Has Laparoscopic Bariatric Surgery been Accepted in Japan? The Experience of a Single Surgeon

Abstract

In bariatric surgery, LRYGBP is the most effective treatment for morbid obesity, while LAGB has a low risk of postoperative complications. LSG is also a safe procedure for supermorbidly obese patients. We expect that bariatric surgery will be a common procedure for patients with morbid obesity in Japan.

Effects of changes in adipocyte hormones and visceral adipose tissue and the reduction of obesity-related comorbidities after laparoscopic sleeve gastrectomy in Japanese patients with severe obesity

“…Currently, LRYGB is considered the gold standard procedure for severe obesity, and it leads to excellent long-term sustained weight loss and remarkable resolution of comorbidities worldwide [25]. Kasama et al reported that the weight reductions of LRYGB and LSG in Japanese obese patients were 32.0 kg and 27.4 kg 6 months after operation, respectively [26]. They also reported that the BMI changes and %EWL between LRYGB and LSG were -11.8 kg/ m 2 and -10.1 kg/m 2 , 72.7 % and 49.7 %, respectively [26].…”

“…Kasama et al reported that the weight reductions of LRYGB and LSG in Japanese obese patients were 32.0 kg and 27.4 kg 6 months after operation, respectively [26]. They also reported that the BMI changes and %EWL between LRYGB and LSG were -11.8 kg/ m 2 and -10.1 kg/m 2 , 72.7 % and 49.7 %, respectively [26]. In Japan, LSG is the most frequently performed bariatric surgery, and it accounted for 54 % of such surgeries in 2011 due to its a relatively low rate of complications, less malabsorption, and a shorter learning curve compared to LRYGB [5].…”

Laparoscopic Sleeve Gastrectomy with Duodenojejunal Bypass: Technique and Preliminary Results

“…That procedure would be beneficial for a resolution of type 2 diabetes mellitus [6,25,26]. In fact, our resolution rate of DM by LSG/DJB was 93%, and it was much higher than that of LSG in our experience (67%) [1] and Rosenthal et al (63%) [27]. We suppose that the advantage of LSG/DJB over LBPD/DS is a less malnutritional complication.…”

“…The weight loss and percent excess BMI loss (%EBMIL; mean ± standard deviation (SD)) at the third, sixth, ninth, twelfth, and eighteenth month follow-up points were 18± 4.5, 25±7.5, 27±6.2, 31±8.2, 37±5.0 kg and 47±29, 63± 23, 66±23, 78±24, 96±10%, respectively. In comparison with our series of other procedures [1], the weight loss was not enough during a short-term observation; however, the %EBMIL of LSG/DJB was similar to that for LRYGBP and superior to LSG and laparoscopic AGB (LAGB) ( Table 1).…”

“…Bariatric surgery is still not common in Asia, but the results of bariatric surgery for Asian people are as good as they have been for Westerners. In the series of bariatric surgeries I have performed in Japan, the results of laparoscopic Roux-en-Y gastric bypass (LRYGBP) has been superior to restrictive procedures such as adjustable gastric banding (AGB) or laparoscopic sleeve gastrectomy (LSG) regarding weight loss and cure of comorbidities [1]. However, there is an important problem for the investigation of the excluded stomach after RYGBP in countries with a high occurrence rate of gastric cancer as is the case for Japan.…”