ABSTRACT
Gastric reduction operations are being performed for the treatment of the morbidly obese. Loop gastric bypass, Roux-en-Y gastric bypass, horizontal gastroplasty, and vertical banded gastroplasty are the four major types of gastric reduction operations that have been performed since 1966 at the University of Iowa Hospitals and Clinics. Vertical banded gastroplasty, the procedure currently being performed, creates a small upper pouch volume (10 to 30 ml) and a small stoma diameter (10 to 12 mm). This necessitates making drastic changes in patients' eating patterns, such as taking 30 minutes to eat a small meal and not drinking liquids with the meals. The changes help eliminate such complications as disruption of the staple line, stretching of the pouch, and obstruction of the stoma. A 30-ml medicine cup and a clock are important behavior modification tools to encourage patients to eat small amounts of food and sip beverages slowly. The dietitian can play a paramount role as educator for gastric reduction operation patients and should therefore become closely involved in their perioperative and long-term care.
