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Vertical Sleeve Gastrectomy—Open

(Sleeve Gastrectomy—Open; VSG—Open)

by Sarah J. Kerr, BA

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

Definition

Reasons for Procedure

Possible Complications

What to Expect

Call Your Doctor

En Español

Definition

Vertical sleeve gastrectomy (VSG) is surgery to decrease the structure and size of your stomach. This restricts the amount of food you are able to consume.

The Stomach

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

Reasons for Procedure

Body mass index (BMI) determines if a person is overweight or obese. A normal BMI is 18.5-25. This surgery is an option for people with:

BMI greater than 40
BMI 35-39.9 and a life-threatening condition or severe physical limitations that affect employment, movement, and family life

If lifestyle changes are made, the benefits of VSG include:

Weight reduction
Improvement in obesity-related conditions
Improved movement and stamina
Enhanced mood and self-esteem

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

Stitches or staples may loosen
Pouch stretches or leaks
Bleeding
Infection
Reaction to anesthesia
Heart attack
Blood clots
Nausea, vomiting

Long-term complications include vomiting and gallstones.

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

Smoking
Drinking
Chronic disease such as diabetes

What to Expect

Prior to Procedure

Each bariatric surgery program has specific requirements. Your program will likely include the following:

Physical exam and review of medical history
Blood test and other tests to check your health
Meetings with a registered dietitian
Mental health test and counseling

Prior to the procedure:

Talk to your doctor about your medications, herbs, and dietary supplements. You may be asked to stop taking some medications up to one week before the procedure.
You may be given antibiotics.
You may be given laxatives or an enema.
Arrange for a ride to and from the hospital.
The night before, eat a light meal. Do not eat or drink anything after midnight.

Anesthesia

General anesthesia will be given through an IV. It will block pain and keep you asleep through the surgery.

Description of the Procedure

An 8-10 inch incision will be made to open the abdomen. Surgical staples will divide the stomach vertically. The new stomach will be the shape of a slim banana. The rest of the stomach will be removed. Your new stomach can hold 50-150 mL (milliliters) of food—about 10% of what a normal adult stomach can hold.

Staples or stitches will be used to close the incision.

Immediately After Procedure

The breathing tube and catheter will be removed.

How Long Will It Take?

About 2 hours

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay

The usual length of stay is 4-6 days. If there are any problems, you will need to stay longer.

Post-procedure Care

At the Hospital

You can expect the following after the procedure:

A small thin tube with a camera will be used to look down your throat and into your stomach to check for problems.
You will receive nutrition through an IV at first, but slowly start eating again.
Your bowels will work more slowly than usual. Chewing gum may help speed the process of your bowel function returning to normal.

While in the hospital, you may be asked to:

Use a device called an incentive spirometer to prevent breathing problems
Wear elastic surgical stockings or boots to promote blood flow in your legs
Get up and walk daily

Preventing Infection

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

Washing their hands
Wearing gloves or masks
Keeping your incisions covered

There are also steps you can take to reduce your chance of infection such as:

Washing your hands often and reminding visitors and healthcare providers to do the same
Reminding your healthcare providers to wear gloves or masks
Not allowing others to touch your incision

At Home

You will need to practice lifelong healthy eating and exercising habits. After your surgery:

Do not lift anything heavy for at least 2 weeks.
You may have emotional changes after this surgery. Your doctor may refer you to a therapist.
You will meet regularly with your healthcare team for monitoring and support.

For good nutrition:

Eat a clear liquid diet for about 1 week or as advised by your doctor.
You will begin with 4-6 small meals per day. A meal is 2 ounces of food.
Progress from soft, pureed foods to regular foods.
Solid food must be well-chewed.
Get enough protein.
Do not eat too much or too quickly.
Avoid high-calorie foods.
Avoid dehydration by drinking fluids before or after meals.

Call Your Doctor

Contact your doctor if your recovery is not progressing as expected or you develop complications such as:

Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
Persistent cough, shortness of breath, or chest pain
Worsening abdominal pain
Blood in the stool
Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
Persistent nausea or vomiting
Pain and/or swelling in your feet, calves, or legs
New or unexpected symptoms

If you think you have an emergency, call for emergency medical services 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. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T483434/Bariatric-surgery . Updated October 23, 2017. Accessed December 22, 2017.

Bariatric surgery. Merck Manual Professional Version website. Available at:
...(Click grey area to select URL)
Updated December 2016. Accessed December 22, 2017.

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 December 22, 2017.

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 December 22, 2017

Gastric sleeve surgery. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/departments/bariatric/treatments/gastric-sleeve. Accessed December 22, 2017.

Sleeve gastrectomy. Virginia Mason Medical Center website. Bariatric Surgery Center of Excellence website. Available at: https://www.virginiamason.org/sleeve-gastrectomy. Accessed December 22, 2017.

Weight management procedures. North Shore Medical Center website. Available at: https://nsmc.partners.org/weight_management/procedures. Accessed December 22, 2017.

3/23/2015 DynaMed Plus Systematic Literature Surveillance http://www.dynamed... : Short V, Herbert G, Perry R, et al. Chewing gum for postoperative recovery of gastrointestinal function. Cochrane Database Syst Rev. 2015;(2):CD006506.

Last reviewed November 2018 by EBSCO Medical Review Board Marcin Chwistek, MD
Last Updated: 3/23/2015

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