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Vertical Banded Gastroplasty

Vertical Banded Gastroplasty

This is another procedure which imposes portion control by stapling the top part of the stomach and banding the outlet at 12 mm (about the size of your little finger). Food will have to pass through this restriction before it drains into the main stomach.

The new stomach or the “pouch” is about the size of a small egg or (5 cm long) and “staple breakdown” is infrequent because this pouch is completely divided from the main stomach.

Advantages & Disadvantages:

The outlet provides a tight restriction right away, so patients will lose weight faster than with the Lap-Band procedure, but slower than with the gastric bypass procedure. However, the band has a permanent size and is not adjustable like the Lap-Band.

The Procedure:

The procedure is performed Laparoscopically and under general anesthesia, where 5 small incisions are made in the upper abdomen. Special instruments are used to carefully cut and staple the stomach.

During the procedure, leak tests are routinely performed to check the integrity of the tissues and staples.

The surgery usually takes less than an hour and patients are given clear liquids after their surgery. Most patients are ready to go home the next day and recovery usually takes around 1-2 weeks.

Post Surgery Follow-up:

Follow up is recommended at 1 week after surgery, 1 month after surgery, then every 3 months during the first year, then every 6 months thereafter.

Since food will continue to pass through the natural processing route, there is less chance of malabsorption of vitamins, minerals and other nutrients with this procedure; however, taking a daily multi-vitamin is still advised.

Problems encountered with the Lap VBG: (Study of 189 patients)

Outlet stricture (11%)
Outlet dilatation (6%)
Redo (6%)
Leaks (3%)
Staple line disruption (2%)
No deaths.

Corrections:

In the unusual case of complications, the outlet strictures are usually corrected by endoscopic balloon dilatations. Usually this corrective procedure is only necessary once, but sometimes repeated procedures are necessary if too much scarring occurs at the band site. Dilatations can respond to endoscopic injection of scar producing medication to induce scar formation. But sometimes an additional laparoscopic procedure will have to be performed to correct the problem.