Vertical Banded Gastroplasty—Laparoscopic Surgery
(Stomach Stapling; Bariatric Surgery; Weight-Reduction Surgery)
Definition
Vertical banded gastroplasty, also called stomach stapling, is surgery to divide the stomach into two parts.
There are many types of weight loss surgery. This option is not done as often, but still may be used on some people.
This surgery involves re-shaping the stomach to reduce the amount of food it can hold.
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Reasons for Procedure
This surgery is done to make the size of the stomach smaller. This will make a person feel full quickly. It will promote weight loss in people who are severely obese. It is done when other methods have not been helpful.
In addition to helping a person lose weight, this surgery may also:
- Improve physical function
- Lower high blood pressure
- Lower blood glucose levels
- Lower cholesterol levels
- Lower the risk of heart disease
- Reduce sleep apnea
Possible Complications
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Infection
- Blood clots
- Lasting nausea and vomiting
- Breakdown of the staples, allowing stomach fluids to leak into the abdomen
- Slipping or wearing away of the band
- Enlargement of the pouch
- Acid reflux
- Gallstones
- Hernia
- Heart attack
Things that may raise the risk of problems are:
- Smoking
- Drinking alcohol
- Chronic diseases, such as diabetes
What to Expect
Prior to Procedure
The bariatric surgery team will meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from surgery
- Specialists you may need to see, such as a registered dietitian
- Tests that will need to be done before surgery, such as mental health counseling
Anesthesia
You will be given general anesthesia. You will be asleep.
Description of the Procedure
Several small incisions will be made in your abdomen. Gas will be pumped in to inflate your abdomen and make it easier to view the stomach. A thin, lighted tool with a tiny camera will be inserted through an incision. A monitor will be used to view the images. Other tools will be inserted into other incisions. Staples will be used to divide your stomach into two unequal parts. The upper part will be a small pouch. The small pouch can hold only ½ to 1 cup of soft, moist, and well-chewed food. A normal stomach can hold 4 to 6 cups. The pouch will empty through a tiny opening into the lower part. 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 be closed with staples or stiches. A bandage will be placed over the area.
How Long Will It Take?
About 2 hours
Will It Hurt?
Pain and swelling are common in the first 1 to 2 weeks. Medicine and home care can help.
Average Hospital Stay
You will be in the hospital for 2 to 5 days. If you have any problems, you may need to stay longer.
Post-procedure Care
At the Hospital
After the procedure, the staff may:
- Take an x-ray to look for leaks from the stomach pouch.
- Give you pain medicine.
- Give you clear liquids
- Encourage you to begin walking
- Teach you how to use an incentive spirometer to prevent breathing problems
- Give you compression stockings to promote blood flow to your legs
During your stay, the hospital staff will take steps to lower your risk of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to lower your risk of infection, such as:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your incisions
At Home
It will take a few weeks for the incision and muscles to fully heal. Physical activity will be limited during this time. You will need to ask for help at home and delay your return to work.
Dietary changes, regular exercise, and counseling will need to be part of your recovery and lifelong weight loss plan.
Problems to Look Out For
Call the doctor if you are not getting better or you have:
- Signs of infection, such as fever and chills
- Redness, swelling, excessive bleeding, or discharge from the incision
- Pain that you cannot control with medicine
- Pain and swelling in your feet, calves, or legs
- Lasting nausea or vomiting
- Blood in your stool
- Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
- Cough
- Shortness of breath
- Chest pain
- New or worsening symptoms
If you think you have an emergency, call for medical help right away.
RESOURCES:
American Society for Metabolic and Bariatric Surgery
https://asmbs.org
National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov
CANADIAN RESOURCES:
HealthLink BC
https://www.healthlinkbc.ca
Weight Loss Surgery
https://weightlosssurgery.ca
REFERENCES:
Bariatric surgery. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/nutritional-disorders/obesity-and-the-metabolic-syndrome/bariatric-surgery. Accessed September 27, 2021.
Bariatric surgery in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/bariatric-surgery-in-adults. Accessed September 27, 2021.
Weight-loss (bariatric) surgery. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/weight-management/bariatric-surgery. Accessed September 27, 2021.
Last reviewed July 2021 by EBSCO Medical Review Board Marcin Chwistek, MD Last Updated: 9/28/2021