Stomach Stapling vs. Stomach Folding
Stomach Stapling (Vertical Banded Gastrectomy)
Vertical banded gastrectomy is one of the oldest forms of surgery for weight loss. It is used to limit the amount of food that can be eaten. It does not alter any part of the digestive process, and none of the stomach is removed. During this procedure, the upper part of the stomach near the esophagus is stapled vertically. This creates a small pouch. The rest of the stomach is then banded, leaving a small opening at the bottom of the small pouch, which opens into the larger portion of the stomach. A mesh or plastic tissue is placed around the small opening to prevent stretching. This process is known as a restrictive surgery because it limits the amount of food that can be consumed at one time, which causes patients to feel fuller faster. After surgery, most meals must be limited to approximately one ounce. This surgery does not typically cause malnutrition or dumping syndrome. The entire procedure typically lasts between 3 and 4 hours. Vertical banded gastrectomy surgery is reversible, but the procedure to do so is quite complex.
In general, candidates for this procedure will either have a BMI over 40 or a BMI between 35 and 40 plus weight-related health problems. Women who are 80 pounds over their goal weight and men who are 100 pounds over their goal weight are also good candidates for this surgery.
Average Weight Loss Results
On average, most patients are able to lose approximately 50 to 60 percent of their excess body weight after one year. Weight gain can happen easily if the patient does not adhere to consuming very small portions of food and drinks.
If the surgery is performed laparoscopically, the patient will need to remain in the hospital for 2 or 3 days. If it is performed in an open surgery, then the hospital stay is longer, usually 4 or 5 days. Patients will initially need to follow a liquid diet and gradually move onto thicker liquids and soft foods. After about one month, most patients are able to eat solid foods and return to normal activities.
Common Side Effects
Patients may experience side effects such as reflux, stomal stenosis, incisional hernia, staple-line disruption, intolerance to the band, gastric leak, bleeding, fistulas, pulmonary embolus, and peritonitis. More commonly, side effects such as vomiting can occur if a strict diet is not followed, if food is not chewed properly, or if food is eaten too quickly.
The average cost of this procedure is $20,000 to $25,000. Insurance may cover a portion of the cost.\
Stomach folding, also known as gastric plication, is a relatively new procedure that is considered experimental and is performed laparoscopically. It is a minimally invasive surgery, and it usually takes just about an hour to complete. During the procedure, the surgeon makes five small incisions in the abdomen in order to reach the stomach. The surgeon then folds the stomach into a smaller, more compact size, typically reducing its volume by about 70 percent. Depending on the size of the stomach of the patient, the surgeon will do one or two folds, and the folds will be held with non-absorbable sutures. This surgery is potentially reversible, so if the stomach needs to be returned to its original size for any reason, that will most likely be possible. With a smaller stomach, patients typically feel fuller faster, and they often have a decrease in appetite as well. This surgery does not usually result in any severe food restrictions. With surgery and lifestyle changes, many patients are able to reduce or eliminate their need for blood pressure, diabetes, and depression medications.
In order to be eligible for this surgery, individuals must have a BMI of at least 27. The ideal candidate will have a BMI of 40 or more, or they will have a BMI over 35 with at least one weight-related health problem.
Average Weight Loss Results
Patients can typically lose 2 pounds per week after the completion of this procedure. In total, most patients lose between 40 and 60 percent of their excess body weight within a year.
Patients often must stay in the hospital for a day or two after the surgery, but within a week, they can usually return to work. Full recovery takes about 4 weeks. The first 2 weeks after surgery, the patient is required to consume an all liquid diet. The patient will then be able to add in thicker liquids, yogurt, and fruit. Eventually, regular foods can be consumed, but most people are only able to eat up to four spoonfuls of food per meal.
Common Side Effects
The most common side effects are nausea and vomiting, but oral medication can be given to minimize these effects. Even without medication, these side effects typically disappear within a week.
The average cost of stomach folding is approximately $10,000 to $15,000. Insurance does not typically cover this procedure.