Laparoscopic mini-gastric bypass: short-term single-institute experience

Abstract

The elevated variety of procedures proposed for surgical treatment of obesity in the last few years suggests the necessity to find an ideal operation. Laparoscopic mini-gastric bypass (LMGB) was developed to obtain better results with lesser morbidity and mortality. LMGB was introduced by Rutledge, in 1997, and it consists of a long lesser-curvature tube with a terminolateral gastroenterostomy 180 cm distal to the Treitz ligament. From July 1995 to May 2011 we have performed 552 bariatric operations, among them we have operated 197 laparoscopic mini-gastric bypass (Fig. 1). There were 147 female (75%) and 50 male (25%) with the mean age of 37.9 years (range 20-55) and the mean BMI of 52.9 kg/m(2). All procedures were completed laparoscopically, without conversion and the mean operative time was 120 min (range from 90 to 170 min). The average postoperative stay was 5.0 days. We report one case of mortality for pulmonary septic complications. Major complications were two cases of pulmonary embolism (treated in ICU), six cases of melena on seventh postoperative day and three cases of anastomotic ulcers resolved with high doses of PPI. We registered a significant reduction of BMI and percentage of excess weight after surgery with a significant improvement in obesity-related comorbidities including blood pressure, hyperglycemia, blood lipid, uric acid, and liver function. An ideal weight loss operation should be effective, easy to perform and safe. Laparoscopic Roux-en-Y Gastric Bypass is actually the "gold-standard" technique but LMGB seems to be an attractive alternative: shorter operative time, with less morbidity and mortality, easier to teach and to perform. Another advantage could be the presence of a single anastomosis alone reducing the possibility of leaks.

Single anastomosis gastric bypass: A novel bariatric procedure

“…The metabolic effects are summarized in another chapter in the present issue of the article, but it is a popular research subject studied by various researchers. [7][8][9][10][11][12][13][14][15][16] All data are summarized in Table 2.…”

“…Our results have also indicated an excess body weight loss rate of 68.7% and 83.4% in 6 months and 1 year, respectively (See Table 2 for details), which is comparable to the data shown in the literature by high volume centers. [2][3][4][5][6][7][11][12][13][14][15][16] However, our results seem better since it is a single center study and a single surgeon performed the surgeries in less than two years.…”

“…[2][3][4][5][6][7][11][12][13][14][15][16] We believe that it depends on the anesthesia type, blood loss, and overall comorbidities of the patient. In our institution, we prefer keeping the patient until the postoperative third day following gastrografin swallow.…”

A Safe and Efficacious Alternative to Roux-en-Y Gastric Bypass for the Treatment of Morbid Obesity and Type 2 Diabetes - One Anastamosis / Mini Gastric Bypass

“…T2DM remission rates were mostly more than 84% [18,[20][21][22][23][26][27][28][29] Table 2 details the summary of complications in the same studies. 9 studies reported 0% mortality in their series.…”

Mini-Gastric Bypass for Bariatric Surgery Increasing Worldwide

“…and pre-and post-operative clinic, inspecting his substantial follow-up. The MGB has since increased throughout the world [3][4][5][6][7][8][9][10][11][12][13][14]. With the decrease in gastric banding, the MGB in 2015 became the third most common bariatric operation internationally [15].…”