Morbid obesity: use of vertical banded gastroplasty.
Vertical banded gastroplasty has evolved from gastric bypass and earlier forms of gastroplasty as a safe and effective gastric reduction procedure for the treatment of morbid obesity. This article provides a step-by-step description of the technique. Spatial orientation by use of landmarks such as an Ewald tube in the esophagus, the angle of His, and a Penrose drain around the esophagus is important in avoiding injury to adjacent structures. Careful measurement of the pouch volume at a pressure of 70 cm H2O is necessary. For patients between 170 and 225 per cent of ideal weight, a 5.0 cm circumference collar is used around the outlet. For heavier patients, a 4.5 cm collar is used. Bypass is not necessary because weight control depends on a small pouch and stoma.
Mason
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D006801:Humans; D009767:Obesity, Morbid / Q000628:therapy*; D013270:Stomach / Q000033:anatomy & histology / Q000601:surgery*; D013526:Surgical Mesh; D013528:Surgical Staplers; D013536:Suture Techniques