Journal of Gastrointestinal Surgery

, Volume 17, Issue 4, pp 805–808 | Cite as

Conversion of Vertical Banded Gastroplasty to Stand-Alone Sleeve Gastrectomy or Biliopancreatic Diversion with Duodenal Switch

  • Kunoor Jain-Spangler
  • Dana Portenier
  • Alfonso Torquati
  • Ranjan SudanEmail author
Case Report



Vertical banded gastroplasty (VBG) originated as a simplified bariatric operation to avoid malabsorption and provide lasting results due to a fixed stoma. Short-term results were excellent (50–70 % excess weight loss); however, patients often displayed maladaptive eating behaviors, and many failed to either achieve or sustain adequate long-term weight loss. Complications were also common including severe reflux and regurgitation, gastric outlet stenosis or stricture, gastrogastric fistula, and breakdown of the staple line.


VBG conversions to Roux-en-Y gastric bypass or sleeve gastrectomy as well as endoscopic interventions such as band removal have been described but have very high complication rates. We describe conversion of VBG to biliopancreatic diversion with duodenal switch using endoscopic guidance to take down the VBG staple line and the mesh around the outlet.


This technique can also be used to safely convert a VBG to a stand-alone sleeve gastrectomy.


Complication rates have been low by this technique, and we encourage others to adopt this technique.


Sleeve gastrectomy Duodenal switch Biliopancreatic diversion Vertical banded gastroplasty Robotic 


Conflict of interest

The authors have no commercial associations that might be a conflict of interest in relation to this article.


  1. 1.
    Mason, E.E., Vertical banded gastroplasty for obesity. Arch Surg, 1982. 117(5): p. 701–6.PubMedCrossRefGoogle Scholar
  2. 2.
    Hess, D.W. and D.S. Hess, Laparoscopic Vertical Banded Gastroplasty with Complete Transection of the Staple-Line. Obes Surg, 1994. 4(1): p. 44–46.PubMedCrossRefGoogle Scholar
  3. 3.
    Ojo, P. and E. Valin, Cost-effective restrictive bariatric surgery: laparoscopic vertical banded gastroplasty versus laparoscopic adjustable gastric band. Obes Surg, 2009. 19(11): p. 1536–41.PubMedCrossRefGoogle Scholar
  4. 4.
    Nocca, D., et al., Laparoscopic vertical banded gastroplasty. A multicenter prospective study of 200 procedures. Surg Endosc, 2007. 21(6): p. 870–4.PubMedCrossRefGoogle Scholar
  5. 5.
    Scozzari, G., et al., 10-year follow-up of laparoscopic vertical banded gastroplasty: good results in selected patients. Ann Surg, 2010. 252(5): p. 831–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Brolin, R.E., et al., Weight loss and dietary intake after vertical banded gastroplasty and Roux-en-Y gastric bypass. Ann Surg, 1994. 220(6): p. 782–90.PubMedCrossRefGoogle Scholar
  7. 7.
    Berende, C.A., et al., Laparoscopic sleeve gastrectomy feasible for bariatric revision surgery. Obes Surg, 2012. 22(2): p. 330–4.PubMedCrossRefGoogle Scholar
  8. 8.
    Greenbaum, D.F., et al., Duodenal switch with omentopexy and feeding jejunostomy--a safe and effective revisional operation for failed previous weight loss surgery. Surg Obes Relat Dis, 2011. 7(2): p. 213–8.PubMedCrossRefGoogle Scholar
  9. 9.
    Sugerman, H.J., et al., Conversion of failed or complicated vertical banded gastroplasty to gastric bypass in morbid obesity. Am J Surg, 1996. 171(2): p. 263–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Karmali, S., et al., Endoscopic management of eroded prosthesis in vertical banded gastroplasty patients. Surg Endosc, 2010. 24(1): p. 98–102.PubMedCrossRefGoogle Scholar
  11. 11.
    Sudan, R., V. Puri, and D. Sudan, Robotically assisted biliary pancreatic diversion with a duodenal switch: a new technique. Surg Endosc, 2007. 21(5): p. 729–33.PubMedCrossRefGoogle Scholar
  12. 12.
    Marsk, R., et al., High revision rates after laparoscopic vertical banded gastroplasty. Surg Obes Relat Dis, 2009. 5(1): p. 94–8.PubMedCrossRefGoogle Scholar

Copyright information

© The Society for Surgery of the Alimentary Tract 2013

Authors and Affiliations

  • Kunoor Jain-Spangler
    • 1
  • Dana Portenier
    • 1
  • Alfonso Torquati
    • 1
  • Ranjan Sudan
    • 1
    Email author
  1. 1.Department of SurgeryDuke University Medical CenterDurhamUSA

Personalised recommendations