Vertical bamded gastroplasty for morbid obesity

ABSTRACT

Vertical banded gastroplasty [VBG] involves creating a vertical pouch by stapling the front to the back wall of the stomach below the esophagogastric junction with newly created gastric pouch outlet. [VBG] is an effective operation for treatment of morbidly obese patients especially bulk eater. Twenty-one consecutive patients with morbid obesity of more than 5 years duration with mean body mass index [BMI] +/- 40.3 operated on between September 2001 to September 2004. They all were performed vertical banded gastroplasty [VBG] using re loaded linear notched TA90-B stapler, and the outlet of the gastric pouch banded with Prolene Mesh. Mean operative time was 89 minutes [range from 65 to 135 minutes]. Mean hospital stay was 5.5 days [range from 4 to 10 days].All patients were restored daily activities by the end of the first weak post operative and returned to their work by the end of the third week post operative. Operative and postoperative complications includes; One super obese female patient [4.8%]had iatrogenic injury of the spleen durin the procedure and spleenectomy was done, one case [4.8%] of immediate postoperative jaundice due to anesthetic Halothane inhalation, 3 cases [14.4%] developed vomiting after solid food ingestions, two cases of incisional hernia [9.6%]and one case[4.8%] developed stomal ulcer. There was no postoperative death [0%]. Follow up was for 2 +/- 0.5 years for 10 patients [48%], 1.5 +/- 0.3 year for 7 patients [33.6%] and 0.5 +/- 0.1 year for four patients [19.2%]. 18 patients [86.4%] showed good control of losing their extra body weight. Vertical banded gastroplasty [VBG] using re loaded linear notched TA90-B stapler is an effective modality of bariatric surgery for treating morbid obesity. It was left body anatomy intact with no dumping syndrome or nutritional deficiencies. It was financially economic compared to the original Mason VBG in which two staplers "linear and circular' used. Correctly, performed operation is a safe and easy to perform with considerable postoperative complications especially if done by an expert surgical team. It has the advantages of being a pure restrictive procedure with long run good weight loss results especially in bulk eaters patients