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Dr. Matthew Brengman and Dr. Gregory Schroder form Central Virginia's most experienced and recommended surgical gastric sleeve team, based in Richmond, Va.

What is a Vertical Sleeve Gastrectomy?

The vertical sleeve gastrectomy (also referred to as a "gastric sleeve") is a restrictive form of weight-loss surgery in which approximately 85% of the stomach is removed, leaving a cylindrical or sleeve-shaped stomach, which is about the size of a banana. With this surgery, the outlet valve and the nerves to the stomach remain intact and, while the stomach is drastically reduced in size, its function is preserved.

For obese patients with a relatively low BMI, the vertical sleeve gastrectomy may be a good choice, especially where existing conditions such as anemia or Crohn’s disease prevent them from having other forms of bariatric surgery. In addition, patients may choose this form of surgery if they are concerned about the long-term effects of bypass surgery or object to having a "foreign body" implanted into their body, as is the case with an adjustable gastric band.

Watch Dr. Matthew Brengman Discuss Sleeve Gastrectomy >>

How is the Sleeve Gastrectomy procedure performed?

Most sleeve gastrectomy procedures are now performed laparoscopically, which is a minimally-invasive technique. During the procedure, several small cuts will be made in your abdomen. Gas will be pumped in to inflate your abdomen, making it easier for the doctor to see. A laparoscope (a thin, lighted tool affixed with a tiny camera) and surgical tools will be inserted through the incisions. The laparoscope sends images of your abdominal cavity to a monitor, through which your surgeon will view his work during the procedure.

Surgical staples will be used to divide the stomach vertically, leaving a new, smaller stomach pouch, which can hold 50-150 mL (milliliters) of food — about 10% of what a normal adult stomach can hold. Incisions will be closed with staples or stitches. The gastric sleeve results in fewer restrictions on the foods that patients can consume after surgery, although the quantity of food eaten is still considerably reduced. It does not involve any bypass or the intestinal tract.

Primary Advantages of Sleeve Gastrectomy:

  • Limits the amount of food that can be eaten at a meal.
  • Food passes through the digestive tract in the usual order, allowing vitamins and nutrients to be fully absorbed into the body.
  • No postoperative adjustments are required.
  • In clinical studies, patients lost an average of 55% of their excess weight.
  • Shown to help resolve high blood pressure and obstructive sleep apnea, and to help improve type 2 diabetes and hyperlipidemia.

Disadvantages of the sleeve gastrectomy are that weight loss can be slow if a patient does not follow a strict diet, complications can result from stomach stapling, and patients with high BMI can require future treatment to achieve their goal. This procedure is also not reversible. As with any surgery, you should review your risks with your care team prior to your procedure.