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Advantages: Vertical Banded Gastroplasty (VGB)

One of the most widely recognized bariatric procedures is vertical banded gastroplasty (VGB).  Vertical Banded Gastroplasty is the most frequently used restrictive operation for weight control. Introduced in the United States in 1982, VBG uses both a band and staples to create a small stomach pouch to restrict food intake.

Restrictive gastrointestinal surgery restricts food intake and does not interfere with the normal digestive process. To perform the surgery, doctors create a small pouch at the top of the stomach where food enters from the esophagus. Initially, the pouch holds about 1 ounce of food and later expands to 2-3 ounces. The lower outlet of the pouch usually has a diameter of only about 3/4 inch.

This small outlet delays the emptying of food from the pouch and causes a feeling of fullness. As a result of restrictive surgery, most people lose the ability to eat large amounts of food at one time. After an operation, the person usually can eat only 3/4 to 1 cup of food without discomfort or nausea. Also, food has to be well chewed.

The advantages to the VBG are that the digestive system continues to work normally after eating so there is little, or no problems, with malabsorption and this procedure is technically easier than other procedures. This procedure is not recommended for people who report a lifestyle of eating sugars and simple carbohydrates.

One of the bigger advantages with VBG is that it can be performed in either the open or laproscopic method – a technique that can’t be used with all bariatric surgeries. The laparoscopic method uses a camera to see inside the patient’s body, helping doctors perform the surgery with fewer incisions. The result is a faster recovery time, better physiological results and an overall better cosmetic appeal.

In a Mexican study conducted by professional bariatric surgeons, a double-blind randomized clinical trial compared the postoperative outcome and 1-year follow-up of 2 cohorts of patients who underwent either open VGB (OVBG) or laparoscopic VGB (LVBG).

30 patients with morbid obesity were randomized into 2 groups (14 OVBG and 16 LVBG). Pain intensity, analgesic requirements, respiratory function, and physical activity were blindly analyzed during the first 3 postoperative days. Complications, weight loss, and cosmetic results after 1 year follow-up were evaluated.

Both groups were highly comparable before surgery. Surgical time was longer in the laparoscopic procedure. Patients in this group required less analgesics during the first postoperative day. There was an earlier recovery in the expiratory and inspiratory forces, as well as faster recovery of physical activities in patients who underwent LVBG. Postoperative complications were more frequent in the open group. Excess body weight loss after 1 year was similar in both groups. Cosmetic results were significantly better in the laparoscopic group.

The end result concluded that LVBG had advantages over the open procedure in terms of analgesic requirements, postoperative recovery, and cosmetic results.

Although the laproscopic approach may be slightly better than the traditional open method, both kinds of surgery offer the same long term benefits for patients. Some of these advantages of the VBG include:

  • surgery is completely reversible
  • body anatomy is left intact
  • no dumping syndrome
  • no nutritional deficiencies

VBG is a renowned and respected procedure used by some of the world’s top physicians. This, along with the RNY, is one of the two major types of operations recognized by the National Institute of Health for the treatment of clinically severe obesity.