VSG isn't necessarily better for getting rid of grehlin than plication. See below for what Dr Brad Watkins posted on the subject.
"Ghrelin, the hormone, gets a lot of attention these days.
Here is what we know about ghrelin:
Ghrelin is one of many hormones involved in appetite. We are learning that appetite is a very complex system and part of our body's survival mechanism. The brain wants us to breathe and eat - these two items are at the top of its list! The drive to eat is a very powerful biological drive.
Ghrelin is a feedback hormone and pressure in the wall of the stomach is what suppresses it. In other words, when you eat, the food activates pressure receptors in the wall of the stomach and ghrelin levels go down. If you haven't had the pressure receptors in your stomach activated for a while, ghrelin levels rise and so does hunger.
The most important way to suppress ghrelin levels is PRESSURE. Cutting out stomach that produces ghrelin doesn't eliminate ghrelin. The parts of the stomach that are left can produce lots of ghrelin but if there is pressure (food in the smaller stomach) then ghrelin levels will be low.
After gastric bypass, ghrelin levels go way down even though the entire stomach remains. After Lap Band surgery ghrelin levels are suppressed in general and get low after eating and the food creates PRESSURE in the small gastric pouch. It is the pressure reducing these levels since the entire stomach is still there.
Keep in mind that the ghrelin levels are a small part of a very complex system. When you talk to plication patients they have reduced appetite particularly after a small meal since the food creates pressure and activates the pressure receptors in the wall of the stomach.
There are probably many pharmaceutical companies working on an "anti-ghrelin" drug but it is likely that even if such a drug is created and works, the other hormones involved in appetite will increase over time reducing its effectiveness.
All this to say, the best way to reduce appetite is to stretch the wall of the stomach and if a stomach surgery has been done to reduce its size (band, bypass, plication, stapled sleeve, etc, etc) then you will get appetite reduction on smaller calories. One of the reasons weight loss operations work so well is that you are reducing appetite through normal biological channels, not a drug with side effects and decreased effectiveness over time.
Many people worry about ghrelin levels. The important question is, "does the operation reduce appetite?" If the answer is "YES" then you have a very powerful operation for weight loss regardless of ghrelin levels. We know that weight loss operations are suppressing things that float around in the blood stream that are yet to be discovered.
Vince Lombardi once said, "I don't give a #{:content:}amp;%! about statistics as long as we WIN!"
Brad Watkins MD "