Laparoscopic Vertical Banded Gastroplasty

Abstract

The technique for laparoscopic vertical banded gastroplasty (VBG) arose from the open procedure in 1993, as minimally invasive surgical approaches were applied to virtually all commonly performed operations (1,2). In 1992 approximately 85% of bariatric surgeons utilized an open VBG as ddescribed by Mason at the University of Iowa, and the initial laparoscopic approaches attempted to mimic that technique (3,4). The Mason-like VBG incorporated a circular stapler to create an opening near the lesser curve, in order to insert a linear stapler vertically alongside a bougie to form a vertical pouch (Fig. 19.1-1), and the laparoscopic techniques followed that general form, but authors reported technical issues and controversies in attempting to replicate the open procedure, which will be discussed later in this chapter (3,4). In 1995 we developed a novel approach to performing a laparoscopic VBG by omitting the circular stapler and employing a totally linear stapler technique to wedge out a segment of the fundus to create a vertically oriented pouch (Fig. 19.1-2), as an alternative to the classic procedure (5).