Maclean Vertical Banded Gastrioplasty

This procedure can be either Laparoscopic or open. The MacLean method is one of the most stable and effective procedures for long-term weight loss. MacLean Surgery sections off a small portion of the stomach to restrict food intake. A small outlet is left at the bottom of the stomach. Since the outlet is small, food stays in the pouch longer and you also feel full for a longer time.

It is a trouble free procedure that requires little aftercare and maintenance. Once “fitted” it can be forgotten and the candidate has an easier time losing weight.
This method is purely restrictive, meaning that it is an operation simple in concept, which produces a small pouch within the stomach with a banded opening leading into the remainder of the stomach. Solid food makes the person feel full, whereas liquids tend to pass through much more easily.
Unfortunately, this operation does not produce as much weight loss as the Gastric Bypass, there tends to be a late weight gain and a common problem is vomiting because food does not pass easily through this small opening and therefore backs up. In addition, it has been found that another possible complication is a disruption or opening up of the staple line, so that food empties into the main stomach without passing through the banded opening. 

Advantages: Restrictive operations are easier to perform and are generally safer than malabsorptive operations. AGB is usually done via laparoscopy, which uses smaller incisions, creates less tissue damage, and involves shorter operating time and hospital stays than open procedures. Restrictive operations can be reversed if necessary, and result in few nutritional deficiencies.

Disadvantages: Patients who undergo restrictive operations generally lose less weight than patients who have malabsorptive operations, and are less likely to maintain weight loss over the long term. Patients generally lose about half of their excess body weight in the first year after restrictive procedures. However, in the first 3 to 5 years after VBG patients may
regain some of the weight they lost. By 10 years, as few as 20 percent of patients have kept the weight off. (Although there is less information about long-term results with AGB, there is some evidence that weight loss results are better than with VBG.) Some patients regain weight by eating high-calorie soft foods that easily pass through the opening to the stomach. Others are unable to change their eating habits and do not lose much weight to begin with. Successful results depend on the patient’s willingness to adopt a long-term plan of healthy eating and regular physical activity.

Risks: One of the most common risks of restrictive operations is vomiting, which occurs when the patient eats too much or the narrow passage into the larger part of the stomach is blocked. Another is slippage or wearing away of the band. A common risk of AGB is breaks in the tubing between the band and the access port. This can cause the salt solution to leak,
requiring another operation to repair. Some patients experience infections and bleeding, but this is much less common than other risks. Between 15 and 20 percent of VBG patients may have to undergo a second operation for a problem related to the procedure. Although  restrictive operations are the safest of the bariatric procedures, they still carry risk—in less than 1 percent of all cases, complications can result in death.