[Development of a gastroplasty with variable diameter. Experimental study using artificial sphincters]

The vertical banded gastroplasty is currently the most popular technique in the surgical treatment of morbid obesity. This experimental study was aimed to create a gastroplasty with a variable stoma. The Marlex band was replaced by the cuff of an artificial sphincter to allow selective variation of the diameter of the stoma. The study was carried out on four mongrel dogs. The artificial sphincter was connected to a subcutaneous port. Injection of sterile fluid into the port inflates the cuff and decreases the surface of the stoma. The study was followed up for one year. Under gastroscopic control the system was regularly activated, the diameter and the surface of the stoma was measured and calculated. The sphincter allowed the surface of the stoma to decrease from 103 +/- 2.0 mm2 to 61 +/- 2.1 mm2. There was no significant variation of the surface for each volume unit injected into the system. After one year, the systems and stomachs were harvested and examined. It is possible to create a gastroplasty with a variable stoma. This system works without any technical problem. Microscopic examination of the stoma shows no peri-sphincteric fibrosis.