The Silastic Ring Vertical Banded Gastroplasty

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.


Lose By Restricting Intake

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.

Roux Y Gastric Bypass

When success is defined as “the most weight loss, kept off for the longest period of time,” the Roux-Y Gastric Bypass is among the operations that fulfill this goal without producing major malnutrition. For years it has been known that people who lose weight by restricting their diet undergo a significant reduction in their basal metabolic rate. Their body fights to keep from losing more weight. There is evidence that patients who undergo Gastric Bypass do not exhibit this major reduction in basal metabolism. It is as if their body does not recognize that they are losing weight. This removes one of the major barriers to weight loss associated with restriction of dietary intake. Gastric Bypass patients also exhibit a significant reduction in Ghrelin hormone, a hormone associated with hunger and weight gain. This hormone is elevated in people on a diet.divrygb

We are now performing this operation almost exclusively by the minimally invasive, Laparoscopic approach, and it has become the favored weight management operation in the U.S.

There are several ways to perform Gastric Bypass, but only one is illustrated here. Since there are many ways to complete the re-routing of the food path around the stomach, pancreas, and first portion of the intestine, the operations are similar. Just as there are minor variations in the operation performed by the open surgical approach, there are minor variations in the Laparoscopic approach.

Laparoscopy leaves smaller scars, produces less post-operative pain, and may also shorten recovery time. The major medical improvement from the Laparoscopic approach is the reduction of hernias in the incision. These have been reported to occur in nearly 20% of patients who undergo open Gastric Bypass surgery. It takes another laparoscopic procedure to repair these hernias when they occur.

Your Surgical Options

We consider each procedure to be a tool to enable better health and better results. But each procedure works slightly differently. TheRoux-Y Gastric Bypass is among the laparoscopic operations that fulfill weight loss goals without producing major malnutrition. TheGastric Banding operation produces slower weight loss but can continue for three or more years. The Silastic Ring Vertical Banded Gastroplasty is an operation that functions by restricting the rate and amount of food that a person can eat. With more experience with the Gastric Banding, we have abandoned the Silastic Ring Vertical Banded Gastroplasty.

Improve Yourself. Improve Your Life.

There Is Hope
Both operations function by providing a built-in tool for the patient, allowing them to regain control over their food intake. Apart from the obvious health benefits that weight loss offers, along with the improvement in life expectancy, patients also receive tremendous psychological and emotional benefits. Many patients who have lost weight as the direct result of surgery:

  • Have a substantial improvement in self-image translating into greater happiness
  • Are more likely to receive earlier promotions, better jobs, and higher salaries than those who are morbidly obese
  • Save money due to the significant reduction in the financial burden of subsequent healthcare costs related to complications stemming from morbid obesity

What Have You Got To Lose?

What Is Lost?
Most surgical weight loss operations have been successful in 70-85% of patients. Most patients lose between 50% and 75% of their excess weight, and keep it off. The majority of the weight loss takes place in the first year and usually stops between the second and third years following Gastric Bypass. Weight loss following LAP-BAND has been slower, taking place over a three-year period, instead of rapid-loss the first year. However, LAP-BAND patients have not been observed to experience rebound weight gain as it has become more commonplace after Gastric Bypass.

It should be noted that these operations are not without risks. As a rule, all operations have the potential for complications, and these operations are no exception. However, people who have been frustrated by repeated attempts at dietary management with subsequent failure are willing to undergo surgery because the health risks brought on by morbid obesity profoundly outweigh the benefits of the resulting weight loss.

It has been shown that when someone who is severely overweight attempts to lose weight by diet alone, fewer than 5% achieve success at keeping it off for over two years. A study at Louisiana State University Medical School documented that all patients in that study who lost weight by adhering to a very low calorie liquid diet had regained it all back by seven years. In contrast, a comparable group of patients undergoing Gastric Bypass fared much better. They averaged 88% success at keeping off more than 30% of their excess weight for over six years following surgery.

Why Choose Surgery?

Gastric Bypass And Gastric Banding
Prior to 1970, there was little hope for weight loss, other than dieting. Early surgical efforts proved more harmful than obesity itself. Then, there was a major breakthrough in surgical procedures for the severely overweight.

In 1991, the National Institute of Health held a conference discussing newer surgical approaches and came to an agreement that two procedures could offer great hope to morbidly obese patients. One was the Vertical Banded Gastroplasty (VBG), and the other was the Gastric Bypass (RNY) procedure. In recent years, they have updated their recommendations. A complete copy of their present discussion can be found on the National Institute of Diabetes and Digestive and Kidney Diseases site. The VBG is a purely restrictive operation.

The LAP-BAND System is the latest form of purely restrictive surgery that does not require staples.

It is the first surgery that allows continuous adjustment of the size of the outlet and the level of restriction. With the LAP-BAND, the food path is unaltered – food enters the balance of the stomach. The outlet of the pouch is reduced to less than one-half inch in diameter, limiting the amount of food that can be held, while slowing the emptying of that pouch.

