Silastic ring vertical gastric bypass is a composite operation which maximizes the advantages of the vertical banded gastroplasty and the gastric bypass operations. It is our operation of choice because it appears to date to be the only operation that addresses the medical and psychosocioeconomic problem of severe obesity. Acute complications include wound infection, wound seroma and anastomotic leaks. Late complications include marginal ulcers (6%), staple-line breakdown (4%), Iron deficiency, vitamin B12 deficiency and anemia. The operation is relatively simple, safe, effective and acceptable to the patients and doctors.