Silastic Ring Vertical Gastroplasty Using a Modified TA 90 BN™

Silastic Ring Vertical Gastroplasty (SRVG) is a well-established method in obesity surgery. In the last 5 years we performed SRVG on 76 patients who suffered from morbid obesity. Not included are those patients who received an SRVG as second or third gastric segmentation operation. In performing the first 27 silastic ring vertical gastroplasties using the TA 90 BN™ we repeatedly experienced difficulties in guiding the nasal tube along the lesser curvature through the notch. This problem stimulated us to develop a more simplified procedure of setting the staple-line. In co-operation with AutoSuture Deutschland GmbH, the notched part of the TA 90 BN™ was bent in a 90° angle to the left side of the instrument. This way it is much easier to place the nasal tube exactly at the lesser curvature and through the bent notch of the newly developed TA 90 BNK. Thus, we were able to create a sufficient pouch along the lesser curvature. Of 76 patients 27 underwent the SRVG with a TA 90 BN™ and 49 with the TA 90 BNK. The average age of the patients was 39 years, 83% women, 17% men. The overweight ranged from 40 kg to 177 kg, the BMI from 39 to 94. In 12 cases a staple-line rupture occurred, 26% with the TA 90 BN™ and 10% with the TA 90 BNK. In nine patients a reoperation because of stoma stenosis was necessary, 11% with the TA 90 BN™ and 12% with the TA 90 BNK.