Vertical Banded Gastroplasty
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GENERAL INFORMATION:
What is vertical banded gastroplasty (VBG)?
- Vertical banded gastroplasty (GAS-troh-plas-tee) is also called "gastric stapling" or "stomach stapling". VBG is a surgery that is done to help a severely obese (very overweight) person lose weight. During surgery caregivers use a soft band and staples to make a small stomach pouch. The staples help to form the side wall of the pouch. The band is located at the lower part of the pouch and creates a narrow opening.
- When you eat, food collects in the stomach pouch. Because the pouch is very small, you will feel full quickly. The narrow opening (stoma) at the bottom of the stomach pouch allows food to pass into the rest of the stomach. Between meals, the food moves from the pouch to the stomach and is digested (broken down) normally. Over time, you may lose weight because you feel full sooner and cannot eat as much food during a meal.
How is VBG done? VBG may be done during laparoscopic surgery. During surgery, small incisions (cuts) are made in your stomach. A laparoscope (tube with a camera on the end) and other instruments are put through the incisions. Caregivers use them to staple your stomach, and place a band around the bottom of the stomach pouch. VBG may also be done during a laparotomy. In this procedure, one large incision is made in your stomach. Caregivers staple your stomach and put on the gastric band through this incision.
When will I begin to lose weight? Right after surgery, you will look and weigh about the same as you did before surgery. As you begin your new eating habits, you will begin to lose weight. The amount of weight, and the speed at which you lose it depends on certain things. These include how well you follow your diet and exercise plans, how healthy you are, and how much you weighed before surgery. Losing the amount of weight that you want after VBG takes time. It may take 18 to 24 months to reach the weight that is best for you.
What is body mass index (BMI)? BMI is a number that describes the type of weight that you have. People with a normal weight have a lower BMI. An overweight or obese person has a higher BMI. Caregivers can calculate (find out) your BMI using your height and weight. Your BMI number will help caregivers decide whether or not you are someone who can have weight loss surgery. You may learn your BMI using the following:
- Multiply your weight (in pounds) by 703. For example, if you weigh 300 pounds, this equals 210900.
- Multiply your height (in inches) by your height (in inches). If you are 65 inches tall, this equals 4225.
- Divide the first number (210900) by the second number (4225). This equals 49.9. This is the BMI for a person who weighs 300 pounds, and is 5 feet, 4 inches (65 inches) tall.
Who should have VBG surgery? You may be able to have VBG or another type of weight loss surgery if:
- Your bariatric (weight loss) caregiver suggests that you have it.
- You have tried, but have not been able to lose weight or keep weight off. You may have tried exercise, diets, and weight loss medicines.
- You have a BMI that is one of the following:
- BMI greater than 40 (about 100 pounds or more overweight).
- BMI greater than 35 with a life-threatening health problem that is related to being overweight. Examples of these health problems are heart disease, sleep apnea, high blood pressure, and diabetes.
- BMI greater than 40 (about 100 pounds or more overweight).
- Your obesity causes problems with employment (getting or keeping a job), lifestyle, or movement such as walking.
- You are willing to change eating habits and make the lifestyle changes needed to lose weight and keep it off. You agree to work closely with a caregiver or weight management team. You understand what will happen during and after weight loss surgery, and you accept the risks.
- You will need to talk to doctors to learn if you would be able to have bariatric surgery. You will need to meet with a surgeon to talk about surgery options. The surgeon may ask you to meet with other caregivers for exams and tests. For example, you may need to have a psychological (mental) test. You may need to talk with a specially-trained caregiver about your eating habits. Medical records and test results from other caregivers will help the surgeon decide if you should have this surgery.
- You do not abuse drugs or alcohol.
- Your obesity is not caused by a problem with your glands.
How do I find a weight loss surgeon? A bariatric surgeon is a specially-trained caregiver who does weight loss surgery. Talk to your doctor about your health and weight loss surgery. You may want to contact the following to find a bariatric surgeon in your area:
- American Society of Bariatric Surgeons (ASBS)
100 SW 75th Street
Gainesville, FL 32607
Phone: 1-352-331-4900
Web Address: http://www.asbs.org
What are the benefits of VBG?
- VBG may help you lose weight by decreasing the amount of food you can eat during meals.
- Losing a large amount of weight may decrease or get rid of obesity-related health problems. These problems include diabetes, and problems with your heart, blood pressure, and joints.
- Losing a large amount of weight may increase a woman's ability to get pregnant.
- Losing weight may make you feel better about yourself, your body, and life in general.
What are the risks with VBG?
- You may bleed too much or get an infection. You may get blood clots. Your esophagus or other organs may be injured during surgery. The gastric band may break, cause a scar or erode (eat into) the stomach tissue. Your staple line could break down. Stomach juices may leak into your abdomen and you may need emergency surgery. You may develop gallstones from losing weight quickly. After surgery, you may lose weight and then gain it back. You may not lose enough weight. Years after surgery, you may gain weight due to breakdown in the surgery area of your stomach. If you get pregnant while you are quickly losing weight, this could harm you and your unborn baby.
- If you often eat too much and do not follow instructions, you may stretch out your stomach pouch. If you eat too much, too fast, or do not chew well enough before swallowing you may have other problems. These problems include feeling sick to your stomach, having a stomachache, and throwing up. You may get acid reflux (heartburn) or a stomach ulcer. Food that is not chewed well enough may get stuck in your stoma (opening between the small and large stomach pouches). You may not get enough protein and vitamins from your diet, especially if you vomit a lot. This may lead to some hair loss, anemia, or other medical problems. You may need another surgery later. As in any surgery, you may die from complications. The risk of surgery must be compared to the risk of being severely obese.
- It is important to follow your weight loss team or caregiver's instructions for the rest of your life. This includes changing your eating habits and lifestyle, taking vitamins and supplements, and going to regular medical appointments. If you do these things, you will decrease your risk of having problems after surgery.
Where can I go for information and support? Talk to your caregivers, family, and friends about VBG and weight loss. Let them help you before and after surgery. Join a bariatric support group and begin attending meetings before you go to surgery. This is a group of people who plan to or have already had weight loss surgery. Ask your caregiver for the names and numbers of support groups near you. For more information about support groups, obesity and VBG, contact the following:
- American Obesity Association
1250 24th Street, NW
Washington, DC 20037
Phone: 1-202-776-7711
Web Address: http://www.obesity.org
CARE AGREEMENT:
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.
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