Gastric Sleeve vs. Stomach Stapling

Question Below Submitted By:  

Anonymous (a patient from Miami)


23 years ago I had my stomach stapling. In the beginning it was a great success. Unfortunately, in 2001 I had to have some of the staples removed as I suffered terribly from reflux, constant vomiting and I was very dehydrated.

So, as a result, I have slowly gained back all the weight plus some since then. Now in 2017, weight loss surgery is more advanced and I am once again considering this path.

But I wanted to know if gastric sleeve is the same surgery as the stapling. Is the opening into your stomach made smaller where your food passes through or is it just your stomach that is reduced? Can you eventually eat small regular meals or will you always have to eat soups?


Expert Responses to the Question Above

Surgeon Response to "Gastric Sleeve vs. Stomach Stapling"

by: John Rabkin, M.D., Pacific Laparoscopy

Dear 'Stomach Stapling' Patient,

Today's Verticle Sleeve Gastrectomy (VSG) is very different from the "stomach stapling" procedure you underwent 23 years ago.

Twenty-three years ago you likely had a horizontal gastroplasty which entails stapling off a very small portion of the top of the stomach and separating it from the remainder of the stomach except for a small opening connecting the two to allow for the slow passage of your ingested food into the lower/main portion of the stomach.

The small capacity of the upper portion provided you with a feeling of satiety (feeling of fullness) after consuming only a very small amount of food. However, this also created the severe reflux that prompted you to have some of the staples removed which compromised the efficacy of the procedure in terms of the weight loss achieved.

With the VSG, the greater curvature (stretchy side) of the stomach is entirely removed leaving the remaining stomach a banana shaped tube of approximately two to three ounces capacity based on the stomach's lesser curvature which is more rigid and less likely to stretch out than the portion of the stomach removed.

This has been found to be a much more effective tool to promote weight loss than the historic "stomach stapling" procedures like you previously underwent. Unfortunately, many patients also have symptoms of reflux after the VSG, again primarily due to the small capacity of the remaining stomach.

However, many patients who undergo the VSG are also found to have a hiatal hernia (enlarged opening of the diaphragm through which the esophagus passes from the chest into the abdomen) which exacerbates the reflux symptoms. The hiatal hernia (if present) can routinely be repaired at the same time as the VSG lessening the reflux symptoms patients may experience after undergoing the VSG.

Furthermore, most morbidly obese patients who experience reflux enjoy some relief from those symptoms as they lose their excess weight. Consequently, although you may initially have worse symptoms of reflux after undergoing the VSG, you can look forward to gradual improvement of the reflux symptoms over time as you lose weight following your procedure.

John M. Rabkin, M.D.
Pacific Laparoscopy

(click here for Dr. Rabkin's full bio & contact info)

DISCLAIMER: This educational advice is based on the depth of your question and the details provided. The above should never replace the advice of your local physicians as they have the ability to evaluate you in person.

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Patient Responses to the Question Above

Gastric surgery or staple

by: Ann

Neither, there is a newer procedure if you fall between 30 to 100 lbs. to lose. Obalan balloon. It's nonsurgical, a 10 min process and successful. Please google it for more information. I just read about it in my area in San Diego. There seems to be a few places that offer this procedure.

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