Vertical Banded Gastroplasty (VBG), also known as stomach stapling, is an outdated restrictive weight loss surgery procedure, similar to Lap-Band. First developed in 1982 by Dr. Edward E. Mason, the father of obesity surgery, the procedure was devised as a surgical therapy for obese and morbidly obese.
Stomach stapling operation is not as effective as the current weight loss surgery types, like Vertical Sleeve Gastrectomy (VSG). Dr. Mason also developed the first gastric bypass surgery procedure.
Vertical Banded Gastroplasty has fallen out of favor due to its long-term problems, like band erosion and staple line failure, as well as the emergence of newer more effective procedures like gastric sleeve.
Experts find that Vertical Banded Gastroplasty is more efficient when combined with a malabsorptive technique in which portions of the digestive tract are bypassed. This leads to a reduction of the absorption of both nutrients and calories and extreme weight loss. Some examples of these combination surgeries include Roux-en-Y Gastric Bypass Surgery, Mini Gastric Bypass, and Duodenal Switch surgery.
Learn more about the history of bariatric surgery procedures
Ultimately, Vertical Banded Gastroplasty is losing its appeal as more surgeons are using gastric sleeve surgery because it provides high expected weight loss with minimal complications and risks. The medical community considers Vertical Banded Gastrectomy as a dangerous and serious weight loss surgery.
Also, a large number of patients have experienced inferior long-term weight loss. Some statistics show that only 40-50% of patients lost half of their excess weight, and after five years following surgery, only 30% of patients maintained their weight loss at all.
How Does VBG Work?
During Vertical Banded Gastrectomy, both a band and staples are used to partition the stomach to create a small pouch on the patient. At the bottom of the pouch, a small hole is made through which the contents of the pouch can flow into the rest of the stomach and the gastrointestinal tract. Stomach stapling limits the amount of food that a patient can eat at one time (much like other restrictive surgery types) and shows how fast food moves through the track.
The pouch itself is reinforced with a band of mesh around the outlet of the pouch to prevent it from stretching and creating a full feel. The new stomach pouch is small and can only hold about a one-half ounce at a time.
During Vertical Banded Gastroplasty surgery, 2 to 5 small cuts will be made in the abdomen. A laparoscope is placed through the incisions so the surgeon can see inside the stomach. Most of the stomach will be removed. Whatever is left will be joined with surgical staples creating a long vertical tube. The surgery does not change or cut into the sphincter muscles that allow food to enter or leave the stomach itself. Surgery will take between one to two hours.
One of the primary benefits of stomach stapling is that there is a lessened chance of malnutrition since the body itself is absorbing all minerals and vitamins, unlike other weight-loss operations. This means there is no risk of dumping syndrome. Also, this weight loss surgery procedure is 100% reversible.
This weight loss surgery procedure requires a patient to follow a strict diet for them to succeed. Also, high fiber foods or more dense foods can be difficult to eat and digest. While the surgery itself is reversible, it can be an intense and complex operation. Also, staple lines can leak stomach fluid leading to severe infection if compromised after surgery.
The band around the stomach pouch also can be compromised and begin to erode directly into the stomach. Also, failure of the staple line to reconnect the pouch and the rest of the stomach can lead to serious health issues. In general, severe discomfort and vomiting can occur if food is eaten too quickly or not chewed properly. Also, unlike Lap-Band (gastric banding), the pouch is not adjustable.
Overall this weight loss surgery procedure has mixed results over time. Many patients have difficulty maintaining the tiny portions of food required to eat to keep their pouch small. When they begin to eat more, weight loss stops, and they start to gain weight. Also, the intestines are not bypassed in this surgery, and there is no change in the way the body digests, so there is no limit to the absorption of food in a long-term way.
Total weight loss and weight loss maintenance are the lowest for this surgery compared to other types of bariatric surgeries in the United States. This means that it is not recommended for patients who need to lose a considerable amount of weight or for those who are candidates for other types of weight-loss surgeries with better success rates.