Vertical banded gastroplasty (VBG), also known as stomach stapling, is a form of bariatric surgery for weight control. The VBG procedure involves using a band and staples to create a small stomach pouch. In the bottom of the pouch is an approximate one-centimeter hole through which the pouch contents can flow into the remainder of the stomach and hence on to the remainder of the gastrointestinal tract. Stomach stapling is a restrictive technique for managing obesity. The pouch limits the amount of food a patient can eat at one time and slows passage of the food. Stomach stapling is more effective when combined with a malabsorptive technique, in which part of the digestive tract is bypassed, reducing the absorption of calories and nutrients. Combined restrictive and malabsorptive techniques are called gastric bypass techniques, of which Roux-en-Y gastric bypass surgery (RGB) is the most common. In this technique, staples are used to form a pouch that is connected to the small intestine, bypassing the lower stomach, the duodenum, and the first portion of the jejunum. This type of weight loss surgery is losing favor as more doctors begin using the adjustable gastric band. The newer adjustable band does not require cutting into the stomach and does not use any staple lines, thus making it a much safer alternative. Advantages and disadvantages Advantages No dumping syndrome. No nutritional deficiencies/malabsorption. Disadvantages Needs strict patient compliance to diet. High-fiber foods and foods with a more dense, natural consistency can become very difficult to eat, while highly refined foods cause little discomfort. Many people who regain any weight lost after surgery do so because they begin to avoid the discomfort associated with consuming "healthier" foods, and start eating more easily passed "junk" foods. VBG is in no way a magic bullet or pill. It must be emphasized that lifestyle changes, e.g., diet and exercise, are absolutely imperative for weight loss to occur and be maintained. Realistic expectations are imperative. Reversal of a VBG requires a much more complex and intensive surgical process than getting the VBG. When removal of a polyurethane band is involved (polyurethane was predominantly used in the 1980s and 90s), it likely has built substantial scar tissue that must also be removed, depending on how long since the VBG took place. Removal of the staples involves stitching back together the previously separated parts of the stomach. For these reasons, a reversal should