Understanding Vertical Banded Gastroplasty

Allegheny General Hospital

Miles Lance Weaver, M.D., F.A.C.S.

Allegheny General Hospital

West Penn Allegheny Health System

320 East North Avenue

Pittsburgh, PA 15212-4772

This educational brochure about vertical banded gastroplasty was developed to make you more familiar with the procedure and what to expect before, during and after treatment. We hope that this brochure will answer many of your questions, and after reviewing the information with a staff member, you will have a better understanding of the procedure.

What is obesity?

Obesity is defined as being at least 20 percent over your recommended weight.

What is morbid obesity?

Morbid obesity is defined as obesity of such magnitude that it is considered life- threatening. Morbid obesity means that you are at least 100 pounds heavier than your ideal body weight.

Why should morbid obesity be treated?

Morbid obesity is associated with many severe and, in some cases, life-threatening health problems, such as diabetes, hypertension, heart disease, sleep apnea, gallbladder disease and cancer. Most morbidly obese individuals also complain of severe shortness of breath, back and joint pain, and various other problems. If not corrected, morbid obesity often leads to premature death. Morbid obesity also affects quality of life.

How can I lose this excess weight?

Strict dieting, exercise and, in some cases, medication may help you lose weight. However, less than 5 percent of individuals are able to maintain weight loss. As a result, other options may be necessary.

Is surgery an option for treating morbid obesity?

Various surgical procedures have been developed for the treatment of morbid obesity. The goal of surgery is permanent weight loss. Early weight-reduction surgeries focused on interfering with the body's absorption of calories and other food nutrients. Because of complications associated with these earlier procedures, current weight-loss surgery focuses on limiting the amount of food that the body may take in.

What is vertical-banded gastroplasty?

Vertical-banded gastroplasty is a surgical procedure to create a small pouch in the upper stomach. A gortex band is then applied to the outlet of this pouch. This limits the amount of food your body can take in and allows for prolonged periods of feeling full by slowing the movement of food from the pouch. The procedure does not interfere with the body's nutrient absorption.

Who qualifies for vertical-banded gastroplasty?

To qualify for this surgery, you must be at least 100 pounds over your ideal body weight. Exceptions may be made when obesity contributes to other medical problems. You also must have made serious attempts to lose weight through non-surgical approaches, such as dieting, exercise or joining a weight-loss club. Candidates for the procedure must be motivated and willing to make lifestyle changes that are essential to maintaining permanent weight loss.

Are there risks involved with vertical-banded gastroplasty?

Complications are associated with less than 2 percent of these surgeries. Long-term complications are associated with less than 5 percent of these procedures - lower than the rate of complications associated with morbid obesity. There are risks involved with all abdominal surgery and use of general anesthesia. Those risks include bleeding, infection, pneumonia and other heart and lung problems.

How long will I need to stay in the hospital?

To allow the stomach to adequately heal before you orally take food and liquids, a five-to-six-day hospital stay usually is required following vertical-banded gastroplasty.

What may I eat after I leave the hospital?

There are strict guidelines for what you may eat following hospital discharge. You will be asked to stay on a liquid diet for two weeks, after which you may begin a soft diet. One month after the surgery, you may resume a normal diet. At all times following the surgery, you are permitted to take in calories no more than twice a day and drink only calorie-free liquids.

What other eating guidelines should I follow to successfully lose weight?

In addition to limiting your calorie intake, you should adhere to the following guidelines:

• Chew solid foods thoroughly.
• Slowly sip liquids; do not gulp.
• Stop eating when you begin to feel full.
• Spend no more than 25 minutes eating a meal.
• Take small bites (about the size of a lima bean).
• Drink at least two quarts of liquid a day.
• Eat foods that are high in bulk, such as bread, bagels, pasta and pizza.
• Avoid crackers, toast, cookies, potato chips and other toasted foods.
• Take a high-potency multivitamin (in either chewable or liquid form).

What else can I expect when I leave the hospital?

In addition to dietary guidelines, you will be asked to adhere to the following:

• Do not drive for one to two weeks.
• Do not lift for six weeks.
• Wait at least six weeks before returning to work.

How much weight can I expect to lose? How long will it take?

The amount of weight loss varies by patient and is largely determined by your original weight. The heavier you are, the faster you are likely to lose weight. By following the instructions provided before surgery, you can expect to lose your excess weight within 12 to 18 months.

Is exercise important?

Exercise is important for maximizing your weight loss and improving general muscle tone and circulation. Exercise may also help tighten your skin after your weight loss.

How can I learn more about the surgery?

An Allegheny General nurse teaches a class at the hospital for all patients scheduled for the vertical banded gastroplasty by Miles Lance Weaver, M.D., F.A.C.S. At the class, you will meet other patients considering the surgery, as well as a patient who has undergone the procedure. This class includes a question-and-answer session.

What is the first step?