Divided vertical banded gastroplasty either for correction or as a first-choice operation

Background: Staple-line disruption may occur after vertical banded gastropl asty (VBG). Methods: Since May 1996, the authors have performed the gastric restrictive procedure divided VBG, as described by MacLean, as a first-choice operatio n and not only as correction for staple-line breakdown. Divided VBG was don e in 111 patients, 32 as correction after staple-line disruption and 79 as a first choice, 29 of them by hand-assisted laparoscopy with the dexterity pneumosleeve. Results: Weight loss and nutritional status have been very satisfactory. Op erating time for the standardized operation has been no longer than 60 minu tes. Conclusion: Divided VBG, especially if done by hand-assisted laparoscopy us ing the dexterity pneumosleeve, is a valid restrictive procedure.