The Silastic Ring Vertical Banded Gastroplasty is an operation that functions by restricting the rate and amount of food that a person can eat. Although this was the most common opertaion performed in the 80’s in the U.S., the safer, and more effective Adjustable Gastric Banding has replaced this operation in our practice since July 2001. There are four rows of staples placed parallel to the strongest sidewall of the stomach, making it difficult for the small resulting stomach pouch to expand. In past years, when the staple line was placed horizontally, or parallel to the other wall of the stomach, many patients experienced short-term success, which was followed by weight regain, as the horizontally oriented pouch expanded.
The Silastic Ring is flexible, but inelastic, thus creating a restriction to the emptying of the stomach pouch where food first enters. This operation does result in the reduction in basal metabolism experienced by people who lose weight by dieting and in a rise in ghrelin hormone which promotes hunger and weight gain.
Since its only method of producing weight loss is by restricting intake, and it does not restrict liquid and soft food intake as much as solid foods, it is possible to gain weight after this surgery by making soft, semisolid, and liquid foods the staple of the patients’ diet. Fats, oils, or concentrated carbohydrates make foods “soft”. This is the reason that any Gastroplasty is a poor choice for anyone who make sweets a food choice more than three times per week, or those who are not prepared to limit meals to only three times per day. It is also possible to defeat this restrictive surgery by frequent meals, snacking, or “grazing”.
Nonetheless, this is an inherently safer operation than the Gastric Bypass because there is no cutting and sewing of the intestine like in Gastric Bypass operation. In summary, this operation does not produce as much weight loss as the Gastric Bypass and is easier for the patient to defeat. This operation has less risk of complications. Unfortunately, it also suffers a high rate of late staple line disruption, which can lead to regaining of weight.