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GASTRIC SLEEVE SURGERY

The Verticle Sleeve Gastrectomy (VSG) is a weight loss surgery that induces weight loss by restricting food intake. With this procedure, the doctor removes approximately 80-85 percent of the stomach laparoscopically so that the stomach takes the shape of a tube or "sleeve." This procedure is usually performed on superobese or high risk patients with the intention of performing another surgery at a later time. This surgery may also be done on regular patients (BMI of 30+) who desire a lower risk procedure than the RNY Bypass while getting similar results. The second procedure a gastric bypass can then be done if necessary for the superobese to reach goal.

The vertical sleeve gastrectomy or the 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 with a capacity ranging from about 60 to 150 cc, depending upon the surgeon performing the procedure. Unlike many other forms of stomach stapling 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. Again, unlike other forms of surgery such as the Roux-en-Y gastric bypass, the vertical sleeve gastrectomy is not reversible.

Because the new stomach continues to function normally there are far fewer restrictions on the foods which patients can consume after surgery, albeit that the quantity of food eaten will be considerably reduced. This is seen by many patients as being one of the great advantages of the vertical gastrectomy, as is the fact that the removal of the majority of the stomach also results in the virtual elimination of hormones produced within the stomach which stimulate hunger.

Perhaps the greatest advantage of the gastric sleeve lies in the fact that it does not involve any bypass of the intestinal tract and patients do not therefore suffer the complications of intestinal bypass such as intestinal obstruction, anemia, osteoporosis, vitamin deficiency and protein deficiency. It also makes it a suitable form of surgery for patients who are already suffering from anemia, Crohn’s disease and a variety of other conditions that would place them at high risk for surgery involving intestinal bypass.

Finally, it is one of the few forms of weight loss surgery in Mexico which can be performed laparoscopically in patients who are extremely overweight or who have a BMI of 30+.

Perhaps the main disadvantage of the vertical sleeve gastrectomy is that it does not always produce the weight loss which people would wish for and, in the longer term, can result in weight regain. This is indeed true of any form of purely restrictive weight loss surgery, but is perhaps especially true in the case of the vertical sleeve gastrectomy.

Because the procedure requires stomach stapling patients do run the risk of leakage and of other complications directly related to stapling of the stomach. In addition, as with any surgery, patients run the risk of additional complications such as post-operative bleeding, small bowel obstruction, pneumonia and even death. The risk of encountering any of these complications is however extremely small and varies from about 0.5 and 1%. Having said this, the risk of death from this form of surgery at about 0.25% is extremely small.

As a general rule the gastric sleeve is best suited to individuals who are either extremely overweight or who are looking to have weight loss surgery with a BMI of 30+. In the case of the former the vertical sleeve gastrectomy would normally form the first of a two-part plan of weight loss, with further bariatric surgery being performed once the patient’s weight has fallen sufficiently to allow for other forms of weight loss surgery to come in to play. In the case of the latter, it is designed as a standalone surgery.

Expected Weight Loss

This combined approach has tremendously decreased the risk of weight loss surgery for specific groups of patients, even when the risk of the two surgeries is added. Most patients can expect to lose 60 to 80% of their excess body weight over a 12 - 24 month period with the gastric sleeve alone. Most non superobese patients may not even need the second procedure to achieve their goal weight. The timing of the second procedure will vary according to the degree of weight loss, typically 6 - 18 months after completion of the first surgery.

Postoperative management.
The patient is allowed to leave the hospital as soon as a few days after the surgery. This is usually on the third post operative day. The patient is restricted to a clear liquid diet for 1 week, a semi-liquid diet for 1 week, followed by a pureed diet for another 3 weeks. If there are no problems, the patient is advanced to a regular diet. Sweets, alcohol and carbonated drinks should be banned. Exercising is encouraged from the second post operative week on.

Vertical Gastrectomy: How it Works

This procedure generates weight loss solely through gastric restriction (reduced stomach volume). The stomach is restricted by dividing it vertically and removing more than 85% of it. This part of the procedure is not reversible. The stomach that remains is shaped like a 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 functions of 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-Y gastric bypass stomach can be reconnected (reversed) if necessary. Note that there is no intestinal bypass with this procedure, only stomach reduction.

