Surgical Endoscopy

, Volume 14, Issue 10, pp 902–907 | Cite as

Hand-assisted laparoscopic vertical banded gastroplasty

Early results
  • J. I. S. Bleier
  • A. S. Krupnick
  • D. Kreisel
  • H. K. Song
  • E. F. Rosato
  • N. N. Williams
Original Articles



Minimally invasive hand-port-assisted laparoscopic vertical banded gastroplasty has the potential to reduce postoperative complications after bariatric surgery.


We analyzed the postoperative course of 46 hand-port-assisted laparoscopic vertical banded gastroplasties (LVBG) completed between January 1998 and April 1999.


The operating time for the LVBG was shorter (140.8±6.0 vs 180.2±6.3 min; p<0.05). Individuals were able to ambulate sooner (1.36±0.09 vs 2.44±0.16 days; p<0.05), and start oral intake earlier (2.7±0.27 vs 3.7±0.17 days; p<0.05) than the open vertical banded gastroplasty (VBG) controls. Three staple line leaks were detected in this group. Two leaks resolved without clinical sequelae, but one patient developed intraabdominal sepsis. This complication extended the average hospital stay to 6.8±2.00 days, as compared to 7.71±0.18 days for historical controls. By discounting this patient from the analysis, we arrive at a more representative length of hospitalization of 4.82±0.34 days (p<0.05).


LVBG offers a good alternative to the standard open VBG. Although this procedure has a relatively short learning curve, it should be done at centers with an interest in bariatric surgery.

Key words

Laparoscopic surgery Vertical banded gastroplasty Hand-port laparoscopy Bariatric surgery Laparoscopy 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bass EB, Pitt HA, Lillemoe KD (1993) Surgical treatments of cholelithiasis. Am J Surg 165: 466–471CrossRefGoogle Scholar
  2. 2.
    Brolin RE (1996) Prospective, randomized evaluation of midline fascial closure in gastric bariatric operations. Am J Surg 172: 328–331CrossRefGoogle Scholar
  3. 3.
    Brolin RE, Robertson LB, Kenler HA, Cody RP (1994) Weight loss and dietary intake after vertical banded gastroplasty and Roux-en-Y gastric bypass. Ann Surg 220: 782–790CrossRefGoogle Scholar
  4. 4.
    Eating disorders and obesity: a comprehensive handbook. Guilford Press, New YorkGoogle Scholar
  5. 5.
    Capella JF, Capella RF (1996) The weight reduction operation of choice: vertical banded gastroplasty or gastric bypass? Am J Surg 171: 74–79CrossRefGoogle Scholar
  6. 6.
    Cleveland RD, Zitsch III RP, Laws HL (1989) Incisional closure in morbidly obese patients. Am Surg 55: 61–63PubMedGoogle Scholar
  7. 7.
    Cowan GS (1992) The non-surgical treatment of serious obesity. Obesity Surg 2: 216CrossRefGoogle Scholar
  8. 8.
    Deitel M, Alhindawi R, Yamen M, To TB, Burul CJ (1990) Dexon plus versus maxon fascial closure in morbid obesity: a prospective randomized comparison. Canadian Journal of Surgery 33: 302–304Google Scholar
  9. 9.
    Gotley DC, Smithers BM, Rhodes M, Menzies B, Branicki FJ, Nathanson L (1996) Laparoscopic Nissen fundoplication—200 consecutive cases. Gut 38: 487–491CrossRefGoogle Scholar
  10. 10.
    Goulding ST, Hovell BC (1995) Anesthetic experience of vertical banded gastroplasty. Br J Anaesth 75: 301–306CrossRefGoogle Scholar
  11. 11.
    Hunter JG (1997) Advanced laparoscopic surgery. Am J Surg 173: 14–18CrossRefGoogle Scholar
  12. 12.
    Knol JA (1994) Management of the problem patient after bariatric surgery. Gastroenterol Clin North Am 23: 345–369PubMedGoogle Scholar
  13. 13.
    Macgregor AM, Rand CS (1993) Gastric surgery in morbid obesity outcomes in patients aged 55 years and older. Arch Surg 128: 1125–1130CrossRefGoogle Scholar
  14. 14.
    Mason EE (1992) Gastric surgery for morbid obesity. Surg Clin North Am 72: 501–513CrossRefGoogle Scholar
  15. 15.
    Mason EE, Ito D (1967) Gastric bypass in obesity. Surg Clin North Am 47: 1345–1351CrossRefGoogle Scholar
  16. 16.
    Mason EE, Tang S, Renquist KE, Barnes DT, Cullen JJ, Doherty C, Maher JW (1991) A decade of change in obesity surgery. National Bariatric Surgery Registry (NBSR) contributors. Obesity Surg 7: 189–197CrossRefGoogle Scholar
  17. 17.
    National Task Force on the Prevention and Treatment of Obesity Long-term pharmacokinetics in the management of obesity. JAMA 276: 1907–1915Google Scholar
  18. 18.
    Owen ER, Abraham R, Kark AE (1989) Gastroplasty for morbid obesity: technique, complications and results in 60 cases. Br J Surg 76: 131–135CrossRefGoogle Scholar
  19. 19.
    Owen ER, Cooper MK, Kark AE (1991) Obesity surgery in the United Kingdom: survey of 970 general surgeons. Ann R Coll Surg Engl 73: 36–38PubMedPubMedCentralGoogle Scholar
  20. 20.
    Pories WJ (1997) The surgical approach to morbid obesity. In: Sabiston DC (ed) Textbook of surgery: the biological basis of modern surgical practice. WB Saunders, Philadelphia, pp 933–945Google Scholar
  21. 21.
    Rosenbaum M, Liebel L, Hirsch J (1997) Obesity. New Engl J Med 337: 396–407.CrossRefGoogle Scholar
  22. 22.
    Sjostrom LV (1992) Mortality of severely obese subjects. Am J Clin Rev 55: 516SCrossRefGoogle Scholar
  23. 23.
    Soper NJ, Brunt ML, Kerbl K (1994) Medical progress: laparoscopic general surgery. N Engl J Med 330: 409–419CrossRefGoogle Scholar
  24. 24.
    Sugarman HJ, Kellum JM, DeMaria EJ, Reines HD (1996) Conversion of failed or complicated vertical banded gastroplasty to gastric bypass in morbid obesity. Am J Surg 171: 263–267CrossRefGoogle Scholar
  25. 25.
    Yale CE (1989) Gastric surgery for morbid obesity: complications and long-term weight control. Arch Surg 124: 941–946CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2000

Authors and Affiliations

  • J. I. S. Bleier
    • 1
  • A. S. Krupnick
    • 1
  • D. Kreisel
    • 1
  • H. K. Song
    • 1
  • E. F. Rosato
    • 1
  • N. N. Williams
    • 1
  1. 1.Department of Surgery, Division of Gastrointestinal SurgeryHospital of the University of PennsylvaniaPhiladelphiaUSA

Personalised recommendations