Why the Operation I Prefer is Vertical Banded Gastroplasty 5.0

Abstract

Vertical banded gastroplasty (VBG) is easy for the patient, requiring no nasal gastric tube, gastrostomy, feeding enterostomy, or central venous line. Clear liquids are begun the first morning and pursed foods the second day. VBG with a 5.0 cm collar and a 13 ml pouch provides sufficient weight control with minimal risk and side effects. Splenectomy risk is 0.3%, peritonitis from leak 0.6% and operative mortality 0.24%. VBG causes no malabsorption or bacterial overgrowth because there are no blind segments. VBG does not predispose to difficult to diagnose, lethal, closed segment obstruction because of the absence of exclusion. VBG minimizes risk of acid peptic disease by preserving normal feedback control of acid secretion. Revisions have been less than 2% per year. The first 250 patients to be followed for 5 years with VBG-5.0 showed an 80% success in achieving 25% of excess weight loss without revision. For these successful patients the average percentage excess weight loss was 60% for the morbid obese (MO 160 to 225% of ideal) and 52% for the super (SO over 225% of the ideal). Absolute weight averages changed from 122 to 86 kg for MO and from 159 to 110 kg for SO.

Predictors of success after laparoscopic gastric bypass: a multivariate analysis of socioeconomic factors

“…Superobese patients are known to have lower EWL than morbidly obese patients [13,14], especially after the lap-Band procedure [25,26]. Although superobese patients need to lose more pounds to achieve the same EWL (because of the larger denominator), these patients also need to lose more weight to have a significant metabolic response in terms of resolution of their comorbidities.…”

“…The rate of obesity varies with age, sex, ethnicity, race, and socioeconomic status [10]; therefore, the degree of weight loss after bariatric surgery could vary according to some or all of these factors. Different studies have compared weight loss between different ethnic groups [11,12], patientsÕ weight [13,14], type of surgery [15,16], or even different techniques of the same operation [13]. Many of these studies have shown subtle or major differences in outcome, but we are unaware of studies aimed to identify predictors of better weight loss in a large cohort undergoing the same operation (laparoscopic gastric bypass).…”

Klinische Ergebnisse und Veränderung der metabolischen Parameter nach adipositaschirurgischen Maßnahmen bei Patienten mit Adipositas Grad III

“…Vertical Banded Gastroplasty VBG nach Mason [9]: 1 % Gastric Banding in der Technik nach Molina [10]: 1 % rungszufuhr. Um Patienten maximal zu motivieren und Komplikationen wie Mineralstoff-und Vitaminmangel zu vermeiden, sind regelmäûige Nachuntersuchungen unabdingbar.…”

20 Jahre Dünndarmbypasschirurgie

“…Die chirurgische Therapie der extremen Adipositas hat 2 Therapieansätze, da Liposuktion und Dermolipektomie [6] nur lokale Fettdepots behandeln: · Einschränkung der Nahrungszufuhr durch Eingriffe am Magen (Gastric Bypass, vertikale Gastroplastik, anpaûbares Magenband) [11,12,26] und · Einschränkung der resorbierenden Oberfläche (Jejunoileostomie, biliopancreatic diversion, Duodenumbypass) [9,10,17,31].…”