Rejecting the Demise of Vertical-Banded Gastroplasty: a Long-Term Single-Institute Experience

Abstract

Surgical interventions have proven to be more effective than other measures in the treatment of morbid obesity. The short-term outcomes of the various surgical interventions have been well documented in the literature, with fewer reports on long-term outcomes. The reported long-term outcome of the vertical-banded gastroplasty (VBG) is conflicting. The aim of the present study was to evaluate our long-term experience with VBG. A retrospective review of a prospectively maintained database was conducted. Records of patients who underwent VBG five or more years ago were retrieved. An analysis of the long-term weight changes and reported complications was conducted. The study included 150 patients: 43 males (29%) and 107 females (71%). Their mean age was 30 years old (12-53), and the mean body mass index (BMI) was 47 ± 8.4 kg/m2. Patients were followed up for an average of 8 years (5-11). More than 60 % of patients had good long-term weight loss (EWL > 50%). A significant negative correlation was found between the excess weight loss percent (EWL%) and the pre-operative BMI (p < 0.05). The differences in EWL% between males and females were not significant (p = 0.061). Nevertheless, the change in EWL% over time for both males and females was significant (p = 0.004). Revision surgery was required in seven patients (4.7%). Five patients had conversion of VBG to gastric bypass (3.3%), while two patients (1.3%) had reversal of the procedure. Late complications included mesh erosion in three cases, staple line dehiscence in two patients, and stomal stenosis in six patients. VBG could be a long-term effective intervention for the treatment of morbid obesity. Good selection is the cornerstone for long-term success. Late complication rate is acceptable after VBG. VBG is a specifically useful tool under stringent financial circumstances.

Ten-Year Results of Laparoscopic Sleeve Gastrectomy: Retrospective Matched Comparison with Laparoscopic Adjustable Gastric Banding—Is There a Significant Difference in Long Term?

“…Aim of this modification was to prevent recanalization between the pouch and the fundus in order to avoid weight regain. Long-term weight loss ranged from 42 to 69%EWL (excess weight loss percent) [3][4][5][6][7][8], but laparoscopic approach and revisional surgery were challenging tasks after VBG. In the early 2000s, the laparoscopic adjustable gastric band (LAGB) replaced VBG as the most common restrictive procedure.…”

Reversing a Vertical Banded Gastroplasty for Obstruction: Technical Pointers

“…2 Another advantage of the VBG is low perioperative morbidity and mortality rates. This operation is associated with a 0.24% mortality rate, 0.6% leak rate, and a 1.4% wound infection rate.…”

Endoscopic revision for weight regain after open vertical-banded gastroplasty

“…Vertical-banded gastroplasty (VBG) was one of the most popular restrictive bariatric procedures in the 1980s and 1990s, with excellent short- and medium-term results. 1 , 2 Mason described the open VBG (OVBG) for the first time in 1982, 3 consisting of the application of staples from above the gastric crow’s foot up to the angle of His to create a tiny pouch (<50 mL), together with the construction of a neopylorus with a polypropylene mesh collar ( Fig. 1 ).…”