Laparoscopic Vertical Sleeve Gastrectomy Back Laparoscopic vertical sleeve gastrectomy (VSG) is a new restrictive procedure that can be an alternative to gastric banding, with no foreign body implantation. It can be done as a standalone procedure, or as a stage procedure for high risk patients. Typically, the expected weight loss is approximately 45 – 50% of excess body weight, which is comparable to the gastric banding (Lap Band). Laparoscopic Sleeve Gastrectomy (VSG) versus Lap Band The advantages of the VSG over the Lap Band are: No erosion problem No band slippage resulting in prolapse associated with Lap Band. The disadvantage of VSG over Lap Band is: Small possibility of leak, resulting in infection The Operation With this operation, the pylorus is preserved. The pylorus acts like a valve to slowly allowing food to go into the small intestine. There is no rearrangement of bowel, which means there is no dumping syndrome or marginal ulcer associated with gastric bypass. Surgery is done with 5 to 6 small incisions. Typical hospital stay is overnight, and there is no nasogastric tube or drain. Typical patient can return to work in a week, with little restriction. Weight Loss Mechanism The bulk of the stomach is resected, where the stomach is now fashioned into a tube with the volume about 100 cc. This decreases the volume of food intake, result in full sensation.