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Bariatric Surgery/Details of VSG surgery

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Question
Hi Karla, you replied to me recently and recommended the VSG as my best bet. My BMI is 38, Im 5"4 and 30yrs old and weigh 217lbs. Ive recently read horror stories about the VSG leaking and a woman having to go on a feeding tube. This makes me a little bit nervous. I've also heard it's irreversible. Is there a possibility they can make your stomach too small? Also can you still drink alcohol in small amounts? What are the usual side effects following this surgery? Is this the most safe?  Thanks Karla

Answer
Hi Sophia:

You're right in that the sleeve is irreversible.  Once they remove your stomach, you can't get it back.  However, even though they do remove most of the fundus (the stretchy bit), your sleeve will still stretch over time, so you will be able to eat more at 5 years out than at say 1 year out.  (However, it will never stretch back to the size of a "normal" stomach).

There are always a few horror stories out there; however, the sleeve has a very good safety record.  The key is choosing your surgeon. You want an experienced surgeon... one who not only who has done at least 100 sleeves, but is also continuing to operate regularly.  (So you don't want somebody who did 100 sleeves three years ago, but has only done 5 since then.)  

Leaks and other complications do happen, but their rate is extremely low.  Even if she were on a feeding tube, it is unlikely to be permanent, but only until her stomach healed.  The risk of serious complication 30 days after surgery is around 1% http://asmbs.org/2012/06/new-studies-weigh-in-on-safety-and-effectiveness-of-new

The Lap-Band has an even lower rate, but it's results are not as good long-term.

Having said all that, you can die from any surgery.  It's not common, but it is a very real possibility.  That's why surgeons insist on pre-op tests and the like... to ensure that you are healthy enough for surgery.  The VSG is the surgery that they choose to do on the heaviest people, those with BMIs over 60 or 70.  One can assume that if it's viewed as safe for somebody with that high of a BMI, it should be quite safe for somebody your size.

Sometimes stomachs are made too small, and then a gastroenterologist goes in and dilates the sleeve (through the mouth) with a balloon or what not.  It's rare, though, and I've only heard of it being done in a few cases.  Typically, a sleeve is sized over a bougie (French for tube) of 32F-36F.  I wouldn't go smaller (or larger) than that.

Yes, you can drink, but it's best to be a little cautious in seeing how your body reacts. (So drink at home until you know more).  You're eating less, your BMI is going down, so alcohol will have a stronger effect.

Hope this helps.

Karla

Bariatric Surgery

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Karla K.

Expertise

I'm very familiar with the four main types of bariatric surgery: Lap-Band/Adjustable Gastric Band, Vertical Sleeve Gastrectomy, Roux-en-Y, and Duodenal Switch. I'm familiar with the Mini-Gastric Bypass and Revisions as well. I'm also beginning my seventh year post-op as a successful bariatric patient--so I can answer questions regarding pre-op, post-op honeymoon, and maintenance phases. I'm less familiar with the nuances of plastic surgery following bariatric surgery--but I do know a bit.

Experience

Have been an avid researcher of the science of obesity and bariatric surgery for over ten years now. My professional career used to involve medical device research.

Education/Credentials
Master's in Business Administration.

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