Transoral Gastroplasty is a New Bariatric Surgery
Gastroplasty (Hg And Vbg)
The term “gastroplasty” may refer to any surgical procedure designed to repair a defect in the stomach or lower esophagus, but here it refers to restrictive bariatric stapling procedures to reduce stomach size in order to treat severe clinical obesity.
Gastroplasty Procedure
In this weight loss operation, bariatric surgeons divide the stomach into two parts – an upper small stomach pouch and a lower (distal) stomach section – through the use of gastric staples. A small gap (stoma) in the staple-line is left to permit digested food in the pouch to pass through into the distal stomach. Because the upper stomach pouch is so small (egg-size, compared to melon-size before the gastroplasty), the patient feels full very quickly and therefore calorie-intake is drastically reduced. If patients continue to eat, they develop nausea, vomiting, or pain, which naturally constrains further eating.
Vertical Banded Gastroplasty Surgery
The latest type of gastroplasty procedure is called Vertical Banded Gastroplasty. This overcomes certain complications resulting from earlier gastroplasty methods, such as “stretching” of the stoma. It achieves this by using a vertical row of staples across a less stretchy part of the stomach and uses a gastric band or silastic ring as a collar to maintain the width of the stoma.
Health Complications
A serious complication of gastroplasty is known as anastomotic leak – a leakage in the staple line. This rare complication, arising in fewer than 2 percent of patients, requires immediate hospitalization. Other health side-effects include: stenosis with persistent vomiting, if untreated, ulcer, incisional hernia, wound infection and band erosion.
Weight Loss After Gastroplasty
Weight reduction following bariatric gastroplasty is good in the short-term (typically a loss of about 25 percent of initial weight) but long term weight loss results are less successful than with gastric bypass owing to the need for strict patient compliance with post-operative diet guidelines. Weight regain after 2-3 years is common. One reason for this weight regain is that patients can “cheat” by eating calorie-dense liquids such as ice cream or regular soda. Unfortunately, long-term changes in eating habits must take place for gastroplasty to be successful. Even so, with proper patient dietary compliance, vertical banded gastroplasty is a viable treatment alternative for severely obese individuals.
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