How Much Is Stomach Stapling Surgery In The UK
Also known as vertical banded gastroplasty surgery (VBG), stomach stapling is a surgical procedure performed to aid with weight loss in obese patients. The procedure involves inserting staples into your stomach to close off the majority of it; leaving you with a small pouch that restricts that amount of food you can take in.
Two Types Of VBG
There are two leading methods of vertical banded gastroplasty, open and laparoscopic.
Open VBG is the original procedure, the only available option prior to the advent of laparoscopic technology. It is also the most common method of conducting this procedure. During an open VBG procedure, the patient is placed under general anaesthesia for an operation that can take anywhere between one to two hours to complete. The surgeon begins by making an incision into the upper abdomen before cutting through tissue to access the upper part of the stomach. The surgeon will then input a line of surgical sutures to create a small pouch that should be around 10% of the size of the full stomach. Ideally, this pouch should be able to hold a tablespoon of solid food at the most. Once the correct size has been determined, the surgeon inserts a polypropylene plastic band, and attaches it to the pouch. The polypropylene material will not stretch, so there is no risk of the pouch expanding and being able to hold more food. This also means food stays in the pouch for longer, leaving the patient feeling fuller for a longer period of time having only consumed a small portion of food. Once satisfied with the placement of the band, the incision is closed and the patient can begin recovery.
A laparoscopic procedure is the newer, more sophisticated method of achieving the same results. An open VBG is still the most common method of performing this type of procedure however, as surgeons are required to undergo more specialist training to do the procedure laparoscopically. During a laparoscopic vertical banded gastroplasty, a surgeon will carry out the procedure using a bariatric laparoscope. This tube is 10mm in diameter, and carries a fibreoptic cable to enable the surgeon to see on a high-res video screen in the operating room. With this camera, the surgeon can view the abdominal cavity in detail. After making incisions to insert the laparoscope, the surgeon will make an incision through which to form the stomach pouch. This incision is normally around 14cm long, and the pouch will be created and band inserted using a combination of this and the other incisions. Owing to the specialised nature of the procedure and the fact that the surgeon is restricted by the small size of the incisions, a LVBG takes longer than an open VBG, lasting between two and four hours.
After undergoing either an open or laparoscopic VBG, patients can expect to stay in hospital for between four and five days, and should be able to return to work and normal activities between four and six weeks after the surgery.
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The VBG procedure was pioneered by Dr. Edward E. Mason in 1982, and is now a common weight loss surgical procedure carried out around the world.
There are two ways to carry out stomach stapling, either laparoscopically or through an open incision. During the procedure, the stomach is reduced in size in order to limit the amount of food that can be consumed. The stomach is sutured or “stapled” to close off the majority, leaving behind just a small pouch. Food can only be held in this remaining small part, meaning patients feel full for longer and have a reduced appetite. This reduction in food intake has been shown to result in sustainable weight loss. Patients begin to see dramatic weight loss within the first six months of the surgery, and lose up to 50% of excess weight on the 18-24 months following the procedure.
There are a few risks associated with this surgery, ranging from surgery-specific risks such as infection and blood cutting through to more specific risks that include damage to the spleen, a hernia, and the staples coming loose (known medically as Dehiscence). The procedure is recommended for patients suffering with morbid obesity, or a BMI of between 35 and 40.
Results Of Stomach Stapling
Stomach stapling has proven weight loss results, with around 80% of patients seeing a dramatic weight loss. However it is less effective than other weight loss surgeries, as some studies have shown that only around 30 percent of stomach stapling patients achieve a normal weight, and long term maintenance of weight loss is more difficult.
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Risks and Complications Of Stomach Stapling
As with any surgical procedure, stomach stapling comes with numerous general risks including infection, nausea and vomiting, internal bleeding and reactions to the anaesthesia used. In addition to these there are also a number of procedure-specific risks, including:
- Leakage from the site of stapling which may require a further surgical procedure to fix.
- Severe discomfort and/or vomiting if food is not chewed properly and eaten too quickly or if the pouch left is too small.
The risks associated with stomach stapling have led to the introduction of preferred weight loss surgery techniques such as gastric banding or gastric bypass. As with any surgical procedure, you should always discuss the potential risks and side effects with your surgeon before undergoing your procedure.
Is Stomach Stapling Available On The NHS?
Stomach stapling is no longer available on the NHS, as it has been replaced with newer, safer techniques such as:
In order to receive one of these procedures on the NHS you will need to meet their eligibility criteria, which is usually having a BMI of 40 or above, or a BMI of 30 or above if you have a medical condition linked to excess weight such as hypertension or type II diabetes.
There are numerous alternative weight loss surgery procedures, including gastric banding, gastric bypass and sleeve gastrectomy.
Gastric banding achieves similar results to stomach stapling, but does not involve making cuts in the stomach so is therefore safer. It is also more flexible in achieving the right size of stomach pouch as the band is adjustable.
Gastric bypass surgery is very similar to stomach stapling, but the use of sutures instead of staples is associated with a reduced risk of stomach leakage and quicker healing times.