The article discusses four operations for vertical gastroplasty performed for the first time in Russia at the Research Centre of Surgery, RAMS, for degree IV obesity (the body weight of the patients ranged from 115 to 183 kg). The suturing instruments CEEA-28, TA-90, and CIA-90 manufactured by Auto Suture Instruments, USA, were used. Subsequent examination of patients in follow-up periods of as long as 4 months showed a favorable effect of the operations: body weight reduced, the patient's health and the course of concomitant diseases was milder.