Vertical Banded Gastroplasty
Purely restrictive procedure
[edit | edit source]- Upper part of stomach partitioned by a vertical staple line with a tight outlet wrapped by a prosthetic mesh or band
- Upper pouch fills quickly with solid food and prevents consumption of a large meal
- Effectiveness depends on durability of pouch and stoma (outlet) size
- Not beneficial for those eating calory-dense foods
- Unsustained weight loss
- High incidence of complications requiring revision
Complications
[edit | edit source]- Staple line disruption
- Stomal stenosis (20-33%)
- Occurs either due to fibrosis of the stomach or by the band itself
- Try endoscopic dilatation initially, but it might be unsuccessful due to the rigid nature of the prosthetic band (overall success rate 68%)
- Symptoms likely to return after dilatation
- Surgical revision can be quite difficult due to dense scarring
- Band erosion
- Band disruption
- Pouch dilatation
- Vomiting
- GORD
- Late complication which may reflect stomal stenosis and pouch dilatation
- If unresponsive to maximal medical therapy, may require conversion to RYGB or reversal