Brief History and Summary of Bariatric Surgery

Chapter 5.

GASTROPLASTY

The gastroplasty was designed in the early 1970s to be a safer alternative to the RYGBP and the JIB. The operation itself was made possible by the introduction of mechanical staplers. The gastroplasty was the first purely restrictive operation performed for the treatment of obesity. The original (horizontal) gastroplasty involved stapling the stomach into a small partition – and only leaving a small opening for food to pass from the upper stomach pouch to the lower one. Thus the lay term – stomach stapling. This form of gastroplasty resulted in very poor long-term weight loss and, after several attempted modifications, was abandoned eventually.

The vertical banded gastroplasty (VBG) features a pouch based on the lesser curvature of the stomach and a polypropylene mesh band or Silastic® ring around the outlet of the pouch. The advantages of the VBG include a low mortality rate and the virtual absence of micronutrient deficiencies. Also, since no anastomosis is created, there is a lower risk of infectious complications.

However, once a very popular surgical option for obesity, the VBG is being performed much less frequently, because long-term studies have shown a prominent rate of weight regain or exacerbation of severe heartburn. Several randomized, prospective trials have demonstrated superior weight loss with RYGBP compared to VBG. Weight loss for sweets eaters has been shown to be superior with RYGBP compared to VBG, presumably as a result of symptoms of the dumping syndrome with sweets.

REFERENCES

Gastroplasty

Mason, EE Vertical banded gastroplasty for obesity. Arch Surg 1982;117: 701-6.

Eckhout GV, Willbanks OL, Moore JT. Vertical ring gastroplasty for morbid obesity. Five year experience with 1,463 patients. Am J Surg 1986;152:713-6.

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TABLE OF CONTENTS

• Chapter 1. INTRODUCTION

• Chapter 2. JEJUNOILEAL BYPASS

• Chapter 3. GASTRIC BYPASS & LAPAROSCOPIC GASTRIC BYPASS

• Chapter 4. BILIOPANCREATIC DIVERSION DUODENAL SWITCH

• Chapter 5. GASTROPLASTY

• Chapter 6. GASTRIC BANDING & LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING

• Chapter 7. ON THE HORIZON & SUMMARY

• References

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