Modification of the gastric partitioning operation for morbid obesity.

Two hundred patients operated on for morbid obesity were followed through the evolution and modification of gastric partitioning. Twenty-six patients (group I) were treated by complete TA-90 partitioning with a 1.2 cm gastrogastrostomy; only 23 percent had an excellent result. Fifty-nine (group II) were treated with a single TA-90 partitioning from which three staples were removed to form the stoma between the proximal and distal stomach; 44 percent had excellent results. One hundred fifteen patients (group III) were treated with TA-90 partitioning (three staples removed) using additional staple line reinforcement with 2-0 interrupted silk sutures and support of the stoma with a circumferential 1-0 silk suture reinforced with Teflon pledgets; all have had a good or excellent response. There have been minimal complications and no deaths. We encourage the adoption of this procedure as a safe and reliable surgical method in attacking the problem of morbid obesity. These patients must be treated by a team of surgeons, dietitians, nurses and office personnel who will provide the long-term support system necessary for the behavior modification induced by the surgery.