A vertical gastric sleeve, also known as a sleeve gastrectomy, is a weight-loss surgery designed to help individuals with obesity achieve significant and sustainable weight reduction. This procedure involves removing approximately 75-80% of the stomach, leaving a narrow, tube-like structure that resembles a sleeve. The reduced stomach size restricts the amount of food that can be consumed and also decreases hunger by lowering levels of ghrelin, the hormone responsible for appetite regulation.

The surgery is typically performed laparoscopically, meaning it is minimally invasive, with small incisions and a quicker recovery time compared to traditional open surgery. Patients usually begin to see noticeable weight loss within a few months, with many achieving their weight-loss goals within one to two years. Additionally, vertical gastric sleeve surgery has been shown to improve or resolve obesity-related health conditions, such as type 2 diabetes, hypertension, and sleep apnoea.

While the vertical gastric sleeve offers numerous benefits, it requires a commitment to significant lifestyle changes. Patients must adhere to a structured diet, regular exercise, and lifelong medical follow-ups to maintain their results and prevent complications. For those struggling with obesity and its related health issues, the vertical gastric sleeve provides an effective and life-changing solution when combined with the right support and dedication.

Overview of Vertical Gastric Sleeve Surgery

Vertical gastric sleeve surgery, commonly referred to as sleeve gastrectomy, is a bariatric procedure designed to assist individuals in achieving substantial weight loss. The surgery involves removing approximately 75-80% of the stomach, leaving behind a slender, tubular structure. This reduction in stomach size limits food intake and promotes early satiety while also significantly decreasing the production of ghrelin, the hunger hormone, helping patients manage their appetite more effectively. Typically performed laparoscopically, the procedure is minimally invasive, resulting in shorter hospital stays and quicker recovery times compared to open surgeries.

This surgery not only facilitates weight loss but also offers significant improvements in obesity-related health conditions such as type 2 diabetes, hypertension, and sleep apnoea. However, it requires a lifelong commitment to healthy eating, regular physical activity, and ongoing medical follow-up to ensure long-term success. With proper support and adherence to post-operative guidelines, vertical gastric sleeve surgery can serve as a transformative solution for those struggling with obesity and its associated health challenges.

How Does a Vertical Gastric Sleeve Work?

Vertical gastric sleeve surgery works by altering the size and function of the stomach to promote weight loss and improve overall health. The procedure removes approximately 75-80% of the stomach, leaving a narrow, sleeve-shaped structure that restricts food intake and reduces the volume the stomach can hold. Additionally, the removal of the larger portion of the stomach decreases the production of ghrelin, the hormone responsible for hunger, helping patients feel less hungry and more satisfied with smaller meals.

Key Ways the Vertical Gastric Sleeve Promotes Weight Loss:

• Restricts Food Intake: The smaller stomach limits the amount of food that can be consumed at one time, encouraging portion control.
• Reduces Appetite: Lower levels of ghrelin decrease hunger signals, making it easier to manage cravings.
• Improves Metabolic Health: Weight loss achieved through the surgery often leads to improvements in conditions such as type 2 diabetes, hypertension, and high cholesterol.
• Supports Sustainable Change: The physical changes encourage healthier eating habits and facilitate long-term weight management.

Who Is a Candidate for Vertical Gastric Sleeve Surgery?

Vertical gastric sleeve surgery is an effective option for individuals struggling with obesity, particularly those who have not achieved significant weight loss through diet, exercise, or other non-surgical methods. It is most suitable for patients who meet specific health criteria and are committed to making the necessary lifestyle changes to ensure long-term success.

Ideal Candidates for Vertical Gastric Sleeve Surgery:

• Body Mass Index (BMI): Individuals with a BMI of 40 or higher, or those with a BMI of 35-39.9 accompanied by obesity-related health conditions such as type 2 diabetes, hypertension, or sleep apnoea.
• Age Range: Adults typically between the ages of 18 and 65, though exceptions may be considered based on medical evaluation.
• Health Status: Patients without severe medical conditions that could increase surgical risks, such as advanced heart or liver disease.
• Commitment to Change: Those who are willing to adhere to a strict post-surgery diet, engage in regular physical activity, and attend follow-up medical appointments.

Risks and Complications of Vertical Gastric Sleeve Surgery

Like any surgical procedure, vertical gastric sleeve surgery carries certain risks and potential complications. While it is considered a relatively safe and minimally invasive bariatric option, understanding the possible outcomes is essential for informed decision-making. Most complications are rare and manageable with proper care and follow-up.

