Bariatric surgery is an effective treatment for severe obesity, but the various terms used for the same procedures often cause confusion. Understanding the specific terminology and mechanisms behind these operations is the first step in making an informed decision. This article clarifies the relationship between common surgical terms and provides a detailed overview of the most popular procedure.
Clarifying the Terminology: VSG and Gastric Sleeve
VSG and Gastric Sleeve refer to the exact same surgical procedure. VSG is the acronym for Vertical Sleeve Gastrectomy, which is the formal medical name for the operation. “Gastric Sleeve” is the common, simplified name used by patients and many healthcare providers. This type of bariatric surgery is currently the most frequently performed weight loss procedure globally.
The Mechanism of Vertical Sleeve Gastrectomy
The Vertical Sleeve Gastrectomy permanently reduces the size of the stomach. A surgeon removes approximately 75 to 85% of the stomach, leaving behind a narrow, tube-like structure that resembles a banana. This newly created “sleeve” significantly limits the amount of food a person can consume, creating an earlier and prolonged feeling of fullness.
The procedure’s effectiveness incorporates significant hormonal changes beyond simple restriction. The portion of the stomach removed, known as the fundus, is the primary site for producing the hunger-stimulating hormone Ghrelin. Excising the fundus causes a drastic decrease in circulating Ghrelin levels. This reduction helps suppress appetite, contributing substantially to the surgery’s success. Furthermore, the rapid delivery of food to the small intestine triggers an increase in gut hormones like GLP-1 and PYY, which enhance satiety and improve glucose metabolism.
Recovery and Long-Term Outcomes
The Vertical Sleeve Gastrectomy is typically performed laparoscopically, utilizing small incisions. This contributes to a relatively short recovery period, with most patients spending only one to two days recovering in the hospital. A return to normal, non-strenuous activities often occurs within two to four weeks.
The long-term results of VSG focus on sustained weight loss and the resolution of obesity-related health conditions. Patients typically achieve an excess weight loss (EWL) between 50% and 70% in the first one to two years after surgery. This reduction frequently leads to the improvement or complete remission of comorbidities such as Type 2 Diabetes, hypertension, and obstructive sleep apnea. To maintain these results, patients must commit to lifelong changes in diet, nutritional supplementation, and physical activity.
How VSG Differs from Other Bariatric Surgeries
The Vertical Sleeve Gastrectomy is fundamentally different from other common bariatric procedures based on its mechanism of action. Unlike the Roux-en-Y Gastric Bypass (RNY), the VSG is primarily restrictive and hormonal; it does not rearrange or bypass a portion of the small intestine. The RNY procedure is both restrictive and malabsorptive because it reroutes the small intestine, leading to fewer calories being absorbed. Consequently, VSG has a lower risk of long-term nutritional deficiencies compared to RNY.
The VSG also contrasts sharply with the Adjustable Gastric Band, which is a purely restrictive, reversible procedure. The band involves placing an inflatable device around the upper stomach to create a small pouch, but it does not involve permanent alteration or removal of stomach tissue. Because the VSG involves permanent removal of stomach tissue, it offers a distinct advantage in appetite suppression due to the reduction in Ghrelin.
Ultimately, the VSG is often considered a middle-ground option. It is simpler than the RNY but more effective and permanent than the gastric band.