الفهرس 
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Abstract
SUMMARY
Morbid Obesity is now known as silent creeping epidemic to the Universe. It is generally accepted that Morbid Obesity is defined as BMI over 40 kg/m2; BMI is now the formula of measurement in handling the morbid obese patient weights.
Our study underwent consideration of V.B.G. ( laparoscopic vertical banded gastroplasty , modified technique) as a primary safe, satisfactory barriatric procedure with minimal complications and effective results in good weight loss in study of 50 morbid obese patients with long term follow up of 2 years.
Our candidates ,of these study were 50 morbid obese patients, 33 female and 17 male properly selected with mean BMI 51 kg/m2 fulfilling the selection criteria which include age between 18years and 60 years failed to sustain any weight loss through the last five years in non surgical methods of weight control, all of them had got the willingness to cooperate for 2 years follow-up and accepted surgical risks, all of them had no major psychological problems or endocrine disease or positive history of alcoholism, , some of candidates has a co-morbid diseases namely hypertension, adult onset DM, and chronic cholecystitis.
In this study, all our candidates are pre-operatively educated and instructed about the surgical procedure, future size of their stomach, the diet schedule they will follow firmly and results hoped to occur..
They had the routine pre operative assessment as before any major surgical operation , operated with V.B.G. laparoscopic vertical banded gastroplasty (modified technique) and close follow-up in early stage in hospital doing gastrographin meal on the second day as well as late stage for 2 years follow-up of weight loss through out patient clinic.
We stated the weight loss as the key role of this study. We follow patients up every 6 months weighing them and tracing the effect of weight loss on other co-morbid diseases that they might have. We found that the great majority of our patients lost most of the excess weight by the end of the 2nd year. With marked improvement up to cure for some diseases.
Repeated reviewing of diet behavior is so important because its side effect on weight loss, weight gain and excessive weight loss is so obvious.
Patients were instructed to change the feeding habits and strictly minimize the intake of sugars.
Laparoscopic vertical banded gastroplasty (modified technique) can be an option in the armamantarian of surgical treatment of barriatric patients.
The ( laparoscopic vertical banded gastroplasty , modified technique)helps to reduce the cost, the time of surgery and to minimize the size of the pouch thus helping to achieve a better restriction.
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