The Vertical Gastrectomy procedure (also called vertical Sleeve Gastrectomy, Greater Curvature Gastrectomy, Parietal Gastrectomy, Gastric Reduction and even Vertical Gastroplasty) generates weight loss by restricting the amount of food that can be eaten (removal of stomach or vertical gastrectomy) without any bypass of the intestines or malabsorption. The stomach pouch is usually made smaller than the pouch used in the Duodenal Switch.
Of the procedures that are currently performed for the treatment of obesity, it is ideal
for patients who have very high medical risk, high weight or BMI, complex surgical
histories or those who are fearful of potential complications from an intestinal bypass. It is also ideal for lower BMI patients who wish to avoid a more complex
intestinal bypass or the possibility of vitamin or nutritional deficiencies secondary to
procedures which cause malabsorption. Patients interested in Gastric Banding may
also want to consider this procedure, since it avoids theforeign body issue of a Band. Patients using anti-inflammatory medications also should consider this procedure be
cause ulcer risk is probably less than after gastric bypass or band procedures.
Restriction (Vertical Gastrectomy): The stomach is restricted by dividing it vertically and removing more than 85 percent of it. This part of the procedure is not reversible. The stomach that remains is shaped like a thin banana and measures from 2-5 ounces (60 - 150cc) depending on the surgeon performing the procedure. The nerves to the stomach and the outlet valve (pylorus) remain intact with the idea of preserving the functionsof the stomach while reducing the volume. By comparison, in a Roux-en-Y gastric bypass, the stomach is divided, not removed, and the pylorus is excluded. The Roux-en-Ygastric bypass stomach can be reconnected (reversed) if necessary.
Note that there is no intestinal bypass or malabsorption with this procedure, only stomach reduction.
- Stomach volume is reduced, but it tends to function normally so most food items can be consumed in small amounts.
- Eliminates the portion of the stomach that produces the hormones that stimulates hunger (Ghrelin).
- No dumping syndrome because the pylorus is preserved.
- Minimizes the chance of an ulcer occurring.
- By avoiding the intestinal bypass, the chance of intestinal obstruction (blockage), anemia, osteoporosis, protein deficiency and vitamin deficiency are almost eliminated.
- Very effective as a first stage procedure for high BMI patients (BMI >55 kg/m2).
- Limited results appear promising as a single stage procedure for low BMI patients (BMI 35-45 kg/m2).
- Appealing option for people with existing anemia, Crohn’s disease and numerous other conditions that make them too high risk for intestinal bypass procedures.
- Can be done laparoscopically in patients weighing more than 500 pounds.