Vertical Banded Gastroplasty—Open Surgery

Definition

Reasons for Procedure

Possible Complications

What to Expect

Problems to Look Out For

En Español

Vertical Banded Gastroplasty—Open Surgery

(Stomach Stapling; Bariatric Surgery; Weight-Reduction Surgery)

by Cynthia M. Johnson, MA

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.

The Stomach

This surgery involves re-shaping the stomach to reduce the amount of food it can hold.

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

A large inch incision will be made to open the abdomen. Surgical staples will be used to divide your stomach into two unequal parts. The upper portion 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 portion. A plastic band will be wrapped around the tiny opening. It will prevent it from stretching. This band can be adjusted after surgery. The incisions will be closed with stiches or staples. Bandages 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:
...(Click grey area to select URL)
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

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