Vertical Gastroplasty
Vertical gastroplasty, popularly known as stomach stapling, is a type of weight loss surgery. It is also known as vertical sleeve gastrectomy, or VSG. Gastroplasty is considered to be a restrictive method of bariatric surgery because it works by restricting the size of the stomach, and therefore the amount of food that may be consumed. After surgery, patients feel full after eating a small amount of food.
During surgery, a band and staples are used to create a small stomach pouch, removing up to 90 percent of the patient’s stomach. Though vertical gastroplasty is still commonly performed, some surgeons now prefer the adjustable gastric band, and consider it a safer and less invasive alternative.
Are you a good candidate?
Weight loss surgery is intended for patients who are at least 80-100 pounds overweight, with a BMI (body mass index) of at least 40. Patients who are overweight with a BMI of between 30 and 40 may undergo vertical gastroplasty if their weight is affecting their health. For a successful outcome, patients who undergo VSG must be committed to making significant lifestyle changes.
Procedure
The surgery is typically performed in a hospital with general anesthesia. Most surgeries take two to three hours to perform. It may require a lengthy incision in the abdomen, though more commonly it is performed as a laparoscopic procedure, requiring several smaller incisions, each only an inch long. Then, the surgeon uses a small camera and specialized surgical tools to complete the procedure.
During vertical gastroplasty, an incision is made in the stomach. Then, the edges of the incision are stapled to create a hole. A restrictive band is threaded through this hole. After surgery, the band will decrease the speed that food moves through the stomach. Then, the stomach is stapled around this area, cutting off 85% or more of the stomach and forcing food to leave the stomach through the restrictive band. Then, the exterior incisions are closed with sutures or surgical tape.
The result is a tube-shaped stomach with a capacity of about one to two ounces. After surgery, the food must pass through the restrictive ring as it leaves the stomach on its way to the intestines, which slows digestion. The vertical gastroplasty procedure leads to weight loss by making patients feel full faster and limiting the amount of food that can be eaten.
Complications & Risks
Possible complications of surgery include infection, bleeding, and negative reaction to anesthesia. Other health risks after vertical gastroplasty include erosion of the band into the stomach wall or problems with the gastric staple line, such as leakage, which may require a second surgery.
If food is eaten too quickly or is not chewed thoroughly enough, or if the patient overeats, vomiting and severe discomfort can result. Continued overeating may stretch the stomach pouch, making it larger and defeating the purpose of undergoing surgery. Unlike with malabsorptive techniques of weight loss surgery, which affect how nutrients are absorbed by the digestive tract, there is no risk of nutritional deficiencies following vertical gastroplasty surgery.
Recovery Time
Patients usually stay in the hospital for a few days to recover before returning home. Most patients return to their normal activity level and are back to work within about three weeks. However, heavy lifting and strenuous exercise should be avoided for 6-8 weeks after surgery.
During the initial recovery phase, the stomach will be swollen and sore. Your doctor may prescribe pain medication to relieve any discomfort during this time. For the first 2 weeks, patients are restricted to a liquid-only diet to allow their stomach to heal. This is followed by two weeks of a soft and pureed food diet before patients can return to eating solid foods. After undergoing surgery, patients must follow a nutritious diet plan and eat slowly, chewing each bite thoroughly to avoid blocking the narrow channel through their stomach.
Average weight loss within the first three years of surgery is about 60-80 percent of the excess weight. This depends on the patient’s starting weight and adherence to a diet and exercise plan, among other factors.
Vertical Sleeve Gastroplasty Cost
The cost of stomach stapling is around $20,000, though it can vary from as little as $10,000 to as high as $35,000, depending on the patient’s specific situation. These costs may be covered by health insurance, particularly in cases where excess weight has contributed to chronic health conditions such as diabetes or heart disease. Talk to your insurance company to find out if they will cover all or part of the procedure, and whether they have any requirements such as medical tests that must be completed to qualify for this coverage. If you will be paying some or all of the costs of vertical gastroplasty yourself, ask your surgeon about financing plans and payment options.