve gastrectomy. UC San Diego Health website. Available at: https://health.ucsd.edu/specialties/surgery/bariatric/weight-loss-surgery/gastric-sleeve/Pages/default.aspx. Accessed September 27, 2021.

Gastric sleeve surgery. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/departments/bariatric/treatments/gastric-sleeve. Accessed September 27, 2021.

Weight-loss (bariatric) surgery. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/weight-management/bariatric-surgery. Accessed September 27, 2021.

Weight management procedures. North Shore Medical Center website. Available at: https://nsmc.partners.org/weight_management/procedures. Accessed September 27, 2021.

Last reviewed July 2021 by EBSCO Medical Review Board Marcin Chwistek, MD
Last Updated: 9/27/2021

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