Technical Modification of Laparoscopic Vertical Banded Gastroplasty

Background: Technical improvements of laparoscopic bariatric procedures are important to minimize operative time and increase safety and simplicity. Methods: A modification is described of the "classic" Mason - MacLean vertical banded gastroplasty (VBG), performed by laparoscopy, with wedge resection of the gastric fundus, thus avoiding the time-consuming and technically difficult gastro-gastrostomy window. Results: The technique used was simple and safe, and required less operative time than the "classic" method, without serious intra- or postoperative complications. Weight loss in 18 patients who underwent the modified laparoscopic VBG and were followed-up for 1 year was equal to that achieved in patients who underwent openVBG at our Institution. Gastro-gastric fistula was not observed in upper GI barium studies performed 12 months postoperatively. Conclusion: The modified technique is preferable when lap-VBG is indicated for surgical treatment of morbidly obese patients.