Am approved for surgery but have been struggling with whether or not to do it. (analysis paralysis, chicken, etc.) Main concern is any potential long term negative consequences. So in reading the book 'Weight Loss Surgery for Dummies' (suggested by my bariatric team) Chapter 3 explains the various surgery options. It says "In the 1980's the term 'stomach stapling' referred to vertical banded gastroplasty' and goes on to say 'the failure rate for VBG was very high'. My question: what has changed that now makes the vertical sleeve (which uses staples from top to bottom) different/successful?

I read that book and didn't related the VBG to VSG at all. Hmmm, maybe I need to check my reading comprehension skills! I know nothing about VBG, so I can't comment on that. But, I know a little bit about VSG, and it involves some fairly new techniques added to an old surgical procedure. Removal of all or a portion of the stomach has been done for many years for things like stomach cancer and ulcers. My late mother in law had most of her stomach removed because of stomach cancer.

The difference with VSG is that the techniques to remove part of the stomach have been advanced to the point where the surgery can be done laparascopically most of the time. The stapling technique has also evolved into a fairly simple procedure wherein a tube (bougie/bougle) is passed down the throat into the stomach and the surgeon uses an automatic stapler/cutter to close off the removed section and the remaining section, then removes the excess stomach through a laparscopic incision.

In traditional stomach surgery, the patient is opened up with a midline incision and the stomach is removed. My mother in law had a long scar on her tummy and she said the doctor hand-sewed her stomach closed after removing the cancerous part of her stomach. I do believe that her remaining stomach was more restrictive than my sleeve is.

Most of the WLS procedures that involved stapling or re-routing the stomach before left the excluded part of the stomach intact in the body. That did not keep people from getting ulcers or cancer in that section, nor did it remove the part of the stomach that produced ghrelin, which is the hormone that makes us hungry. So, you have someone with an intact urge to eat, but without the stomach capacity to eat enough to eliminate the hunger. My sister in law had a gastric bypass and says that she fights the actual hunger every day. Those WLS surgeries also often involved re-routing of the intestines and, sometimes, removal of the pyloric valve. That's the valve at the bottom of your stomach that releases your food into the intestines to be digested.

Sleevers keep their pyloric valve, lose the ghrelin, and can eat most foods safely, although in smaller quantities than before. Some never get the hunger back, some do. Overall, though, VSG is safer, with fewer side effects and guaranteed complications than most of the other WLS surgeries available, In my opinion anyway!

I think that's a fairly complete description, but please, anyone, correct me if I've given erroneous information.

Good luck with your decision!!

First, I would like to say, I am not a medical professional. I understand that the VBG is a much different operation than the sleeve. The sleeve works by restriction and reducing grelin.The surgery itself is about an hour. The VBG is not done anymore by most surgeons in my area (I do not think any of the many surgeons I went to do it and my ins only covers lap band, gastric bypass & sleeve), because it is a long surgery and had many complications . I am about 5 wks out from the sleeve and it has been working for me so far. My Dr used a 40 Fr bougie,so I have restriction but I have not had vomiting and I can eat regular food- although there are foods I can not eat yet. (My nutritionist gave me a list of what I can eat, when).There are other foods, like cake and ice cream, that have lost their appeal to me. I am basically on a high protein diet, and the cravings for sugary foods are gone. At this point. I am no longer waiting to "start my diet tomorrow" or dealing with guilt, because I messed up again. I feel free from "dieting" and feeling hungry, even though I am actually on a long term food plan ("diet" ). For me, at this time, the sleeve has made me feel I can become a normal weight again, it will just take time- but it is not impossible. The sleeve has given me hope. (Before I had it done, I was skeptical -since "the Dr did not operate on my brain", but I was desperate. So I figured, since I didn't want to be the half ton mother, I had to do something. I am much, much happier now. It was definitely worth it for me- but I was ready for change and to make the committment to change my life. As I said, for me - I am not walking around feeling hungry all of the time- it is a tool that is helping me feel satisfied. Good Luck whatever you decide.

