Vertical Banded Gastroplasty (VBG), also known as Stomach stapling, has been the most common restrictive operation for weight control. Both a band and staples are used to create a small stomach pouch. In the bottom of the pouch is an approximately 1-cm hole through which the pouch contents can flow into the remainder of the stomach and thence onto the remainder of the gastrointestinal tract.

Stomach stapling is a restrictive technique for managing obesity. The pouch limits the amount of food a patient can eat at one time and slows passage of the food. Stomach stapling is more effective when combined with a malabsorptive technique, in which part of the digestive tract is bypassed, reducing the absorption of calories and nutrients. Combined restrictive and malabsorptive technique are called gastric bypass techniques, of which Roux-en-Y gastric bypass surgery (RGB) is the most common. In this technique, staples are used to form a pouch that is connected to the small intestine, bypassing the lower stomach, the duodenum, and the first portion of the jejunum.

This type of weight loss surgery is losing favor as more doctors begin using the Adjustable gastric band. The newer adjustable band does not require cutting into the stomach and does not use any staple lines, thus making it a much safer alternative.

VGB Advantages & Disadvantages

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VBG Advantages

• Completely reversible, body anatomy is left intact
• No dumping syndrome
• No nutritional deficiencies/malabsorption

VBG Disadvantages

• Needs strict patient compliance to diet
• Vomiting if food is not properly chewed or if food is eaten too quickly.
• Not adjustable (as with the Adjustable gastric band (aka "Lap band")).
• As with any surgical procedure, there are risks of complications. It has been observed that approximately one in every hundred patients undergoing VBG die within a year. There may also be other medical complications down the road, but the risk is relatively low. Miami Herald 2005 article

Long term

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Although restrictive operations lead to weight loss in almost all patients, they are less successful than malabsorptive operations in achieving substantial, long-term weight loss. 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.

Bariatrics