Vertical Banded Gastroplasty
Vertical banded gastroplasty, also known as stomach stapling, is a bariatric surgery employed in the treatment of obesity. It can be performed laparoscopically through tiny incisions as a minimally invasive surgery instead of through a large, open abdominal incision.
Vertical banded gastroplasty is a restrictive bariatric surgery which uses a combination of non-adjustable bands and staples to create a stomach pouch that can hold only a limited amount of food without having to alter the
normal digestive process. The goal of the surgery is to lose weight by making you feel full more quickly with less food, thereby limiting your calorie intake.
Disease Overview.
Obesity is a chronic condition in which there is an excessive accumulation of fat in the body.
Obesity is defined as a Body Mass Index (BMI) of 30 to 34.9 and extreme obesity is a BMI of 40 or more. When a person’s BMI is 50 or higher, it is referred to as super obesity.
Obesity is a global problem affecting people of almost all age groups and is associated with an increased risk of chronic diseases.
Indications.
Vertical banded gastroplasty is recommended for obese patients when non-surgical options such as diet, exercise and medication are unsuccessful in reducing weight.
Vertical banded gastroplasty is indicated for obese patients with:
BMI of 40 or more or
BMI of 35-39.9 with one or more obesity-associated health complications.
Health conditions associated with obesity include:
Type 2 diabetes
Heart disease
High blood pressure
High cholesterol
Sleep apnea
Nonalcoholic fatty liver disease
Cancer
Surgery:
Vertical banded gastroplasty is generally performed under general anesthesia. The surgeon makes several small incisions in the abdomen. A laparoscope, a thin instrument with a light and camera is inserted through one incision which allows the surgeon to view the internal organs on a monitor. Small surgical instruments are inserted through the other incisions to perform the surgery.
Your surgeon cuts out a hole in the stomach and staples the margins of the incision. A restrictive band is then looped through this hole. The upper portion of the stomach above the hole is stapled vertically to form a pouch, forcing food to exit the stomach through the restricted region. The incisions are closed with sutures once completed.
Post-operative care:
Your doctor may prescribe pain relieving medications to make you feel comfortable.
Keep the incision area clean and dry.
You will feel full sooner.
Avoid strenuous exercises and lifting heavy weights
For the first month after the procedure, eat only small amounts of soft foods
Sip water throughout the day to prevent dehydration.
Your dietitian will tailor a new diet regimen for you to follow.
Advantages and Disadvantages of vertical banded gastroplasty:
Advantages:
Reduced stomach volume enhances the feeling of fullness so you eat less
Normal functions of the stomach are retained
No dumping syndrome
Can be performed laparoscopically
Shorter hospitalization stay
Less operative time
Minimal post-operative pain and discomfort
Shorter recovery time
Disadvantages:
Reversal is a complicated procedure
Pouch can dilate if you eat too much
Requires strict dietary compliance
Potential for inadequate weight loss
Risks and Complications:
As with any surgery there are potential risks and complications involved.
The risks include blood loss, infections, problems associated with anesthesia, and deep vein thrombosis (blood clot in the leg).
The major complications associated with Vertical banded gastroplasty include:
Leakage of gastric contents from the staple line.
Potential for band slippage
Enlargement of pouch
Vertical banded gastroplasty is a weight loss surgery for patients who have been unsuccessful losing weight through other means. The surgery helps to treat obesity which is one of the leading causes of preventable death worldwide. The outcome of the surgery changes the lifestyle of an individual and success is dependent on how well you follow the post-operative instructions advised by your bariatric surgeon.