Am approved for surgery but have been struggling with whether or not to do it. (analysis paralysis, chicken, etc.) Main concern is any potential long term negative consequences. So in reading the book 'Weight Loss Surgery for Dummies' (suggested by my bariatric team) Chapter 3 explains the various surgery options. It says "In the 1980's the term 'stomach stapling' referred to vertical banded gastroplasty' and goes on to say 'the failure rate for VBG was very high'. My question: what has changed that now makes the vertical sleeve (which uses staples from top to bottom) different/successful?

I'm no expert on the issue, but yesterday I read that the "old version" was to staple off a small stomach. The Stomach tissue outside of the digestive system would suffer necrosis aka die. Then there could be infection etc.

Some appear to have found another way to perform that "old version" now termed plication. Sorry if I spelled incorrectly or got my facts wrong. But it isn't yet approved in US. It's called plication and defined as reversible vertical sleeve. I liked the idea very well until I read about the old version and the problems with it. Sorry I don't have the answer to your question. It appears that not having the unused old stomach is a better option.

There is a lady on the boards whos name is former_vbg - maybe she can shed some light. My understanding is it is a completely different surgery.

Libbe, I feel stupid, cause I thought her "vbg" stood for very big girl.

Omg that cracked me up! :-) VBG could stand for either I guess!!! Thanks all for the input! Maybe the two aren't as similar as I thought.

I former supervisor of mine had the VBG done...that's the one when they place a metal band around your stomach as well as staple it...she lost over 140 pounds, and has been successful for the last 6 years....you are confusing the two surgeries...the sleeve is a VSG = vertical sleeve gasrectomy...

HAHA! I didn't think of that! I just remember seing one of her first posts and she talked about having it and revising to VSG

Libbe, I feel stupid, cause I thought her "vbg" stood for very big girl.

I hope she's not insulted! I just thought she was a FORMER very big girl! Since I'm working on being the same, I thought it was a cool name!

You guys crack me up! No, I'm not insulted Lissa, you gave me a good chuckle. Yes, my screen name was in reference to my original WLS that I had 14 yrs ago come this March. The "VBG" could easily have stood for "very big girl", cuz I was. I love saying I WAS cuz while I'm not yet thin, I'm getting much closer!!

Honestly, I don't have anything negative to say about the procedure. It was actually very successful for me. As of this morning, I weigh exactly the lowest weight I reached when I had the VBG surgery and I don't blame the surgery for not reaching goal. I think it was a combination of things.

First, there wasn't ANYTHING like there is now with regards to the support post-surgery from the Dr.'s or support groups. I think I went in for one follow up, maybe two at the most a few months after surgery and never saw the Dr. again. I didn't think anything of it. They didn't tell you Protein first, not sure they knew. My highest at the time of that surgery was 305#. I got down to 162 within I think maybe 6 or 7 months, it's been so long ago my memory has faded a bit on some of those specifics. The other thing that happened for me was I was so thrilled with the attention from men that I got involved in a long term relationship with someone who ate lots of junk food, and was fortunate that at most he had a small to medium sized gut as a result. He didn't really take seriously my requests to eat more healthy around me, and consequently I just gave in to those eating habits. I kept the weight off for a few years actually, but then started bouncing back up close to #200, then I would drop back down to the 170#'s and then back up.

The reason for the "failure" of the surgery persay is more about me thant he surgery honestly. I'm not one to go to the Dr. unless I have a serious pain or whatever, just not a complainer. What had happened over time was that I had developed inflammation in my esophagus which could have EASILY been resolved by a reflux medication. Instead what happened is that my esphagus would make it difficult for the "good / more dense" foods to go down. I started gravitating to the slider foods because they wouldn't come back up. The inflammation wasn't everyday, nor every week- just intermittment and so it just became a way of life for me. I never said anything to my PCP all those years. I really wish I had, I may not have shot up to the weight I got to this time around.

