Gastric Bypass: Current Results and Different Techniques

Abstract

Obesity has been steadily increasing over the last three decades and is one of the leading causes of increased health costs due to its associated comorbidities. Unfortunately, conservative treatment including lifestyle changes did not achieve the desired results. Bariatric surgery, on the other hand, has emerged as an effective and safe treatment for obesity and its related comorbidities such as type 2 diabetes. Much time has passed since the first Roux-en-Y gastric bypass was performed in the 1960s, and the operation technique has since evolved. New variations such as the distal gastric bypass as well as the omega loop bypass have been developed. Today, the laparoscopic gastric bypass is still the most widely applied bariatric operation technique, followed by laparoscopic sleeve gastrectomy and laparoscopic adjustable gastric banding. The refinement of the surgical technique and the introduction of laparoscopy have resulted in low perioperative morbidity and mortality after gastric bypass surgery. In this article, we will be discussing the history of gastric bypass surgery as well as presenting current data on excessive weight loss and resolution of comorbidities with a focus on diabetes. We will be looking into newer techniques such as omega loop bypass and their efficacy compared to the standard gastric bypass. Furthermore, we will be addressing the most important early and long-term complications, their diagnostic strategies as well as their management.

Is It Possible to Predict Weight Loss After Bariatric Surgery?—External Validation of Predictive Models

“…Possible explanation of such performance may be unstandardized surgical techniques. There are many technical differences in bariatric procedures including volume of the pouch or limb lengths in RYGB and distance from the pylorus, bougie size, or completeness of fundus resection in SG [35,36]. As all of these procedural modifications and adjustments have significant impact on clinical outcomes, they may have affected comparison among different bariatric centers [35][36][37].…”

Efficacy of Laparoscopic Mini Gastric Bypass for Obesity and Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

“…Up to date, several bariatric surgeries exist [ 13 ]. Laparoscopic adjustable gastric banding (LAGB), laparoscopic sleeve gastrectomy (LSG), and laparoscopic Roux-en-Y gastric bypass (LRYGB) are the three most commonly used bariatric surgeries and LRYGB, accompanied with more rapid and more substantial weight loss than “restrictive” procedure (LAGB) and less risk of failure or complication than the “malabsorptive” procedure (LSG), is generally considered as the “gold standard” procedure [ 14 ].…”

Bariatric surgery in Azerbaijan: a single center experience

“…Roux-en-Y gastric (RYGB) bypass and minigastric (MGB) bypass were performed according to the standard technique that has been described elsewhere by other researchers. [10,11] However, LSG was performed ac-cording to our modified technique. Briefly; we complete resection by 32 Fr calibrating tube and 60 mm lined staple towards fundus in parallel with minor curve after 2 cm distance from pylorus.…”