An assessment of vertical banded gastroplasty-Roux-en-Y gastric bypass for the treatment of morbid obesity

• Published in: The American journal of surgery Vol. 183; no. 2; pp. 117 - 123
• Main Authors: Capella, Joseph F, Capella, Rafael F
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-02-2002; Elsevier; Elsevier Limited
• Subjects: Adult; Anastomosis, Roux-en-Y; Bariatric surgery; Biological and medical sciences; Body weight; Complications; Embolism; Female; Fistula; Gastric Bypass; Gastrointestinal surgery; Gastroplasty - methods; Humans; Incidence; Ligaments; Male; Medical sciences; Mesentery; Metabolic diseases; Morbid obesity; Morbidity; Mortality; Obesity; Obesity, Morbid - surgery; Patients; Postoperative Complications - epidemiology; Reoperation; Retrospective Studies; Small intestine; Stomach; Stomach, duodenum, intestine, rectum, anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Sutures; Treatment Outcome; Ulcers; Vertical banded gastroplasty-Roux-en-Y gastric bypass; Weight; Weight control; Weight Loss; Morbid obesity; Vertical banded gastroplasty-Roux-en-Y gastric bypass; Gastric bypass; Bariatric surgery; Human; Vertical; Stomach; Obesity; Nutrition disorder; Roux en Y loop; Result; Plasty; Treatment; Bypass; Surgery; Complication; Technique; Severe; Nutritional status
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/S0002-9610(01)00871-6

Objective: To analyze retrospectively the mortality, morbidity, and weight loss of a specific form of gastric bypass for the treatment of morbid obesity. The technique incorporates a small pouch along the lesser curvature of the stomach, an outlet restricted by a nondistensible band and a Roux-en-Y gastric bypass.
Material and methods: We analyzed 652 consecutive patients with no previous bariatric surgery who underwent our present form of gastric bypass. Parameters used to evaluate the technique included mortality, weight loss at 5 years and complications. The operation is a combination of vertical banded gastroplasty and Roux-en-Y gastric bypass (VBG-RGB). The patients followed up to 5 years had an initial weight of 140 kg [range, 94 to 288] and a BMI of 50 [range, 38 to 86]. Superobese individuals (BMI of 60 [range, 48 to 86]) made up 42% of the group.
Results: There was an early reoperation rate of 0.5%. The incidence of late complications that required reoperation was 0.5%. There were 2 deaths in the study from pulmonary embolism for a mortality of 0.3%. At 5 years, the patients had lost an average of 58kg [range, 14 to 143] and had a percentage excess weight loss of 77 [range, 32 to 108]. Their BMI was reduced to 29 kg/m
2 [range, 20 to 43] and 93% lost more than 50% of the excess weight.
Conclusions: VBG-RGB is effective in producing superior weight loss in morbid and superobese patients and has a low mortality and morbidity. We recommend this procedure without reservations.