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 foodwithout 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 withan 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 40or 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 anaesthesia. 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 verticallyto 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 anaesthesia, and deep vein thrombosis (blood clot in the leg).
The major complications associated with Vertical banded gastroplastyinclude:
- Leakage of gastric contents from the staple line.
- Potential for band slippage
- Enlargement of pouch
