Type of Surgery
Information
Last updated: 11/24/2009
There are two major types of VBG—open, which is the older of the two procedures; and the laparoscopic VBG, which is performed through very small incisions, with the help of special instruments.
Open vertical banded gastroplasty
The open VBG is done under general anesthesia. In most cases, it takes one to two hours to perform. The surgeon makes an incision several inches long in the patient's upper abdomen. After cutting through the layers of tissue over the stomach, the surgeon cuts a hole or "window" into the upper part of the stomach a few inches below the esophagus. The second step involves placing a line of surgical staples from the window in the direction of the esophagus, which creates a small pouch at the upper end of the stomach. The surgeon must measure the size of this pouch very carefully; when completed, it is about 10% of the size of a normal stomach and will hold about a tablespoon of solid food.
After forming the pouch and checking its size, the surgeon takes a band made out of polypropylene plastic and fits it through the window around the outlet of the stomach pouch. The vertical band is then stitched into place. Because the polypropylene does not stretch, it holds food in the stomach longer, which allows the patient to feel full on only a small amount of food.
Following the placement of the band, the surgeon will check to make sure that there is no leakage around the window and the line of surgical staples. The area of surgery will then be washed out with a sterile saline solution and the incision closed.
Laparoscopic vertical banded gastroplasty
A laparoscopic vertical banded gastroplasty, or LVBG, is performed with the help of a bariatric laparoscope. A laparoscope is a small (10 mm in diameter) tube that holds a fiberoptic cable that allows the surgeon to view the inside of the abdominal cavity on a high-resolution video screen and record the operation on a video recorder. In a laparoscopic VBG, the surgeon makes three small incisions on the left side of the abdomen for inserting the laparoscope, and a fourth incision about 2.5 in (14 cm) long on the right side. The formation of the stomach pouch and insertion of the plastic band are done through these small incisions. Because it is more difficult for the surgeon to maneuver the instruments through the small openings, an LVBG takes longer than an open VBG, about two to four hours.
A laparoscopic VBG requires that the surgeon spend more training and practice than with an open VBG. As of 2003, about 90% of VBGs performed in the United States are done as open procedures. In the event of complications developing during a laparoscopic VBG, the surgeon usually completes the operation using the open procedure.
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Other Information
Vertical banded gastroplasty (VBG), also known as stomach stapling, is a restrictive operation for weight control. Both a band and staples are used to create a small stomach pouch. In the bottom of the pouch is an approximately one-centimeter hole through which the pouch contents can flow into the remainder of the stomach and thence onto the remainder of the gastrointestinal tract.
Stomach stapling is a restrictive technique for managing obesity. The pouch limits the amount of food a patient can eat at one time and slows passage of the food. Stomach stapling is more effective when combined with a malabsorptive technique, in which part of the digestive tract is bypassed, reducing the absorption of calories and nutrients. Combined restrictive and malabsorptive techniques are called gastric bypass techniques, of which Roux-en-Y gastric bypass surgery (RGB) is the most common. In this technique, staples are used to form a pouch that is connected to the small intestine, bypassing the lower stomach, the duodenum, and the first portion of the jejunum.
This type of weight loss surgery is losing favor as more doctors begin using the adjustable gastric band. The newer adjustable band does not require cutting into the stomach and does not use any staple lines, thus making it a much safer alternative.
VBG is known in the medical community as a very serious and dangerous procedure. It has been classified by the AMA as a "severely dangerous" operation.
From http://en.wikipedia.org/wiki/Vertical_banded_gastroplasty_surgery
Other Information
The number of Gastric Bypass surgeries climbed more than 600% from 1993 to 2003.
From: Bariatric-Surgery.info
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