Vertical Banded Gastroplasty to Roux-en-Y Gastric Bypass

Abstract

Introduction: Vertical-banded Gastrosplasty {VBG} was popular in 1980's. Patients with chronic vomiting, abdominal pain, weight regain still seek revision to Roux-en-Y (RNY) gastric bypass or Sleeve gastrectomy. Objectives: To demonstrate the technical feasibility and the challenges of laparoscopic conversion of VBG to RNY gastric bypass. Methods: Laparoscopic principles was followed frominitial planning to the introduction of first trocar and continued in each important aspect of the progression of the surgery until the completion. Results: The post operative radiological evaluation of the gastric pouch and gastrojejunostomy [GJ] showed good flow of the contrast in the lumen without obstruction or leak. Patient did subsequently develop GJ stenosis and underwent multiple [three] endoscopic stent dilatations before complete resolution of symptoms. Conclusion: Laparoscopic conversion of VBG to RNY gastric bypass is a very technically demanding procedure. Patients should be made aware of higher rate of conversion to an open procedure. The outcome are significantly better than most other revisional surgeries.