To answer your question on how the VBG procedure is done/ was done is they used either a silastic band or mesh and create a small pouch at the top of your stomach very similar to the lapband. The basic difference between the lapband and the VBG is that it was permanent, where the lapband required fills. I don't believe there was ever anything metal used to create the band- but I suppose some surgeons may have done that but it wasn't common. My original surgeon used the mesh and so when I had the sleeve, it had become embedded into my tissue and so my surgeon for the sleeve simply cut tightly around the mesh because it is still in tact and not really an issue. In some cases, the silastic band was able to be removed for people who had revisions.

When I had my Upper GI done prior to the surgery, I was diagnosed with Esophagitus Stage C on a scale of A through D. And, A being good, and D worst. Basically, it's based on the amount of inflammation you have. Fortunately, after I started taking a PPI, that feeling of food getting "stuck" on the dense foods went away immediately. Only problem was that by that time I was well overweight "again". Could I have just stuck to the same program those of us who have had WLS now and lost weight? Probably, but when I started researching all the changes with WLS, I REALLY liked the idea of having my ghrelin removed so my appetite would be significantly reduced.

I couldn't be happier with my Sleeve!!! My cravings for sweets and sugary things are pretty much gone, and that is a huge deal for me. I think with this being my 2nd time around, I am older (40 yrs old), more in tune with my body, WAY more knowledgeable about weight loss surgeries and I understand much better that this is a tool- not a cure. I don't remember if I thought my first surgery was a cure, but I don't think I realized that even though I had that surgery, I would still have to make the life style changes a LIFE LONG process. I have every reason to believe that I will be able to maintain my loss, and even if I go through some bumps in the road that I will be able to keep things managed before they get out of control.

Feel free to post here or PM me if you have any other questions.

wow, former_vgb, thank you so much for the great information! I love this forum for all the helpful information you can get from others in similar situations. this is such a life-changing decision and I'm kinda anal about wanting to make the 'right' choice. gonna post my next question here in a sec on this board so please feel free to respond! TIA and many blessings!

You guys crack me up! No' date=' I'm not insulted Lissa, you gave me a good chuckle. Yes, my screen name was in reference to my original WLS that I had 14 yrs ago come this March. The "VBG" could easily have stood for "very big girl", cuz I was. I love saying I WAS cuz while I'm not yet thin, I'm getting much closer!!

Honestly, I don't have anything negative to say about the procedure. It was actually very successful for me. As of this morning, I weigh exactly the lowest weight I reached when I had the VBG surgery and I don't blame the surgery for not reaching goal. I think it was a combination of things.

First, there wasn't ANYTHING like there is now with regards to the support post-surgery from the Dr.'s or support groups. I think I went in for one follow up, maybe two at the most a few months after surgery and never saw the Dr. again. I didn't think anything of it. They didn't tell you Protein first, not sure they knew. My highest at the time of that surgery was 305#. I got down to 162 within I think maybe 6 or 7 months, it's been so long ago my memory has faded a bit on some of those specifics. The other thing that happened for me was I was so thrilled with the attention from men that I got involved in a long term relationship with someone who ate lots of junk food, and was fortunate that at most he had a small to medium sized gut as a result. He didn't really take seriously my requests to eat more healthy around me, and consequently I just gave in to those eating habits. I kept the weight off for a few years actually, but then started bouncing back up close to #200, then I would drop back down to the 170#'s and then back up.

The reason for the "failure" of the surgery persay is more about me thant he surgery honestly. I'm not one to go to the Dr. unless I have a serious pain or whatever, just not a complainer. What had happened over time was that I had developed inflammation in my esophagus which could have EASILY been resolved by a reflux medication. Instead what happened is that my esphagus would make it difficult for the "good / more dense" foods to go down. I started gravitating to the slider foods because they wouldn't come back up. The inflammation wasn't everyday, nor every week- just intermittment and so it just became a way of life for me. I never said anything to my PCP all those years. I really wish I had, I may not have shot up to the weight I got to this time around.

