Vertical banded gastroplasty (VBG), most commonly known as stomach stapling or gastric stapling, is a restrictive procedure originally developed in the early 1970’s and perfected over the next few decades. Advances in the use of mechanical staplers made this technique possible. VBG was actually the first purely restrictive operation performed to treat obesity. It was developed to be a safer alternative to the Roux-en-Y gastric bypass and jejunoileal bypass surgeries. VBG has a lower mortality rate, fewer problems with nutritional deficiencies and a decreased risk of infection. This procedure is mentioned out of historical necessity and is not being performed by Dr. Balder at present as there are much better options available today.
VBG involves the use of a band and staples to create a small pouch in the upper portion of the stomach. The purpose of this pouch is to limit food intake while at the same time slow down the passage of food. This small pouch is then reinforced by a band of polypropylene mesh placed around the outlet of the pouch to prevent it from stretching and to create a feeling of fullness. The new stomach pouch is quite small and will only hold about a ½ ounce at a time. The bottom part of the pouch has a small hole approximately 1cm in diameter through which contents pass into the remainder of the stomach and on to the rest of the intestinal tract.
VBG was once a popular surgery for managing obesity, however today it is performed less frequently due to a large number of patients who have experienced very poor long-term weight loss. Statistics show that only 40-50% of patients were successful in losing ½ their excess weight. Five years later only about 30% of patients effectively maintained their weight loss.
Advantages of Vertical Banded Gastroplasty:
- Body anatomy is left intact.
- Less chance of malnutrition since the body is absorbing the vitamins and minerals.
- No dumping syndrome.
- The procedure is reversible.
Disadvantages/Risks of Vertical Banded Gastroplasty:
- Requires the patient’s strict compliance to diet in order to succeed.
- Vomiting can occur if food is not properly chewed or is being eaten too quickly.
- Foods high in fiber can be difficult to eat.
- Reversing the operation can be a very complex, intensive surgery.
- Staple lines, if compromised, can leak stomach fluid causing serious infection.
- The band around the outlet to the stomach pouch can be compromised and begin to dilate over time. There is also a risk of the band breaking or moving, which could enlarge the outlet and promote weight gain.