Weight Loss

The surgery is a tool built into the intestinal tract. It allows you to regain control of your weight by eliminating hunger. It makes eating less pleasurable. It builds in a behavior modification mechanism that limits food intake and encourages healthy food choices. Control is returned to you through the choices you make when you eat. Once you change your diet and begin to lose weight rapidly, you’re motivated by the weight loss itself, and the improvements it makes in your life. You establish your goal weight. The Stomach Bypass and LAP-BAND patients are in total control of their weight and their consequent weight loss.

Use It Wisely
Just like any tool, this tool can be used constructively, or destructively. New eating behaviors must be learned and must become a way of life. It is the job of the Bariatric (obesity) Surgeon to build a good tool and act as your guide, supplying information and direction regarding use. The more weight loss you achieve through the choices you make every meal, the better you feel about yourself, and more empowered you become to continue controlling your weight.

What Does Morbid Obesity Mean?
Morbid obesity is a medical term describing people who have a Body Mass Index (BMI) of 40, or of 35 to 40 with significant medical problems caused by their weight. BMI of 40 amounts to approximately 100 pounds above ideal weight. People who are severely overweight are exposed to health risks including:

  • High blood pressure
  • Diabetes
  • Heart disease
  • Sleep apnea
  • High cholesterol
  • Joint disease
  • Esophageal reflux
  • Loss of bladder control
  • Infertility
  • Reduced life expectancy

Surgery is Just the Beginning.

Remarkable Weight Loss Surgery Results

Does It Work?
It has been said that a picture is worth a thousand words. Yes, this really IS the same person.

does it work karen before dies it work karen did it


How Many People Keep The Weight Off, For How Long, And How Much Weight Was Lost?
These questions are more difficult to answer, because accurate answers require maintaining contact with most patients for many years. Few Surgeons have been able to accomplish this kind of follow-up due to the transient nature of the public. Walter Pories, MD, and his group, an East Carolina Medical School published one of the best reports. He reported the results of following 608 patients for up to 14 years following Gastric Bypass surgery, with only 17 (3%) patients being lost to follow-up. Weight fell from an average of 304.4 lbs (range of 198 to 615 lbs) before surgery, to 192.2 lbs one year following surgery, 205.4 five years out, 206.5 at ten years, and 204.7 (range of 158 to 270 lbs) at 14 years. This represented an average of 69% excess weight lost at one year, 58% at five years, 55% at 10 years, and 49% at 14 years.

Reports in our professional literature indicate that Lap Band patients lose weight more slowly, with average excess weight loss leveling out at about 50% at two to three years but remaining stable therefter. This suggests that the weight loss maintained over the long haul might be about the same for both gastric bypass and Lap Band patients. In other words, it might prove difficult to tell patients apart (to know which operation they had) based upon their weight lost after five or more years have passed.

The number of patients observed at 14 years, is far less than those observed for five or ten years. This report did not address the question about how many of the patients lost very little weight after having surgery, but it must be presumed that the number was small from these averages. In addition, the impressive observation was the persistent long-term weight loss following surgery.

Patients Who Lost Significant Weight, Gained Back Their Health

  • Diabetes: 91% of patients with diabetes had normal blood glucose levels within months of surgery
  • High Blood Pressure: 58% of patients came to surgery with high blood pressure. Only 14% had high blood pressure following surgery
  • Sleep apnea, asthma, snoring, and acid reflux were all reportedly eliminated
  • Arthritis, fertility and regulation of menses were all improved (This study is found in Annals of Surgery, September, 1995.)

The Truth: Weight Control Surgery

weight control surgeryWeight control surgery, such as the Stomach Bypass and LAP-BAND operations, is the only nationally accepted weight loss surgery treatment proven to help severely overweight people LOSE SUBSTANTIAL WEIGHT AND KEEP IT OFF.

If you are severely overweight, we hope that you find this Web site informative and helpful in assisting your decision to have surgery. As you review the information here, we hope you understand who can benefit from this form of therapy, the pros and cons of the various operations being performed, and gain insight into our approach to long-term success. Explore this site to find out how you can change your life forever. Find out what makes obesity surgery work, and how surgery can restore long-term control of your weight on our “Does It Work?” post. You can also find our recommended “Diet” following surgery.

Morbid obesity is a chronic condition. There is no known cure.

Obesity is determined by a few factors:

Internally set points of weight
Eating habits
Because of these factors, the morbidly obese person loses the ability to control their weight.
Dieting First
A successful diet means a person lost weight. Regaining weight after dieting does not constitute failure of the diet. Fewer than 5% of morbidly obese people are successful at losing weight and keeping it off with dieting. There are, however, other alternatives to yo-yo dieting for the morbidly obese.

Consider Weight Loss Surgery
Surgery is not the easy way to lose weight. But it is the best way for morbidly obese persons to achieve long-term weight loss. If you are prepared to make fundamental behavior changes in your approach to food and life, then weight loss surgery might be the right solution for you.
Explore this site and find out how you can change your life forever.

If you decide that this is the right course for you now, you can begin your registration with our program by setting up your own online patient account on our secure internet site.