Rebecca Thoreson1, Joseph J Cullen. 1. Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Abstract
INTRODUCTION: Vertical banded gastroplasty (VBG) was initiated in 1980 as a weight loss operation that restricted oral intake. OBJECTIVE: The aim of our study was to determine the results of patients who presented with complications of the VBG and wanted reversal of the VBG, not a conversion to another gastric weight loss operation. MATERIAL AND METHODS: From 1993 to 2008, 27 patients had reversal of a VBG. Of the patients, 85% were female and presented on average 13 years (range 2-27 years) after the VBG. Presenting symptoms included nausea/vomiting in 88%, reflux in 65%, stricture requiring endoscopic dilatation in 38%, while 7% of patients had upper gastrointestinal bleeding or required total parenteral nutrition. Patients were offered conversion to another weight loss operation but decided on reversal of the VBG alone. All reversals were performed in a similar manner by placing a linear stapler through a gastrotomy resulting in division of the polypropylene mesh band, and reversal of the VBG pouch. RESULTS: No patients died from the procedure and morbidity included one wound infection and one wound seroma. Preoperative Visick score decreased significantly after reversal, while reflux symptoms resolved in 93% of patients. CONCLUSION: We conclude that reversal of a VBG results in symptomatic relief in the majority of patients.
INTRODUCTION:Vertical banded gastroplasty (VBG) was initiated in 1980 as a weight loss operation that restricted oral intake. OBJECTIVE: The aim of our study was to determine the results of patients who presented with complications of the VBG and wanted reversal of the VBG, not a conversion to another gastric weight loss operation. MATERIAL AND METHODS: From 1993 to 2008, 27 patients had reversal of a VBG. Of the patients, 85% were female and presented on average 13 years (range 2-27 years) after the VBG. Presenting symptoms included nausea/vomiting in 88%, reflux in 65%, stricture requiring endoscopic dilatation in 38%, while 7% of patients had upper gastrointestinal bleeding or required total parenteral nutrition. Patients were offered conversion to another weight loss operation but decided on reversal of the VBG alone. All reversals were performed in a similar manner by placing a linear stapler through a gastrotomy resulting in division of the polypropylene mesh band, and reversal of the VBG pouch. RESULTS: No patients died from the procedure and morbidity included one wound infection and one wound seroma. Preoperative Visick score decreased significantly after reversal, while reflux symptoms resolved in 93% of patients. CONCLUSION: We conclude that reversal of a VBG results in symptomatic relief in the majority of patients.