Vertical Banded Gastroplasty in the Severely Obese under Age Twenty-One

Background: The severely obese under 21 years of age are at high risk of missing normal development during a crucial period of life and should be considered for surgical treatment. Vertical banded gastroplasty allows patients to be treated effectively while continuing to have normal digestion and absorption without the risks of complex operations. Methods: This was a retrospective outcome review of 47 severely obese who were under age 21 when surgically treated with VBG. Results: There were no operative mortalities, leaks, or wound infections. Body mass index in 25 patients followed 5 years decreased from an average operative 48.1 to 36.2 kg m⁻². Equally for 14 patients followed 10 years, BMI decreased from an average operative 49.6 to 39.2 kgm⁻². Both patient groups had 74% follow-up. Conclusions: Sustained weight reduction improved general health and allowed participation in life activities that would otherwise not have been possible. Adherence to recommended operative technique and intraoperative measurement of pouch volume is necessary to avoid excessive enlargement of the pouch, with resulting weight gain, reflux, and need for revision.