[A possible late complication of Mason's vertical gastroplasty: the erosion of the vertical band].

Aim: To evaluate possible adverse consequences and complications following the procedure of Mason-McLeans Vertical Banded Gastroplasty (VBG), and in those cases the possibility to be related to a surgical mistake.

Personal Experience: It is based on a casuistic of more than 180 patients, submitted to this restrictive bariatric surgery in the same institution since 2001. Controls of the prescribed postop follow up revealed a very low rate of complications, as only in three cases, all of them with spontaneous presentation, there was a complication related to the banding.

[Main points of vertical banded gastroplasty technique in open surgery].

VGP represents the single more diffuse bariatric operation among the others restrictive ones, proposed and used from Mason since 1970. Other restrictive operations followed, introduced in the surgical armamentarium, but the Mason-like procedure remained the reference one, although with variations introduced by the single surgeon. On a basis of a personal experience of 163 patients operated with VGP, the Authors report the personal modifications of the procedure, in search of safety and better results.

Diaphragmatic relaxation: pathophysiological alterations and current possibilities of surgical repair.

Diaphragmatic relaxation is a pathology not frequently observed because it is generally oligosymptomatic. The development of modern technology has induced an important contribution to the diagnosis and treatment of the disease which can find a possibility of restoration in surgery. A 63-year-old patient with a light syndrome of respiration deficiency and an altered relaxed profile of the right cupola was subjected to surgical treatment with the technique of diaphragmatic plicature without any adverse implication during and after the operation.

[Experience of many years with the Mason-Mc Lean procedure for the treatment of obesity].

Bariatric surgery is still in search of a general agreement among surgeons for the more advisable technical procedure, and the various solutions actually overall performed are almost only on empirical basis. The main wanted result of such variety, of procedures is represented by the possibility to restore the body weight to physiological values without adverse effects. The Authors' experience is referred to 94 consecutive surgical procedures to treat obese patients and is completely homogenous, with all the patients treated by vertical gastroplasty, and the most of them are almost completely controlled till 24 months for clinical, biological, psychological and weight parameters.

[History and pathophysiologic analysis of the various techniques in bariatric surgery].

Bariatric surgery for the treatment of morbid obesity or overweight refractory to medical therapy was born at the beginning of second half of the twentieth century, and its first steps were uncertain and with a not jet well definite purpose. In fact the main result to be pursued seemed to be simply the reduction of body weight, and any change of anatomy of the digestive tract able to reduce the absorbtion of nutrients was judged adequate. But very early the adverse consequences of malabsorption so obtained became evident, and other operations possibly free from those complications were devised and clinically tested.