The Le Goff Technique consists of placing a retro-gastric band (pars flaccida), combined with liberation of the greater gastric tuberosity up to the first gastrophrenic ligament: adherences to the spleen are sectioned but the first gastrophrenic ligament is rarely sectioned.
The band is fixed anteriorly using sero-gastric muscular-oesophageal sutures, thus reducing the gastric pouch underneath the band. All fat in the lower part of the anterior oesophagus is removed, as are the vascular and nerve endings from the left vagus.
All the branches of the left vagal nerve to the oesophagus and stomach are sectioned. Gastric evacuation is thus slowed.
In addition, this lower valve stimulates the IGLE satiety centres in the basal state in the wall of the abdominal oesophagus.
This procedure must be associated with multidisciplinary medical-surgical, nutritional, psychiatric-psychoanalytical treatment, two to four visits in the first year, with the accent firmly on the psychological factors (psychotherapy support often indicated) and a resumption of sport.
Inflation and deflation is carried out by the surgeon in radiology. He is able to judge how the band is functioning, the weight loss according to the tightness of the band and how it is being accepted by the patient.
The operation of the band reflects the mental state. The surgeon will thus do an evaluation of the overall success of the operation.