Checklist #26: Management of Complicated or Failed Vertical Banded Gastroplasty

by Raul J. Rosenthal, MD, FACS, FASMBS; Samuel Szomstein, MD, FACS, FASMBS; and  Emanuele Lo Menzo, MD, PhD, FACS, FASMBS

Column Editor

Raul J. Rosenthal, MD, FACS, FASMBS
Clinical Editor, Bariatric Times, Professor of Surgery and Chairman, Department of General Surgery; Director, The Bariatric and Metabolic Institute; Director, General Surgery Residency Program and Fellowship in Minimally Invasive and Bariatric Surgery, Cleveland Clinic Florida, Weston, Florida

Column Co-editors

Samuel Szomstein, MD, FACS, FASMBS
Associate Director of the Bariatric Institute and Section of Minimally Invasive Surgery at the Cleveland Clinic in Weston, Florida, and Clinical Associate Professor of Surgery, Florida International University

E. Lo Menzo MD PhD FACS FASMBS
Staff Surgeon, The Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic Florida, Weston, Florida.

Welcome to “Checklists in Bariatric Surgery.” This column’s aim is to help bariatric surgeons quickly review the reasons for potential problems when caring for bariatric patients.

This month’s Checklist focuses on management of complicated or failed vertical banded gastroplasty (VBG). The VBG is a procedure that has been abandoned in which restriction was obtained by a lesser curvature based gastric tube, with the outlet restricted by an extrinsic implant. In the original description by Mason, the operation was done open, the vertical staple line of the stomach was not divided, and the outlet was restricted by a ring made of  Marlex or Dacron mesh. In the laparoscopic modification (MacLean) of this procedure, the vertical staple line was divided and the outlet restricted by a silastic ring.

Failure rates after VBG have been reported in up to 79 percent and complications in up to 25 percent of cases.
We present this 26th installment of “Checklists” based on peer-reviewed publications, which might help our readers communicate better and treat patients expeditiously. We hope you clip and save this convenient checklist and find it useful as a reference tool in your everyday practice. Please stay tuned for more checklists in upcoming issues of Bariatric Times.

View the Checklist in the digital edition HERE.

References
1.    Vasas P, Dillemans B, Van Cauwenberge S, De Visschere M, Vercauteren C. Short-and long-term outcomes of vertical banded gastroplasty converted to Roux-en-Ygastric bypass. Obes Surg. 2013;23(2):241–248.
3.    Balsiger BM, Poggio JL, Mai J, Kelly KA, Sarr MG. Ten and more years after vertical banded gastroplasty as primary operation for morbid obesity. J Gastrointest Surg. 2000;4(6):598–605.

Acknowledgment: We would like to acknowledge the indispensable contribution of Dr. Alex Ordonez to this article.

FUNDING: No funding was provided.

DISCLOSURES: Dr. Rosenthal receives educational grants from Covidien, Baxter, Karl Storz, W.L. Gore, and Ethicon Endo-Surgery. He is on the advisory board of MST. Drs. Szomstein and Lo Menzo report no conflicts of interest relevant to the content of this article.

 

Tags: complications, Vertical banded gastroplasty

Category: Checklists in Bariatric Surgery, Past Articles