Vertical Banded Gastroplasty

There are several surgical treatments for obesity called bariatic surgery. Vertical banded gastroplasty seems to be the least intrusive of these surgeries with a shorter recovery time and an overall commendable weight-loss success rate. This treatment modifies the size of the stomach to promote weight loss. The surgeon fashions a small pouch at the upper portion of the stomach with a narrow outlet that measures only ½ inch. The surgeon then reinforces the pouch with a mesh band to prevent stretching. The newly created pouch holds four to eight ounces of food. The weight loss results from the limited food consumption. There are two approaches that a surgeon can take to perform vertical banded gastroplasty: the open method, or the laparoscopic method. A laparoscope is a thin arm-like tool with a miniature camera attached, which is inserted into the abdomen. The camera projects images onto a screen for the surgeon.

Ideal Candidates for Vertical Banded Gastroplasty

Body Mass Index, or BMI, is a unit that physicians use to figure out the client's level of obesity that takes into account both the height and weight of the person being measured. The surgical procedures for obesity are recommended for people who are morbidly or severely obese with a BMI greater than 40, or 100 pounds or more overweight. A physician may also recommend vertical banded gastroplasty to a person who has a BMI of 35–39 who also has a serious medical condition such as diabetes mellitus, cardiac disease, or hypertension. Other considerations that would make someone with a BMI of 35–39 a likely candidate for the bariatric surgery would include impaired physical performance that affects ability to get around safely and ability to perform necessary tasks at home and at work.

Benefits

Research has linked severe obesity with heart disease, metabolic changes (e.g., Type 2 diabetes), gastroesophogeal disease, depression, premature death, infertility, asthma, dyslipidemia, menstrual irregularities, and cancer. The good news is that as the client loses even as little as 10 percent of his or her excess body weight, there is a diminished need for medications, such as [Page 774]antihypertensive and antidiabetic medications. In some instances, a need for medication is completely eliminated with the reversal of the medical conditions.

Sleep apnea and shortness of breath associated with walking is often remarkably improved. After the surgery, the committed person will be encouraged to participate in a personalized exercise program and enjoy an increased activity level.

Risk Factors

Vertical banded gastroplasty, whether the open technique or the laparoscopic technique, is major surgery and comes with associated risks. Clients have a 5 to 8 percent risk in developing complications from the surgery. The risk of death is low at 0.5 percent. Reported complications include pulmonary embolism, bleeding or injury to the spleen, ulcers, anemia/malnutrition, adhesions, scarring causing gastrointestinal obstruction, chronic vomiting, chronic diarrhea, wound infection (related to breakdown of staples allowing leakage from stomach/intestines into abdomen), vomiting related to overeating, slipping or wearing away of the band, enlargement of the pouch, reflux esophagitis, vitamin deficiencies (lifelong supplementation is required), bleeding, abdominal hernia (10 to 20 percent occurrence, which needs surgical repair), gallstones, lung problems, and complications of general anesthesia. Even though risks may be serious, it should be noted that VBG has less risks than Gastric Bypass procedures, particularly when done laproscopically.

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