64 patients were treated with distal oesophageal banding for morbid obesity from 30/4-1984 to 1/6-1988. By this method a Dacron vascular prosthesis is passed around the oesophagus from incisura cardiaca to pars cardiaca. There will be no upper ventricular pouch. The method was introduced in order to avoid the problems seen after operation with gastric banding, such as valve mechanism secondary to pouch distension and band penetration. Such problems have not been encountered following our operative modification. 18 patients were observed for more than two years. The mean weight loss one year after operation was 28 kg, which was equivalent to 26% of preoperative weight. The main problem is excessive tightening of the band. Therefore, in three patients, the band had to be removed later.
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