Gastroplasty with reinforced greater curve stoma for morbid obesity

Forty-four morbidly obese patients underwent gastroplasty with a transverse double stapled partition forming a 20-30 ml proximal gastric pouch and a 10 mm diameter stoma on the greater curve supported by three non-absorbable imbricating seromuscular inverting suture layers to form a neopylorus. All patients have been followed at approximately 4 weekly intervals for at least 72 weeks and all patients have been submitted to endoscopic assessment at the end of 1 year. There was no mortality and there were no major immediate postoperative complications. Three patients (6.8%) had inadequate weight loss (in two associated with partial staple line failure). The other 41 patients (93.2%) reached final weights less than or equal to 40% above ideal weight. Sixteen patients (36.4%) reached their ideal weight. Six patients (13.6%) developed stomal stenosis (two requiring re-operation, and four requiring endoscopic dilatation).