Jin Sol Oh, MD, Saurabh Khandelwal, MD. University of Washington, Seattle, WA
Vertical banded gastroplasty (VBG) was first described by Mason in 1982. As a restrictive procedure, it consisted of creating a gastric pouch with vertical stapling and pouch outlet encircled with polypropylene mesh or silastic ring. Once popular in 80s and 90s, VBG has been largely abandoned due to variable weight losses and high rate of gastric outlet obstructions.
A 64 year old female status post VBG approximately 30 years ago presented with dysphagia to solids, regurgitation, vomiting, and acid reflux. She had one hundred pounds weight loss from the procedure with current BMI of 27. EGD at another institution revealed gastric outlet obstruction.
We discussed with the patient that our typical approach to revision of VBG is conversion to gastric bypass. However, she did not want another weight loss procedure and additional risks of malabsorption and nutrition deficiency. Therefore, we performed a laparoscopic reversal of VBG by dividing the common wall and re-establishing luminal continuity between the gastric pouch and excluded fundus. This minimally invasive approach offers a simple solution to treat gastric outlet obstructions in patients with VBG who do not desire conversion to gastric bypass.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95617
Program Number: V055
Presentation Session: Bariatric II – Revisions
Presentation Type: Video