Vertical banded gastroplasty surgery
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Vertical banded gastroplasty surgery | |
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Other names | Stomach stapling |
ICD-9-CM | 44.68 |
Vertical banded gastroplasty (VBG), also known as stomach stapling, is a form of bariatric surgery for weight control. The VBG procedure involves using a band and staples to create a small stomach pouch. In the bottom of the pouch is an approximate one-centimeter hole through which the pouch contents can flow into the remainder of the stomach and hence on to the remainder of the gastrointestinal tract.
Stomach stapling is a restrictive technique for managing obesity. The pouch limits the amount of food a patient can eat at one time and slows passage of the food. Stomach stapling is more effective when combined with a
This type of weight loss surgery is losing favor as more doctors begin using the adjustable gastric band.[1] The newer adjustable band does not require cutting into the stomach and does not use any staple lines, thus making it a much safer alternative.
Advantages and disadvantages
Advantages
- No dumping syndrome.
- No nutritional deficiencies/malabsorption.
Disadvantages
- Needs strict patient compliance to diet.
- High-fiber foods and foods with a more dense, natural consistency can become very difficult to eat, while highly refined foods cause little discomfort. Many people who regain any weight lost after surgery do so because they begin to avoid the discomfort associated with consuming "healthier" foods, and start eating more easily passed "junk" foods.
- VBG is in no way a magic bullet or pill. It must be emphasized that lifestyle changes, e.g., diet and exercise, are absolutely imperative for weight loss to occur and be maintained. Realistic expectations are imperative.
- Reversal of a VBG requires a much more complex and intensive surgical process than getting the VBG. When removal of a polyurethane band is involved (polyurethane was predominantly used in the 1980s and 90s), it likely has built substantial scar tissue that must also be removed, depending on how long since the VBG took place. Removal of the staples involves stitching back together the previously separated parts of the stomach. For these reasons, a reversal should be considered only if there are serious medical complications.
- Vomiting and severe discomfort if food is not properly chewed or if food is eaten too quickly.
- Not adjustable (as with the adjustable gastric band, aka "lap band")).
Alternatives
- Duodenal switch surgery
- Vertical sleeve gastrectomy
- Roux-en-Ygastric bypass
- Selective vagotomy (snipping the vagus nerve, effectively stopping hunger sensations).
- Mini gastric bypass
Long term
Although restrictive operations lead to weight loss in almost all patients, they are less successful than malabsorptive operations in achieving substantial, long-term weight loss. About 30% of those who undergo VBG achieve normal weight, and about 80% achieve some degree of weight loss. Most studies have suggested that 10 years after surgery, only 10% of patients maintain a minimum weight loss of at least 50% of their total excess weight at the time of their initial surgery. Some patients regain weight. Others are unable to adjust their eating habits and fail to lose the desired weight. Successful results depend on the patient's willingness to adopt a long-term plan of healthy eating and regular physical activity. According to an episode of
Complications
- Staple-line disruption
- Stomal fibrosis
- Gastroesophageal reflux disease
- Incisional ventral hernia
History
Vertical banded gastroplasty was developed in 1980 by
See also
References
- ISBN 978-1-4939-1637-5.
- ISBN 978-981-4699-32-7.
External links
- Media related to Vertical banded gastroplasty at Wikimedia Commons