How much weight will I lose?

This is obviously a key question. Unfortunately, there is no long term data to give us a good answer. Preliminary data suggests that weight loss may be similar to that attained with Roux-en-Y gastric bypass.

Can the staples tear out?

No. Once you have recovered from the surgery, your body's own scar tissue heals the stomach tissue together, just as your skin stays healed long after sutures or staples are removed.

What are the staples made of?

Staples are made of titanium. You can have an MRI scan, and you can go through the detectors at the airport without any problems.

What is a Bougie, and what size do you use?

A bougie is a soft flexible rubber tube that comes in multiple sizes. They are designed to stretch esophageal strictures. We use them to calibrate the size of the gastric sleeve. The size indicates the circumference in millimeters. I use a Size 32 bougie, which translates to a diameter of about 10 millimeters or 0.4 inches. This is very thin, and explains why you can't eat very much!

Why do I have to take vitamins?

The sleeve gastrectomy operation is purely restrictive, so technically you don't need to take vitamins if you are eating a healthy diet. On the other hand, by definition you are eating a hypo-caloric diet, one which will cause you to lose weight. Because of this, we worry that you won't get all the vitamins and minerals you need. This is the main reason we ask you to take vitamins after the surgery.

What are the advantages of the operation over gastric bypass?

There is no rerouting of the intestines, and no new connections need to be made. This makes it safer, easier, and faster to perform. The lack of rerouting eliminates the late risk of bowel obstruction from internal hernia that comes with the gastric bypas operation. Finally, the lack of rerouting also reduces the risk of vitamin and mineral deficiencies. Another advantage is that the operation is ideally suited for conversion to another procedure such as gastric bypass, duodenal switch, or even LapBand.

What are the disadvantages as compared to gastric bypass?

The main disadvantage is that we don't have long-term data to document that weight loss will be maintained. The sleeve may stretch out, resulting in weight regain. Another disadvantage is that the operation is not reversible, in that part of the stomach is removed and thrown away. It can never be replaced. (On the other hand, there should be no reason to want to put it back).

What are the advantages of the VSG over the LapBAND?

With the VSG there is no foreign body to break, slip, or erode. There is nothing to be adjusted. Reoperation rate for these complications is therefore eliminated. You don't need to worry about getting follow-up care if you move to another city.

Weight loss is faster and more reliable with the VSG. The feeling of fullness that you get from the VSG is much more satisfying than the feeling of obstruction or discomfort that you get with the LapBAND. Few patients vomit after the VSG, while many patients continue to have vomiting episodes long after they have their LapBANDs placed.

What are the disadvantages as compared to the LapBAND?

The LapBAND is reversible; the VSG is not. Unfortunately this turns out not to be much of an advantage of the LapBAND, as the only reason to remove a LapBAND is for complications.

If you have questions that have not been answered by this FAQ, please send them to me and I will try to answer them for you.

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Mark A Pleatman MD
43494 Woodward Ave. #202
Bloomfield Hills, Michigan 48302