Vertical Banded Gastroplasty (VBG)

One of the most known procedures in the world of bariatric surgery is the vertical banded gastroplasty, an operation that many people have called stomach stapling. 

This technique was perfected over the past twenty years at the University of Iowa by bariatric surgery pioneer E.E. Mason, MD and at one time was the most commonly performed procedure for weight loss in the world. Enthusiasm for the VBG has waned over the past few years because bariatric surgeons have become more aware of its limitations vis-à-vis the Roux-en-Y gastric bypass (RNY).

Although the procedure is still well respected, patients generally lose less weight than with the RNY, and it is much more common to see a patient not lose a satisfactory amount of weight following the VBG. The primary cause for this is that patients continue to eat sugary foods and/or liquids, which are high in calories.

VBG is performed under general anesthesia, through an incision in the upper abdomen measuring several inches, and requires usually four or five days in the hospital postoperatively. A circular "window" is made through the stomach a few inches below the esophagus. A surgical stapler is then used to create a small vertical pouch by putting a row of staples from the window toward the esophagus. The pouch is carefully measured at the time of surgery and will hold about one tablespoon of solid food. A polypropylene band is placed through the window, around the outlet of the pouch and secured to itself with stitches. The band controls the size of the outlet and keeps it from stretching.

As a result, the VBG limits the amount of food the patient can eat at one time. Unlike the RNY, that uses several different methods to cause weight loss, the VBG works solely by restricting the amount the patient can eat. This can result in substantial weight loss in most patients, but it requires strict patient compliance to the suggested food plan and an avoidance of sugary foods and beverages.

Additionally, the laparoscopic method can be used for the VBG – a method that helps surgeons perform the operation via a small camera. This is the simpler of the two operations (”open” surgery versus laproscopic VBG), with a generally lower risk of complication’s and shorter hospital stay.

VBG has been the most common restrictive operation for weight control. Because both a band and staples are used to create a small stomach pouch in the upper stomach, this procedure is specifically designed to restrict food intake and prolong satiety.

Vertical banded gastroplasty, is one of the two major types of operations recognized by major health groups for the treatment of clinically severe obesity. It is a purely restrictive procedure with no malabsorptive effect. The goal of this procedure is to severely restrict the patient’s capacity to eat certain foods.

About 30 percent of those who undergo VBG achieve normal weight, and about 80 percent achieve some degree of weight loss. Some patients regain weight. Others are unable to adjust their eating habits and fail to lose the desired weight. Successful results depend on the patient’s willingness to adopt a long-term plan of healthy eating and regular physical activity.

VGB is an option for individuals who have a body mass index (BMI) above 40 - about 100 pounds overweight for men and 80 pounds for women - and for people with a BMI between 35 and 40 who suffer from type 2 diabetes or life-threatening cardiopulmonary problems such as severe sleep apnea or obesity-related heart disease.