Vertical Banding Gastroplasty (VBG) was once the desired weight loss surgery option for many institutions and surgeons. In 1991, vertical banding gastroplasty was endorsed by the National Institutes of Health Consensus Conference for the treatment of morbid obesity [3], but today bariatric surgeons opt for more reliable procedures including Roux-en-Y gastric bypass.

Vertical Banded Gastroplasty Revisions

Vertical Banded Gastroplasty is no longer being performed in the United States, however small procedures are being done worldwide.

Since the 1980s, it has been reported that some patients may require a second surgical intervention due to the presence of complications or insufficient weight loss after VBG; however, over time, the number of patients who need revisionary bariatric surgery has grown. [1]

Revising a failed bariatric procedure is a significant challenge for any bariatric surgeon. There are several options to revising a vertical banded gastroplasty including:

  1. Gastric Sleeve Surgery (VSG)
  2. Re-VBG, Re-doing Vertical Banded Gastroplasty
  3. Roux-en-Y Gastric Bypass Surgery
  4. Conversion to a Biliopancreatic Diversion

One study suggest Roux-en-Y Gastric Bypass the go-to revisional surgery option. A 2009 study suggests that compared to Re-VBG, Roux-en-Y Gastric Bypass, demonstrate the lowest rate of complications and better quality of life [1]. Another common option, the Biliopancreatic Diversion with Duodneal Switch (BPD), shows compare rates of complication and sufficient weight loss [2].

Not every patient is capable of converting their VBG to their desired option. In the recent case study, a patient who had intended to revise VBG to Roux-en-Y Gastric Bypass, but when the doctor was performing the surgery he found something unusual.

The band, which wraps around the stomach to restrict the food intake, was lost

The only other option, that the patient can do is perform Gastric Sleeve Surgery. This will allow the patient to heal, so they can undergo gastric bypass surgery at a later date.

Citations:

  1. Peter Vasas, Bruno Dillemans, Sebastiaan Van Cauwenberge, Marieke De Visschere, and Charlotte Vercauteren, “Short- and Long-Term Outcomes of Vertical Banded Gastroplasty Converted to Roux-en-Y Gastric Bypass,” Obesity Surgery, vol. 23, no. 2, pp. 241–248, 2013.
  2. Menon T, Quaddus S, Cohen L.,”Revision of failed vertical banded gastroplasty to non-resectional Scopinaro biliopancreatic diversion: early experience,” Obesity Surgery. 2006 Nov;16(11):1420-4.
  3. Daniel J. Gagné, Elizabeth Dovec, Jorge E. Urbandt, “Laparoscopic revision of vertical banded gastroplasty to Roux-en-Y gastric bypass: outcomes of 105 patients,” Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery 1 July 2011 (volume 7 issue 4 Pages 493-499 DOI: 10.1016/j.soard.2010.10.014)