Vertical banded gastroplasty combines the best that has been learned about gastric reduction operations with another feature: a window through both walls of the stomach just above the crow's foot and next to the outlet along the lesser curvature. This window allows the application of staples up to the His' angle to create a small pouch (less than 50 mL). In addition, the outlet can be banded with a polypropylene mesh collar that is sutured to itself but not to the stomach. This banding provides an outlet diameter that remains constant. In experience with 42 patients during a one-year period, there were fewer complications and greater weight loss than have been obtained with any other operation for obesity, to my knowledge.