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Vertical banded gastroplasty: long-term results comparing three different techniques
1Department of Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. michelsuter@span.ch
Obesity Surgery
|March 15, 2000
Summary
Vertical banded gastroplasty (VBG) offers significant weight loss, but complications are common, especially with silastic bands or adjustable sphincters. Marlex mesh is recommended for banding if VBG is selected.
Area of Science:
- Bariatric Surgery
- Surgical Techniques
- Obesity Treatment
Background:
- Vertical banded gastroplasty (VBG) was a primary surgical treatment for morbid obesity from 1981-1995.
- Three banding techniques were utilized: silastic band, Marlex mesh, and adjustable sphincter.
- Laparoscopic gastric banding replaced VBG in 1995.
Purpose of the Study:
- To present the long-term outcomes of Vertical Banded Gastroplasty (VBG).
- To compare the efficacy and complication rates of different banding materials used in VBG.
Main Methods:
- Retrospective analysis of patient charts from 1981-1995.
- Inclusion of 197 patients with morbid obesity (mean BMI 42.9 kg/m²).
- Categorization of patients based on banding material: silastic band (73), Marlex mesh (40), and adjustable sphincter (84).
Main Results:
- Mean excess weight loss was 66% at 12-24 months, maintained at 50-60% up to 9 years.
- Overall complication rate was 41%, with stenosis (20%) and staple-line disruption (11%) being most frequent.
- Marlex mesh group showed fewer reoperations compared to silastic band and adjustable sphincter groups.
Conclusions:
- VBG leads to rapid, well-maintained weight loss, with potential for slight regain after 2 years.
- High complication rates and reoperation necessity, particularly with silastic bands and adjustable sphincters, impact VBG's overall success.
- Marlex mesh is identified as the preferred banding material for VBG when this procedure is chosen.