Gastric restriction procedures for treating severe obesity.

Gastric restriction procedures are operations to decrease gastric volume. They are the most common, simple, and safe operations for the treatment of severe obesity. The original horizontal gastroplasties were unsuccessful but modern operations such as vertical banded gastroplasty, silastic ring gastroplasty, and gastric banding produce good weight loss with improvement in health. Although late weight gain does occur, satisfactory 5-y results are available and are presented. Patient selection, complications, mechanism of action, and future studies are also discussed. Long-term data with complete patient follow-up and randomized trials comparing modern operations with nonoperative treatment are still needed.