Vertical banded gastroplasty, also called stomach stapling, is surgery that divides the stomach into 2 parts to treat obesity . It causes weight loss by decreasing the amount of food you can eat.
Reasons for Procedure
The surgery treats severe obesity. A calculation called body mass index ( BMI ) is used to determine how overweight or obese you are. A normal BMI is 18.5-25.
This surgery is a weight loss option for people with:
- BMI greater than 40
- BMI 35-39.9 and a life-threatening condition or severe physical limitations that affect employment, movement, and family life
The success of vertical banded gastroplasty depends on your commitment. If lifestyle changes are made and maintained, the benefits of bariatric surgery include:
- Weight reduction
- Improvement in many obesity-related conditions
- Improved movement and stamina
- Enhanced mood, self-esteem, and quality of life
If you are planning to have gastroplasty, your doctor will review a list of possible complications, which may include:
- Blood clots
- Breakdown of the staples, allowing stomach juices to leak into the abdomen
- Slipping or wearing away of the band
- Enlargement of the pouch
- Irritation of the throat due to acid reflux
- Hernia formation
- Complications of general anesthesia
Long-term complications include vomiting and gallstones.
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:
What to Expect
Prior to Procedure
Before the procedure, you may have the following:
- Thorough physical exam and review of medical history
- Ongoing consultations with a registered dietitian
- Mental health evaluation and counseling
Leading up to your procedure:
- Talk to your doctor about your medications, herbs, and dietary supplements. You may be asked to stop taking some medications up to 1 week before the procedure.
- Do not start any new medications, herbs, or supplements without talking to your doctor.
- Arrange for a ride to and from the hospital.
- Arrange for help at home as you recover.
- You may be given antibiotics.
- You may be given laxatives and/or an enema to clear your intestines.
- The night before, eat a light meal. Do not eat or drink anything after midnight unless told otherwise by your doctor.
- Shower or bathe the morning of your surgery.
General anesthesia will be used. You will be asleep for the surgery.
Description of the Procedure
The laparoscopic method begins with several small cuts made in the abdomen. Gas will be pumped in to inflate your abdomen. This will make it easier for the doctor to see. A laparoscope and surgical tools will be inserted through the incisions. A laparoscope is a thin, lighted tool with a tiny camera. It sends images of your abdominal cavity to a monitor in the operating room. Your doctor will operate while viewing the area on this monitor.
Surgical staples will be used to divide your stomach into two unequal portions. The upper portion will be a small pouch. It will empty through a tiny opening into the lower portion. 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.
Next, a plastic band will be wrapped around the tiny opening. This will prevent it from stretching. This band can be adjusted after surgery. The incisions will then be closed with staples or stitches.
Immediately After Procedure
The breathing tube will be removed. You will be taken to the recovery area.
How Long Will It Take?
About 2 hours
How Much Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Average Hospital Stay
You will be in the hospital for 2-5 days. Your doctor may choose to keep you longer, however, if complications arise.
While you are recovering at the hospital, you may receive the following care:
- Pain medication will be given as needed.
- Day of surgery—You will not eat or drink anything.
Day after surgery—You will likely have an
to check for leaks from the stomach pouch. You will drink a special liquid while x-rays are taken.
- If this x-ray is normal, you will be given 30 milliliters (mL) of liquids every 20 minutes.
- If leaks are found, you will receive nutrition through an IV until the leaks are fixed.
- On the second day after surgery—You will have 1-2 tablespoons of pureed food or 1-2 ounces of liquids every 20 minutes.
You may be asked to do the following:
- Use an incentive spirometer to take deep breaths every hour to prevent breathing problems.
- Wear elastic surgical stockings or boots to promote blood flow in your legs.
- Get up and walk daily.
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as:
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incision
Be sure to follow your doctor’s instructions. You will need to practice lifelong healthy eating and exercising habits. After your surgery:
- Do not lift anything heavy for at least two weeks.
- You may have emotional changes after this surgery. Your doctor may refer you to a therapist.
- 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. This will make you feel full quickly. Nutritional steps include:
- You need to eat very small amounts and eat very slowly.
- You will 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.
- When you move to solid foods, food must be well-chewed.
- When making food choices, ensure that you are getting enough 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.
- This procedure does not cause nausea and diarrhea if sweet or fatty foods are eaten. In fact, some people gain back weight because they continue to consume high-calorie foods. To promote ongoing weight loss, avoid high-calorie foods.
- Be sure to follow your doctor’s instructions.
Call Your Doctor
Contact your doctor if your recovery is not progressing as expected or you develop complications such as:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
- Persistent cough , shortness of breath, or chest pain
- Worsening abdominal pain
- Blood in the stool
- Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
- Persistent nausea and/or vomiting
- Pain and/or swelling in your feet, calves, or legs; sudden shortness of breath or chest pain
- New or worsening symptoms
If you think you have an emergency, call for emergency medical services right away.
- Reviewer: Marcin Chwistek, MD
- Review Date: 12/2015 -
- Update Date: 12/20/2014 -