Vertical Banded Gastroplasty

Open Method

The open method begins with an 8-10 inch incision to open the abdomen.

Laparoscopic Method

The laparoscopic method begins with several small incisions in the abdomen. Gas is pumped in to inflate your abdomen. This makes it easier for the surgeon to see. Your surgeon passes a laparoscope and surgical tools through these incisions. A laparoscope is a thin, lighted instrument with a tiny camera that projects images of your abdominal cavity on a monitor. Your surgeon performs the operation while viewing the surgical area on this monitor.

Both Methods

Both surgical methods proceed as follows: Your surgeon uses surgical staples to divide your stomach into two unequal portions. The upper portion is a small pouch. It empties through a tiny opening into the lower portion. Next, your surgeon wraps a band of polypropylene mesh around the tiny opening to prevent it from stretching. This band can be adjusted after surgery.

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.

Your surgeon will close the incisions with staples or stitches.

At the Hospital

While you are recovering at the hospital, you may receive the following care:

• Pain medication will be given as needed.
• If you have sleep apnea, you’ll be placed on a breathing monitor.
• Your diet:
  • Day of surgery—You won't eat or drink anything.
  • Day after surgery—You’ll likely have an upper GI x-ray to check for leaks from the stomach pouch. You’ll drink a special liquid while x-rays are taken.
    • If this x-ray is normal, you’ll be given 30 milliliters (mL) of liquids every 20 minutes.
    • If leaks are found, you’ll receive nutrition through an IV until the leaks are fixed.
  • Second day after surgery—You’ll have1-2 tablespoons of pureed food or 1-2 ounces of liquids every 20 minutes.
• You may be asked to do the following:
  • Use a spirometer to take deep breaths every hour to prevent breathing problems.
  • Wear elastic surgical stockings to promote blood flow in your legs.
  • Get up and walk in the hall daily.

At Home

You may be out of work for 2-6 weeks after surgery (less time with laparoscopic, but more time following an open procedure). Do not drive or lift anything heavy for at least two weeks. You’ll need to practice lifelong healthful eating and exercising habits. You should walk as soon as possible, with a goal of exercising daily. You may have emotional ups and downs after this surgery. 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, causing you to feel full quickly. You need to eat very small amounts and eat very slowly. You’ll 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. Once you move to solid foods, food must be well-chewed.

When making food choices, ensure that you are getting adequate 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. Unlike gastric bypass, vertical banded gastroplasty does not cause symptoms—such as nausea and diarrhea—if sweet or fatty foods are eaten. In fact, some people gain back weight because they continue to consume soda, ice cream, or other high-calorie foods. To promote ongoing weight loss, avoid high-calorie foods.