Vertical banded gastroplasty, or VBG, is an elective surgical procedure in which the stomach is partitioned with staples and fitted with a plastic band to limit the amount of food that the stomach can hold at one time. Gastroplasty is a term that comes from two Greek words, gaster or "stomach," and plassein, "to form or shape." "Stomach stapling," also known as VBG, is part of a relatively new surgical subspecialty called bariatric surgery. The word "bariatric" is also derived from two Greek words, barys, which means "heavy," and iatros, which means "healer." A restrictive bariatric procedure, VBG controls the amount of food that the stomach can hold—in contrast to malabsorptive surgeries, in which the food is rerouted within the digestive tract to prevent complete absorption of the nutrients in the food.
The purpose of VBG is the treatment of morbid (unhealthy) obesity. It is one of the first successful procedures in bariatric surgery. VBG was developed in its present form in 1982 by Dr. Edward E. Mason, a professor of surgery at the University of Iowa.
Bariatric surgery in general is important in the management of severe obesity because it is the only one as of 2003 that has demonstrated long-term success in the majority of patients. Weight reduction diets, exercise programs, and appetite suppressant medications have had a very low long-term success rate in managing morbid obesity. Most people who try to lose weight on reduced-calorie diets regain two-thirds of the weight lost within one year; within five years, they have gained more weight in addition to all the weight they had lost previously. Appetite suppressants often have undesirable or harmful side effects as well as having a low rate of long-term effectiveness; in 1997 the Food and Drug Administration (FDA) banned the sale of fenfluramine and phentermine ("fen-phen") when they were discovered to cause damage to heart valves.
Obesity is a major health problem not only because it is widespread in the American population—as of 2003, 33% of adults in the United States meet the National Institutes of Health (NIH) criteria for obesity—but because it greatly increases a person's risk of developing potentially life-threatening disorders. Obesity is associated with type 2 (non-insulin-dependent) diabetes, hypertension, abnormal blood cholesterol levels, liver disease, coronary artery disease, sleep apnea syndrome, and certain types of cancer. In addition to these disorders, obesity is a factor in what have been called lifestyle-limiting conditions. These conditions are not life-threatening, but they can have a great impact on a people's day-to-day lives, particularly in their relationships and in the working world. Lifestyle-limiting conditions related to obesity include osteoarthritis and gout; urinary stress incontinence; heartburn; skin disorders caused by heavy perspiration accumulating in folds of skin; leg swelling and varicose veins; gallstones; and abdominal hernias. Obese women frequently suffer from irregular menstrual periods and infertility. Finally, societal prejudice against obese people is widespread and frequently mentioned as a source of acute psychological distress. Surgical treatment of obesity has been demonstrated to relieve emotional pain as well as to reduce risks to the patient's physical health.
Rebecca Frey Ph.D., The Gale Group Inc., Gale, Detroit,