Advantages of the Vertical Gastrectomy Weight Loss Surgery

The stomach is reduced in volume but tends to function normally so most food items can be consumed, albeit 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 30-45 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 over 500 pounds.
Disadvantages of the Vertical Gastrectomy Weight Loss Surgery

Potential for inadequate weight loss or weight regain. While this is true for all procedures, it is theoretically more possible with procedures that do not have an intestinal bypass.
Higher BMI patients will most likely need to have a second stage procedure later to help lose the rest of the weight. Two stages may ultimately be safer and more effective than one operation for high BMI patients. This is an active point of discussion for bariatric surgeons.
Soft calories such as ice cream, milk shakes, etc can be absorbed and may slow weight loss.
This procedure does involve stomach stapling and therefore leaks and other complications related to stapling may occur.
Because the stomach is removed, it is not reversible. It can be converted to almost any other weight loss procedure.

Vertical Gastrectomy: Risks and Complications
As with any surgery, there can be complications. This list can include:

Deep vein thrombophlebitis 0.5%
Non-fatal pulmonary embolus 0.5%
Pneumonia 0.2%
Acute respiratory distress syndrome 0.25%
Splenectomy 0.5%
Gastric leak and fistula 1.0%
Postoperative bleeding 0.5%
Small bowel obstruction 0.0%
Death 0.25%
Post-Op Dietary Plan for Vertical Gastrectomy Weight-Loss Surgery Patients

As with all surgical weight-loss programs, it is imperative that gastric sleeve patients adhere to a strict postoperative diet. Once goal weight is achieved, usually 1-2 years after surgery, most patients can consume about 1000-1200 calories per day.

Long-Term Weight-Loss Results

On average, patients who undergo Vertical Gastrectomy surgery experience a 60-80% loss of excess weight.
State of the Art technology and procedures done in State of the Art facilities!  Our Doctors only use the finest  hospitals in Puerto Vallarta, ones that are state of the art, with clean, sterile, and the very best equipment available.  The operating rooms are designed specifically for bariatric surgery and the doctors make sure that they have met all of their requirements.

When you are in Puerto Vallarta and your doctor is providing you service during your medical tourism vacation, if there is an emergency you may contact the doctor, 24 hours a day via telephone or email.  Someone will be available to assist you!

You may also contact us at info@drjoya.com

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Call us @: 866.509.0571
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Please feel free to contact us with any questions, concerns, that you may have regarding our services. If you would like to contact us via e-mail, please forward your information to info@drjoya.com and one of our friendly staff members will contact you directly or via email within 24 hours.  We can provide you with a risk free price quote based on the information you provide.  You may also call us toll free at 866.509.0571 or 817.405.2778
At DRJOYA.com we are all well trained, and bilingual, speaking both English and Spanish.  We have been working in the Medical Tourism industry for more than 15 years.  By selecting to have your surgery with us, you not only get the best doctors in Puerto Vallarta to assist you during your surgery, you also get top notch care before surgery, where you questions are answered usually in less than 24hours, to post op where we are here for you as well.  If you don't have insurance and are looking to go overseas for weight loss surgery, then let us bring you to beautiful Puerto Vallarta.  Our staff will get you the answers to your questions and assist you with getting all of your travel preparation needs in order.  Our staff will also assist you with any other specific needs you may have.  

All of the Doctors and staff that work with our doctors speak English and are University trained.  The Hospitals are also accredited and are located  in the heart of Puerto Vallarta and accessible from every hotel.  The hotel and hospitals are about 10 minutes from the airport.  
We are completely committed to delivering quality medical care to prospective patients.  With our doctors you not only get the best doctors in Mexico for your surgery, but you also get doctors who specialize in the Gastric Bypass, Gastric Sleeve surgery, Gastric Bypass Revision surgeries, Duodenal Switch Surgeries and doctors who have helped patients worldwide lose millions of pounds a year, and all of these treatments can be done at savings over what they cost in the US. The  hospitals in Puerto Vallarta have been approved by and work with most major American Insurance companies.

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