Staged Laparoscopic Roux-en-Y: A Novel Two-Stage Bariatric Operation as an Alternative in the Super-Obese with Massively Enlarged Liver

Nguyen, Ninh T.; Longoria, Mario; Gelfand, Dmitri V.; Sabio, Allen; Wilson, Samuel E.

doi:10.1381/0960892054621062

Cited by 86 publications

(46 citation statements)

References 11 publications

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“…This procedure has a low incidence of complications and mortality, and is particularly useful in the super-super-obese patient who may benefi t from a two-staged procedure. 6,24 When used as single operation, the weight loss is similar to that achieved by LAGB at 12 months, with comparable complication rates. Long-term studies are necessary to confi rm whether SG is a durable procedure for morbid obesity.…”

Section: Discussionmentioning

confidence: 70%

Laparoscopic sleeve gastrectomy for the super-super-obese (body mass index >60 kg/m2)

et al. 2008

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Section: Discussionmentioning

confidence: 70%

Laparoscopic sleeve gastrectomy for the super-super-obese (body mass index >60 kg/m2)

et al. 2008

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“…Little is known about the novel, mainly restrictive procedure, the laparoscopic sleeve gastrectomy (LSG). Initially, LSG was performed as the first operation as part of a staged concept in superobese, high-risk patients, followed by BPD "duodenal switch" or LRYGB, if necessary [11][12][13]. Some studies have also shown LSG to be successful as a single-step operation in many patients [14,15].…”

Section: Introductionmentioning

confidence: 99%

Fewer Nutrient Deficiencies After Laparoscopic Sleeve Gastrectomy (LSG) than After Laparoscopic Roux-Y-Gastric Bypass (LRYGB)—a Prospective Study

et al. 2010

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Background Deficiencies in micronutrients after bariatric operations are frequent, despite routine supplementation. Main outcome measures were pre-and postoperative frequency of nutrient deficiencies and success rate of their treatment. Between 5/2004 and 12/2006, 136 patients (m:f=0:4) with an average body mass index of 45 (35-58) kg/m 2 and age of 53 (21-66) years were prospectively analysed. Laparoscopic Roux-Y-gastric bypass (LRYGB) was performed in 86 patients and laparoscopic sleeve gastrectomy (LSG) was performed in 50 patients. The patients were examined before surgery as well as 3, 6, 12, 24, 30, and 36 months postoperatively using a standard protocol including laboratory tests. The mean follow-up time was 24.4 (12-40) months; the follow-up rate was 100%. Results Prior to surgery, 57% of the patients had at least one deficiency, 23% of whom had vitamin D 3 deficiency. Frequent postoperative deficiencies after LSG were zinc, vitamin D 3 , folic acid, iron, and vitamin B 12 ; after LRYGB, vitamin B 12 , vitamin D 3 , zinc, and secondary hyperparathyroidism. No vitamin B 1 or B 6 deficiencies were found. Calcium levels were normal in all patients. Treatment of the deficiencies was mostly successful. Conclusion Preoperatively, 57% of morbidly obese patients already had a deficiency. Postoperatively, significantly more vitamin B 12 and vitamin D deficiencies and hyperparathyroidism were found in patients who had undergone LRYGB. After LSG, folate deficiency was more frequent (but not significantly so). Calcium levels were normal in all patients; therefore, parathyroid hormone and vitamin D 3 levels are more sensitive markers for early detection of disorders of calcium metabolism. Iron deficiency anaemia is most efficiently treated by IV therapy. Methods

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“…About 7 years ago, some surgeons who were performing the DS operation began to do the first part (the lesser curvature gastric tube) as a first-stage for poor-risk patients, intending to do the second stage (DS or RYGBP) later [1][2][3][4][5][6][7][8]. It was noted that patients occasionally lost significant weight so that they did not require the second stage.…”

Section: Introductionmentioning

confidence: 99%

The First International Consensus Summit for Sleeve Gastrectomy (SG), New York City, October 25–27, 2007

2008

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Sleeve gastrectomy is a rapid and less traumatic operation, which thus far is showing good resolution of comorbidities and good weight loss if a narrower channel is constructed than for the duodenal switch. There are potential intraoperative complications, which must be recognized and treated promptly. Like other bariatric operations, there are variations in the technique used. The laparoscopic sleeve gastrectomy (LSG) is being performed for super-obese and high-risk patients, but its indications have been increasing. A second-stage bariatric operation may be performed if necessary, with increased safety. Long-term results of LSG and further networking are anxiously awaited.

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Staged Laparoscopic Roux-en-Y: A Novel Two-Stage Bariatric Operation as an Alternative in the Super-Obese with Massively Enlarged Liver

Cited by 86 publications

References 11 publications

Laparoscopic sleeve gastrectomy for the super-super-obese (body mass index >60 kg/m2)

Laparoscopic sleeve gastrectomy for the super-super-obese (body mass index >60 kg/m2)

Fewer Nutrient Deficiencies After Laparoscopic Sleeve Gastrectomy (LSG) than After Laparoscopic Roux-Y-Gastric Bypass (LRYGB)—a Prospective Study

The First International Consensus Summit for Sleeve Gastrectomy (SG), New York City, October 25–27, 2007

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