Vertical Banded Gastroplasty: A Simple, Effective and Safe Surgery for Morbid Obesity

No dietary management for morbid obesity hasachieved uniform long-term success. Surgical management should be considered for patients who weigh 100 pounds above their ideal body weight and for patients whose body mass index (BMI) exceed 40 kg/m2 or between 35 and 40 kg/m2 but with high risk comorbid conditions.(1) There are more than 30 surgical procedures that have been developed for the management of morbid obesity(2) and two of them have stood the test of time and are commonly per-formed via celiotomy at present. These two proce-dures are vertical banded gastroplasty (VBGP; Fig. 1) and the Roux-en-Y gastric bypass (RYGB; Fig. 2). Both of them have established records for their safety and effectiveness.(3) Although the mean weight loss after RYGB is approximately 10 % more than after VBGP,(4) VBGP is more easily performed and can avoid many of the complications seen after gastric bypass. Patients retain their normal anatomy after VBGP except the new formation of a small pouch over the proximal stomach.(4,5) VBGP also avoids the complications of blind bypassed digestiv