To answer your question on how the VBG procedure is done/ was done is they used either a silastic band or mesh and create a small pouch at the top of your stomach very similar to the lapband. The basic difference between the lapband and the VBG is that it was permanent, where the lapband required fills. I don't believe there was ever anything metal used to create the band- but I suppose some surgeons may have done that but it wasn't common. My original surgeon used the mesh and so when I had the sleeve, it had become embedded into my tissue and so my surgeon for the sleeve simply cut tightly around the mesh because it is still in tact and not really an issue. In some cases, the silastic band was able to be removed for people who had revisions.

When I had my Upper GI done prior to the surgery, I was diagnosed with Esophagitus Stage C on a scale of A through D. And, A being good, and D worst. Basically, it's based on the amount of inflammation you have. Fortunately, after I started taking a PPI, that feeling of food getting "stuck" on the dense foods went away immediately. Only problem was that by that time I was well overweight "again". Could I have just stuck to the same program those of us who have had WLS now and lost weight? Probably, but when I started researching all the changes with WLS, I REALLY liked the idea of having my ghrelin removed so my appetite would be significantly reduced.

I couldn't be happier with my Sleeve!!! My cravings for sweets and sugary things are pretty much gone, and that is a huge deal for me. I think with this being my 2nd time around, I am older (40 yrs old), more in tune with my body, WAY more knowledgeable about weight loss surgeries and I understand much better that this is a tool- not a cure. I don't remember if I thought my first surgery was a cure, but I don't think I realized that even though I had that surgery, I would still have to make the life style changes a LIFE LONG process. I have every reason to believe that I will be able to maintain my loss, and even if I go through some bumps in the road that I will be able to keep things managed before they get out of control.

Feel free to post here or PM me if you have any other questions.[/quote']

Awwww, I was so happy to read your post. I too had the VBG about 15 yrs ago but mine was a failure due to a combination of things. I was starting to worry if I was making the right decision revising to a vsg. I feel a bit more hopeful. ????

Am approved for surgery but have been struggling with whether or not to do it. (analysis paralysis' date=' chicken, etc.) Main concern is any potential long term negative consequences. So in reading the book 'Weight Loss Surgery for Dummies' (suggested by my bariatric team) Chapter 3 explains the various surgery options. It says "In the 1980's the term 'stomach stapling' referred to vertical banded gastroplasty' and goes on to say 'the failure rate for VBG was very high'. My question: what has changed that now makes the vertical sleeve (which uses staples from top to bottom) different/successful?[/quote']

VBG is a totally different surgery from VSG. It's not done anymore. In VBG the stomach was stapled but left inside. There were a ton of complications. Don't get the two confused.

VBG is a totally different surgery from VSG. It's not done anymore. In VBG the stomach was stapled but left inside. There were a ton of complications. Don't get the two confused.

VBG is not stomach stapeling. It is vertical banded gastroplasty. There were about 2 common techniques used for this procedure. The most common was to use a mesh banding to create basically a ballon the same as the band that people are still getting today. The other was some sort of silicon ring. I had this surgery back in 95 and had the mesh. The basic difference between the VBG and today's band is that today's band is adjustable, the VBG was not adjustable.

Either way, the VBG was not successful for most people and stats say today's band is not very successful either.

VBG is not stomach stapeling. It is vertical banded gastroplasty. There were about 2 common techniques used for this procedure. The most common was to use a mesh banding to create basically a ballon the same as the band that people are still getting today. The other was some sort of silicon ring. I had this surgery back in 95 and had the mesh. The basic difference between the VBG and today's band is that today's band is adjustable' date=' the VBG was not adjustable.

Either way, the VBG was not successful for most people and stats say today's band is not very successful either.[/quote']

Thanks for the clarification. I was mostly trying to stress that it isn't related to VSG at all, which I think has been hammered home. I got my info from Wikipedia which dies say they are the same. http://en.wikipedia.org/wiki/Vertical_banded_gastroplasty_surgery

"Vertical banded gastroplasty (VBG), also known as stomach stapling, is a restrictive operation for weight control. Both a band and staples are used to create a small stomach pouch. In the bottom of the pouch is an approximate one-centimeter hole through which the pouch contents can flow into the remainder of the stomach and thence onto the remainder of the gastrointestinal tract."