Laparoscopic Gastric Bypass at a Large Academic Medical Center: Lessons Learned from the First 1000 Cases

Tejirian, Talar; Jensen, Candice; Lewis, Catherine E.; Dutson, Erik; Mehran, Amir

doi:10.1177/000313480807401017

Cited by 14 publications

(3 citation statements)

References 25 publications

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“…Patients who had LRYGB (January 2003 to December 2008) at a single program were consecutively identified from an existing database. 4 One hundred and ninetyseven patients with at least 1 year follow-up who had agreed to be contacted for research were invited by email to participate in a retrospective survey. One hundred and forty-eight (75%) patients completed surveys.…”

Section: Methodsmentioning

confidence: 99%

Behavioral Factors Associated with Successful Weight Loss after Gastric Bypass

Livhits

Mercado

Yermilov

et al. 2010

The American Surgeon

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103

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Patients undergoing bariatric surgery lose substantial weight (≥50% excess weight loss [EWL]), but an estimated 20 per cent fail to achieve this goal. Our objective was to identify behavioral predictors of weight loss after laparoscopic Roux-en-Y gastric bypass. We retrospectively surveyed 148 patients using validated instruments for factors predictive of weight loss. Success was defined as ≥50 per cent EWL and failure as <50 per cent EWL. Mean follow-up after laparoscopic Roux-en-Y gastric bypass was 40.1 ± 15.3 months, with 52.7 per cent of patients achieving successful weight loss. After controlling for age, gender, and preoperative body mass index, predictors of successful weight loss included surgeon follow-up (odds ratio [OR] 8.2, P < 0.01), attendance of postoperative support groups (OR 3.7, P = 0.02), physical activity (OR 3.5, P < 0.01), single or divorced marital status (OR 3.2, P = 0.03), self-esteem (OR 0.3, P = 0.02), and binge eating (OR 0.9, P < 0.01). These factors should be addressed in prospective studies of weight loss after bariatric surgery, as they may identify patients at risk for weight loss failure who may benefit from early tailored interventions.

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Section: Methodsmentioning

confidence: 99%

Behavioral Factors Associated with Successful Weight Loss after Gastric Bypass

Livhits

Mercado

Yermilov

et al. 2010

The American Surgeon

Self Cite

103

View full text Add to dashboard Cite

show abstract

“…However, there have been some researchers who have found that psychosocial improvements only last for the first couple of years after surgery (Greenberg, Smith, & Rockhart, ). Furthermore, other investigators have found that after surgery, some clients experience distress related to the behavioral adjustments required after surgery (Tejirian, Jensen, Lewis, Dutson, & Mehran, ), develop eating disorders (Bonne, Bashi, & Berry, ; Kalarchian et al., ), experience an increase in high risk‐taking behaviors (Vazzana, ), or experience what some have referred to as the “addictions transfer phenomenon” (Marcus, Kalarchian, & Courcoulas, ; Sarwer et al., ). Sarwer et al.…”

Section: Impact Of Obesity On the Patientmentioning

confidence: 99%

Life After Bariatric Surgery: Perceptions of Male Patients and Their Intimate Relationships

Moore

Cooper

2016

J Marital Family Therapy

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This study explores the experiences of 20 men who have had bariatric surgery, focusing on their couple or marital relationships. The researcher concentrates on men's perspectives regarding relationship satisfaction, sexual intimacy, and social support after surgical intervention. Phenomenology and family systems theory were used to guide the study from which emerged three themes: (a) Unintended consequences (unpredicted problems occurring within intimate relationships); (b) Intimacy as bittersweet (experiencing increasing levels of intimacy, while still desiring more); and (c) Inconsistent social support (experiencing instances where social support is provided, while simultaneously experiencing other areas where social support is not provided). The study includes a rich description of the data, critical analysis, and discussion of clinical implications for therapists and other healthcare professionals.

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“…Tejirian et al 18 reported the experience of 4 surgeons with 1096 gastric bypass procedures over a 5-year period. They, too, modified their technique as their experience progressed and reported an overall complication rate of 7%.…”

Section: Discussionmentioning

confidence: 99%

Procedural Changes to Decrease Complications in Laparoscopic Gastric Bypass

Beitner¹,

Luo²,

Kurian³

2015

JSLS

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Background and Objectives:Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a complex procedure performed in a patient population with significant medical comorbidities. Evaluation and modification of surgical techniques can minimize the complications associated with the lengthy learning curve for this procedure. The purpose of this study was to evaluate a single surgeon's decade-long experience with LRYGB, to determine whether complications decreased with experience and surgical modifications improved perioperative outcomes.Methods:A retrospective review of all procedures performed by a fellowship-trained surgeon (MK) from December 1, 2000, to October 31, 2013, identified patients who underwent LRYGB. We evaluated perioperative outcomes in 1117 patients and examined the impact of modification of surgical techniques on complications. The patients were divided into 4 groups: cases 1–100 (group 1), cases 101–400 (group 2), cases 401–700 (group 3), and cases 701-1117 (group 4).Results:Operating time decreased significantly after the initial 100 cases, from 179.1 minutes for group 1 to 122.1 minutes for group 4. With experience, early complication rates improved from 25.0% to 5.0%, but the rates of early reoperation increased from 1.0% to 2.2% over the 4 case groups. Late complication and reoperation rates increased from 4.0% to 10.5%. However, rates of bleeding, early stricture, internal hernia, and wound infection all decreased after the modification of surgical techniques.Conclusions:Operating time and early complication rates decreased with operative experience, but late complication and early and late reoperation rates increased. However, after modifications of surgical technique, common complications of LRYGB decreased to rates lower than those reported in several gastric bypass case series in the literature. The findings in this study will be helpful to fellow bariatric surgeons who are refining their strategies for reducing morbidity related to LRGYB.

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Laparoscopic Gastric Bypass at a Large Academic Medical Center: Lessons Learned from the First 1000 Cases

Cited by 14 publications

References 25 publications

Behavioral Factors Associated with Successful Weight Loss after Gastric Bypass

Behavioral Factors Associated with Successful Weight Loss after Gastric Bypass

Life After Bariatric Surgery: Perceptions of Male Patients and Their Intimate Relationships

Procedural Changes to Decrease Complications in Laparoscopic Gastric Bypass

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