Vertical Banded Gastroplasty
This is one of the restrictive-only obesity surgeries, sometimes known in the past as "stomach stapling". Vertical banded gastroplasty (pronounced GAS-troh-plas-tee) gives one a smaller usable stomach without affecting digestion. The preferred method today is the roux-en-y procedure.
The stomach is stapled along the top to section off a small part near the end of the esophagus. A non-expandable band is then placed around what is to be the lower portion of the smaller stomach (called the stoma). The food enters this small pouch as usual, but must then pass through the smaller outlet (about 1 centimetre) created by the band. The food then travels through the stomach and intestines to be digested normally.
This is one of the restrictive-only obesity surgeries, sometimes known in the past as "stomach stapling", although it isn't the original stomach stapling surgery. Vertical banded gastroplasty (pronounced GAS-troh-plas-tee) gives one a smaller usable stomach without affecting digestion.
Figure 1
The Guru sketched this image of VBG, or vertical banded gastroplasty.
The stomach is stapled along the top to section off a small part near the end of the esophagus. A non-expandable band is then placed around what is to be the lower portion of the smaller stomach (called the stoma). The food enters this small pouch as usual, but must then pass through the smaller outlet (about 1 centimetre) created by the band. The food then travels through the stomach and intestines to be digested normally.
Because this procedure only effects the amount of food that can be eaten at one time, patients do not get the dreaded dumping syndrome, nor will they have nutritional deficiencies due to malapsorption.
The Father of Gastric Bypass Surgery for Obesity
Figure 2
The original stomach stapling surgery
This particular technique was developed by Dr. Edward E. Mason in 1980, to improve upon the very simple, earlier form of obesity surgery in which staples were simply fired across the top of the stomach to "make" a smaller stomach (see figure 2).
A few staples were removed to allow the food to pass through. There were lots of problems with this, one of the most important being the body's amazing capacity to heal itself. The muscles of the stomach would stretch, causing the pouch to expand, and the stoma to grow larger and larger. Dr. Mason used the body's own strongest parts to get around this. Notice that in figure one the pouch is made vertical and on the left side of the stomach. This is the least stretchy part of the stomach. The band was also added to prevent the stoma from stretching out. He also realised that the best results were obtained by severely limiting the size of the new pouch. Note the difference in the size of the "new stomach" in figures one and two. Dr. Mason is known as the Father of Obesity Surgery.
Studies over the years have shown that restrictive-only bariatric surgery like vertical banded gastroplasty is not as effective for long-term weight loss as gastric bypass surgery for obesity that combines the restrictive and malapsorptive features. Complications associated with this surgery can include band erosion, staple line disrupture (the staples come loose or apart and allow food to "leak" through), and scar tissue forming in the stoma, blocking food from going through.
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