Short-Term Risks:

• Bleeding and Infection: Common surgical risks that may require additional treatment or antibiotics.
• Staple Line Leaks: A rare but serious complication where the stomach’s surgical seam fails, potentially leading to infection or the need for further surgery.
• Blood Clots: Risk of deep vein thrombosis (DVT) or pulmonary embolism, minimised through early mobilisation and preventive measures.
• Nausea or Vomiting: Often temporary, related to dietary adjustments or sensitivity during recovery.

Long-Term Risks:

• Acid Reflux: Some patients may develop or experience worsening gastroesophageal reflux disease (GERD) post-surgery.
• Nutritional Deficiencies: While less common compared to other bariatric procedures, deficiencies in iron, vitamin B12, or calcium can occur without proper supplementation.
• Weight Regain: Possible if patients do not adhere to long-term dietary and lifestyle changes.
• Gastric Stricture: A narrowing of the stomach sleeve, which may require medical intervention.

Recovery Process After Vertical Gastric Sleeve Surgery

The recovery process following vertical gastric sleeve surgery is typically smooth, thanks to the minimally invasive laparoscopic technique. Most patients stay in the hospital for one to two days to monitor for any immediate post-operative complications. During this time, pain and discomfort are managed with medication, and patients are encouraged to begin walking to reduce the risk of blood clots and promote healing. Returning to light daily activities is often possible within a week, while full recovery may take four to six weeks.

Post-surgery, patients follow a structured diet plan to allow the stomach to heal and adapt to its new size. This begins with a liquid diet, progressing to pureed foods, and eventually transitioning to soft and solid foods over several weeks. Adhering to hydration and protein intake recommendations is crucial during this period. Regular follow-up appointments with the surgical team ensure that the recovery is on track and help address any concerns, such as nausea, fatigue, or dietary adjustments. With proper care and commitment, most patients experience significant improvements in their health and quality of life.

Vertical Gastric Sleeve vs. Other Weight Loss Surgeries

Vertical gastric sleeve surgery stands out among weight-loss procedures due to its balance of effectiveness, simplicity, and lower risk profile. Unlike gastric bypass, which reroutes the digestive system, the sleeve involves removing a portion of the stomach without altering nutrient absorption. This makes it a suitable choice for patients who want significant weight loss with a reduced risk of long-term nutritional deficiencies. Compared to adjustable gastric banding, the sleeve offers more consistent and sustainable results without the need for device adjustments.

While gastric bypass may provide faster and more dramatic weight loss, particularly for patients with severe obesity or type 2 diabetes, it requires a greater commitment to lifelong supplementation and carries a higher risk of complications such as bowel obstruction or dumping syndrome. In contrast, the gastric sleeve is often chosen for its less invasive nature and shorter recovery time. Ultimately, the choice between these procedures depends on individual health conditions, weight-loss goals, and lifestyle preferences, underscoring the importance of a thorough consultation with a bariatric specialist.

Long-Term Results of Vertical Gastric Sleeve Surgery

Vertical gastric sleeve surgery has proven to be an effective long-term solution for significant and sustained weight loss. Most patients achieve a reduction of 50-60% of their excess weight within the first two years after surgery, with results often stabilising thereafter. Beyond weight loss, the surgery offers numerous health benefits, including the improvement or resolution of obesity-related conditions, enhancing overall quality of life.

Key Long-Term Benefits:

• Sustained Weight Loss: Many patients maintain their weight loss with adherence to lifestyle changes.
• Improved Health Conditions: Significant improvements in type 2 diabetes, hypertension, sleep apnoea, and joint pain are commonly reported.
• Enhanced Quality of Life: Increased mobility, higher energy levels, and improvements in mental well-being are notable outcomes.
• Lower Risk of Complications: Compared to other bariatric procedures, the sleeve has a lower risk of long-term nutritional deficiencies.

Potential Challenges:

• Weight Regain: A small percentage of patients may experience weight regain due to poor adherence to dietary and lifestyle recommendations.
• Acid Reflux: Some patients develop or experience worsening gastroesophageal reflux disease (GERD) post-surgery.
• Nutritional Monitoring: Lifelong monitoring and supplementation may still be required to prevent deficiencies.

With proper post-operative care, including dietary adherence, regular exercise, and medical follow-up, vertical gastric sleeve surgery provides a durable and transformative solution for those struggling with obesity and its associated health issues.