Vertical Ligated Gastroplasty by Clamp, Cut and Suture: A Series of 504 Cases Dating Back to 1977.
A restrictive operation for obesity makes a small pouch above a reinforced stoma. This series of 504 patients of one surgeon dating back to February 1977 has developed the same end result as the vertical banded gastroplasty, but does not involve stapling. The stomach is divided from the angle of His downwards for 11 or 12 cm, and the right channel is ligated with two ligatures made of Teflon-coated braided stainless steel wire. The pouch is made snug on a 30-French (9.5 mm) bougie, and the stoma is accurately gauged to 43 mm circumference, by matching marks made on the ligature. Making the pouch actually starts from the middle of the stomach and progresses upwards by clamp, cut and suture. The sutured anastomosis would appear to be more reliable than a stapled one. Weight loss is similar to other restrictive procedures, and two series of 30 consecutive cases each are presented with a 100% follow-up: 80% lost at least 60% of their excess weight, and 60% lost more than 60% of their excess weight. There has been no mortality for the primary gastroplasty operation.
Geoffrey
WJ
Braemar Hospital, Hamilton, New Zealand.