Gastroplasty is the origin of the term stomach stapling, and is the prototypical "restrictive" procedure. In this procedure, a portion of the stomach is isolated by applying surgical staplers to seal off the stomach. The original form of the surgery involved stapling the upper portion of the stomach horizontally. A small opening was left in order for food to pass to the lower portion. Unfortunately, horizontal stapling alone led to poor long-term weight loss, and the operation was abandoned.
However, another form of gastroplasty was developed called vertical band gastroplasty (VBG). VBG combines the process of stomach stapling and a polypropylene mesh band around the opening of the created pouch. As most of the gastrointestinal tract is left intact, there are few micronutrient deficiencies, and initial weight loss is good. Yet after long-term observance of VBG, there have been many patients that have regained weight. Surgery alone is insufficient - patients must change their lifestyle and eating habits or this procedure can be compromised. Over time, the pouch can dilate and serve as an increased reservoir, along for higher caloric intake and consequent weight gain. Since some patients have also experienced complications such as severe heartburn or erosion of the mesh, and other procedures have had dramatic successes, the popularity of VBG has suffered in the United States.