Vertical banded gastroplasty is surgery to treat
. It causes weight loss by decreasing the amount of food you can eat.
This surgery involves re-shaping the stomach to reduce the amount of food it can hold.
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The surgery treats severe obesity. A calculation called body mass index (
) is used to determine how overweight or obese you are. A normal BMI is 18.5-25.
This surgery is a weight loss option for people with: BMI greater than 40BMI 35-39.9 and a life-threatening condition or severe physical limitations that affect employment, movement, and family life
The success of vertical banded gastroplasty depends on your commitment. If lifestyle changes are made and maintained, the benefits of bariatric surgery include: Weight reductionImprovement in many obesity-related conditionsImproved movement and staminaEnhanced mood, self-esteem, and quality of life
If you are planning to have gastroplasty, your doctor will review a list of possible complications, which may include: BleedingInfectionBlood clotsVomitingBreakdown of the staples, allowing stomach juices to leak into the abdomenSlipping or wearing away of the bandEnlargement of the pouchIrritation of the throat due to acid refluxHernia
Complications of general anesthesiaDeath
Long-term complications include vomiting and gallstones.
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as: SmokingDrinking
Chronic diseases, such as
Before the procedure, you may have the following: Thorough physical exam and review of medical historyOngoing consultations with a registered dietitianMental health evaluation and counseling
Leading up to your procedure: Talk to your doctor about your medications, herbs, and dietary supplements. You may be asked to stop taking some medications up to 1 week before the procedure.Do not start any new medications, herbs, or supplements without talking to your doctor.Arrange for a ride to and from the hospital.Arrange for help at home as you recover.You may be given antibiotics.You may be given laxatives and/or an enema to clear your intestines.The night before, eat a light meal. Do not eat or drink anything after midnight unless told otherwise by your doctor.Shower or bathe the morning of your surgery.
To prepare you for surgery, an IV will be placed in your arm. You may receive fluids and medications through this line during the procedure. A breathing tube will be placed through your mouth and into your throat. This will help you breathe during surgery. You will also have a catheter placed in your bladder to drain urine.
begins with several small cuts made in the abdomen. Gas will be pumped in to inflate your abdomen. This will make it easier for the doctor to see. A laparoscope and surgical tools will be inserted through the incisions. A laparoscope is a thin, lighted tool with a tiny camera. It sends images of your abdominal cavity to a monitor in the operating room. Your doctor will operate while viewing the area on this monitor.
Surgical staples will be used to divide your stomach into two unequal portions. The upper portion will be a small pouch. It will empty through a tiny opening into the lower portion. The small pouch can hold only ½ to 1 cup of soft, moist, and well-chewed food. A normal stomach can hold 4-6 cups.
Next, a plastic band will be wrapped around the tiny opening. This will prevent it from stretching. This band can be adjusted after surgery. The incisions will then be closed with staples or stitches.
Vertical Banded Gastroplasty
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The breathing tube will be removed. You will be taken to the recovery area.
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
You will be in the hospital for 2-5 days. Your doctor may choose to keep you longer, however, if complications arise.
While you are recovering at the hospital, you may receive the following care: Pain medication will be given as needed.
Day of surgery—You will not eat or drink anything.
Day after surgery—You will likely have an
to check for leaks from the stomach pouch. You will drink a special liquid while x-rays are taken.
If this x-ray is normal, you will be given 30 milliliters (mL) of liquids every 20 minutes.If leaks are found, you will receive nutrition through an IV until the leaks are fixed.On the second day after surgery—You will have 1-2 tablespoons of pureed food or 1-2 ounces of liquids every 20 minutes.
You may be asked to do the following:
to take deep breaths every hour to prevent breathing problems.
Wear elastic surgical stockings or boots to promote blood flow in your legs.Get up and walk daily.
During your stay, the hospital staff will take steps to reduce your chance of infection, such as: Washing their handsWearing gloves or masksKeeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as: Washing your hands often and reminding visitors and healthcare providers to do the sameReminding your healthcare providers to wear gloves or masksNot allowing others to touch your incision
Be sure to follow your doctor’s
instructions. You will need to practice lifelong healthy eating and exercising habits. After your surgery: Do not lift anything heavy for at least two weeks.You may have emotional changes after this surgery. Your doctor may refer you to a therapist.You will meet regularly with your healthcare team for monitoring and support.
Your new stomach is the size of a small egg. It is slow to empty. This will make you feel full quickly. Nutritional steps include: You need to eat very small amounts and eat very slowly.You will begin with 4-6 small meals per day. A meal is two ounces of food.For the first 4-6 weeks after surgery, all food must be pureed.When you move to solid foods, food must be well-chewed.When making food choices, ensure that you are getting enough protein.Eating too much or too quickly can cause vomiting or intense pain under your breastbone. Most people quickly learn how much food they can eat.
This procedure does not cause nausea and
if sweet or fatty foods are eaten. In fact, some people gain back weight because they continue to consume high-calorie foods. To promote ongoing weight loss, avoid high-calorie foods.
Be sure to follow your doctor’s
Call your doctor if any of these occur: Signs of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
, shortness of breath, or chest pain
Worsening abdominal painBlood in the stoolPain, burning, urgency or frequency of urination, or persistent bleeding in the urinePersistent nausea and/or vomitingPain and/or swelling in your feet, calves, or legs; sudden shortness of breath or chest painNew or worsening symptoms
If you think you have an emergency, call for emergency medical services right away.
Bariatric surgery. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated November 3, 2014. Accessed December 4, 2014.
Bariatric surgery for severe obesity. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
http://win.niddk.nih.gov/publications/gastric.htm. Updated June 2011. Accessed December 4, 2014.
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Last reviewed December 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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