Late results of vertical banded gastroplasty for morbid and super obesity

Two hundred one patients who underwent vertical banded gastroplasty have been followed up for a minimum of 2 years to more than 5 years. Staple line perforations occurred in 48% of patients, and 36% underwent reoperation. The instability of the operation becomes apparent only with careful follow-up. More than 50% of patients who maintained a small orifice of less than or equal to 11 mm in diameter and an intact staple line over 3 to 5 years achieved an excellent result (0% to 25% excess weight), which equals the best results in the literature for any gastric-limiting operation, whether bypass or gastroplasty. The results of this operation for super obesity (a body mass index greater than or equal to 50 kg/m2) are disappointing. Only 8% of these patients achieve an excellent result. Failure of vertical banded gastroplasty in the morbidly obese (body mass index of 40 to 50 kg/m2) is frequently technical, and a method that eliminates dependence on integrity of staples should be evaluated. Results should be reported so that unsatisfactory results are apparent. Mean weight loss and mean percent excess weight loss are both highly satisfactory in this study, whereas unsatisfactory results ranged from 10% to 21% for each of the 5 years of follow-up.