Last updated: 11/24/2009

Patients who undergo a VBG are at risk for some of the same complications that may follow any major operation, including death, pulmonary embolism, the formation of blood clots in the deep veins of the leg, and infection of the surgical incision. These risks are increased for severely obese patients; for example, the risk of infection is about 10% for obese patients compared to 2% for patients of normal weight. With specific regard to VBGs, recent studies indicate that the risks of complications after surgery are about the same for open and laparoscopic VBGs.

Specific risks of VBGs

Specific risks associated with vertical banded gastroplasty include:

• Incisional hernia. An incisional hernia is the protrusion of a loop or piece of tissue through a reopened incision. It results from the stress placed on the stitches holding the incision closed in extremely obese patients. Most can be repaired by resuturing the incision. Incisional hernias are more likely to occur with open VBGs than with laparoscopic procedures.
• Dehiscence. Dehiscence is the medical term for splitting open; it can occur in a VBG if the staples forming the pouch at the upper end of the stomach come loose.
• Nausea and vomiting. Nausea and vomiting usually result from eating more food than the stomach pouch can hold, or eating the food too quickly. In most cases, the vomiting disappears as the patient learns different eating habits.
• Formation of a stricture at the site of the plastic band. A stricture is an abnormal narrowing of a body canal or opening. It is also called a stenosis.
• Damage to the spleen. The spleen lies very close to the stomach and can be injured in the process of bariatric surgery. In most cases it can be repaired during the operation.

Long-term risks

The long-term risks of vertical banded gastroplasty include:

• Regaining weight. Patients who have had a VBG are more likely to regain lost weight than those who have had gastric bypass surgery. This is partly because the patient's digestive tract continues to absorb nutrients in food in normal fashion. Because the stomach pouch in a VBG is small, many patients are tempted to eat ice cream and high-calorie liquids that pass quickly through the pouch. A 10-year follow-up study of 70 patients who had had a VBG found that only 20% (14) of the patients had lost and kept off the loss of 50% of their excess body weight.
• Ongoing vomiting and heartburn. About 20% of patients with VBGs report long-term digestive difficulties.
• Psychological problems. Some people have difficulty adjusting to the changes in their outward appearance and to others' changed reactions to them. Others experience feelings of depression, which are thought to be related to biochemical changes resulting from the weight loss.