Vertical Gastrectomy

Anatomy

The Vertical Gastrectomy creates a banana shaped stomach by resecting the lateral aspect of the stomach. This reduces the stomach capacity from about 16 ounces to less than 4 ounces in size. The pylorus, vagus nerves and antral pump are all intact preserving the functional integrity of the stomach.

How it Works

Vertical GastrectomySimilar to the DS, the patients lose weight related to the reduced stomach size. Patients may then be able to adjust their eating behavior and maintain this weight loss, however, if they start to gain weight due to the expansion of the stomach over time, discussion of conversion to the DS can then be entertained.

Advantages

This is purely a restrictive procedure and as such, one does not have to take additional vitamins and supplements except a multivitamin. Like the DS, normal gastric emptying is maintained and dumping does not occur. Marginal ulcers also do not occur and these patients tolerate aspirin and NSAIDS, which are commonly not tolerated with conventional RGB. It is also an operation which can be performed laparoscopically in about 1 hour, giving the highest risk patients the ability to proceed with weight loss surgery when the other more involved procedures would be contraindicated.

Risks

Although the same risks are present, the chance of a leak is extremely low as there are no anastomoses done. In addition, most post-operative problems are related to the length of surgery, blood loss, fluid shifts, etc. In this procedure, because of its simplicity, the risks of these complications are reduced.


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