Background: Vertical Banded Gastroplasty (VBG) was initiated in 1980 as a weight loss operation that restricted oral intake. A small volume pouch is created along the lesser curvature and the outlet is reinforced with a band of polypropylene mesh. Aims: To determine the results of patients who presented with complications of the VBG and wanted reversal of the VBG, not a conversion to another gastric weight loss operation.
Methods: From 1993 to 2007 26 patients had reversal of a VBG. 85% of the patients were female and presented on average 13 years (range 2-27 years) after the VBG. Presenting symptoms included nausea/vomiting in 88%, reflux in 65%, stricture requiring endoscopic dilatation in 38%, while 7% of patients had upper gastrointestinal bleeding or required total parental nutrition. All patients were offered conversion to another weight loss operation but decided on reversal of the VBG alone. All takedowns were performed in a similar manner by making a gastrotomy below the VBG pouch and placing a linear stapler through the gastrotomy with one of the limbs within the lumen of the gastroplasty and the other within the stomach pouch/fundus. The stapler is fired resulting in division of the polypropylene mesh band, resulting in continuity of the pouch with the rest of the stomach and reversal of the VBG pouch
Results: No patients died from the procedure and morbidity included one wound infection and one wound seroma. Preoperative Visick score was 2.8 ± 0.1 and decreased to 1.3 ± 0.1 after the reversal (P < 0.001). Patients had significant weight loss after the VBG (P < 0.001) and prior to the VBG reversal (Table). With a mean followup of 32 months (range 2-144 months), there was not a significant weight gain after the VBG reversal (P = 0.3) (Table). After the reversal, reflux symptoms continued in two patients and nausea and vomiting continued in one patient.
Conclusions: Reversal of a VBG results in symptomatic relief in the majority of patients. Patients should be instructed that some weight gain may occur after the reversal.
Weight changes prior to VBG, prior to reversal, and most recent weight.

Pre-VBG weight (range)	Weight at reversal (range)	Weight after reversal (range)
139 kg (105-182)*	96 kg (56-151)	105 kg (63-157)