Horizontal gastroplasty. A safe, effective alternative to gastric bypass in the surgical management of morbid obesity.

During the period from June 1981 to April 1983, 232 horizontal gastroplasties were performed using a modification of the technique of Dr. C. A. Gomez. The TA-90 cartridge was modified to avoid use of the Gomez "C-clamp." A measured pouch of less than 50 cc was thus created with a measured stoma on the greater curve to equal 11 mm in diameter. Excluding the patients who had staple line disruption (7%) and further revision, the remaining patients had lost an average of 62 per cent of their excess weight at 1 year postoperative. There has been no mortality and minimal morbidity. These results compare favorably with the Roux-en-Y gastric bypass. The reasons for these favorable results are explained herein.