Why the Operation I Prefer is Vertical Banded Gastroplasty 5.0.
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.
Mason
EE
Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 USA.