Vagal Nerve Dissection During Pouch Formation in Laparoscopic Roux-Y-Gastric Bypass for Technical Simplification: Does it Matter?

Perathoner, Alexander; Weiß, Helmut; Santner, Wolfram; Brandacher, Gerald; Laimer, Elisabeth; Höller, Elisabeth; Aigner, Franz; Alexander, Klaus

doi:10.1007/s11695-008-9657-x

Cited by 30 publications

(17 citation statements)

References 31 publications

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“…At 12 or 18 months postsurgery, there was no difference in BMI and EWL between the two groups. Similar results were reported by Martin and Earle 168 for LAGB and by Perathoner and associates 143 for RYGB. In contrast, Kral and coworkers 169 had found that adding truncal vagotomy to VBG improved weight loss (51% versus 34% EWL).…”

Section: Vagus Nervesupporting

confidence: 89%

Mechanisms Responsible for Excess Weight Loss after Bariatric Surgery

Ionut

Bergman

2011

J Diabetes Sci Technol

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Obesity has increased alarmingly in the United States and is increasing in many countries of the world. Because obesity is an important risk factor for type 2 diabetes and other chronic diseases, it is important to develop approaches to counter the rapid increase in adiposity. One approach is bariatric surgery, the most successful clinical intervention known for treating obesity. Surgery can result in impressive weight loss and improvement of obesity-related comorbidities. Yet the mechanisms responsible for this remarkable effect of surgery remain controversial. It is now clear that caloric restriction, per se, does not explain all the reduction in stored fat mass after surgery. A number of gastrointestinal hormones, including glucagon-like peptide (GLP)-1, peptide YY, oxyntomodulin, GLP-2, glucose-dependent insulinotropic polypeptide, ghrelin, and others, can play roles in energy homeostasis and could be involved in bariatric-surgery-related weight loss and weight loss maintenance. Vagal innervation may play a role. In addition, there may be other yet-uncharacterized factors that could participate. This review discusses the possible roles of these hormonal mechanisms in various types of bariatric surgery to help elucidate some of the potential mechanisms at play in short-term and long-term post-bariatric surgery weight loss. Understanding such mechanisms could lead to new and efficacious means to control or even reduce the epidemic of obesity.

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Section: Vagus Nervesupporting

confidence: 89%

Mechanisms Responsible for Excess Weight Loss after Bariatric Surgery

Ionut

Bergman

2011

J Diabetes Sci Technol

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“…[2][3][4] It is well established that both leptin and insulin decrease significantly after WL, 5,6 while ghrelin variations after WL show variable results. 5,[7][8][9][10][11][12][13][14][15][16] Although WL induced by caloric restriction is associated with an increase in plasma ghrelin, [8][9][10][11] ghrelin changes in WL post-bariatric surgery seem to be influenced by the type of surgical procedure in relation to gastric fundus resection 8,[12][13][14] or to the integrity of vagal fibers involved in ghrelin secretion, 7,15,17 with variable results reported after Roux-en-Y gastric bypass (RYGBP). 7,8,16,[18][19][20][21] These inconsistent results have been linked to differences in follow-up time or to the fact that patients were still actively losing weight when ghrelin was measured, as suggested by Faraj et al 17 At present, it is not well established whether the changes in ghrelin observed earliest when losing weight persist at long term.…”

mentioning

confidence: 99%

Baseline circulating ghrelin does not predict weight regain neither maintenance of weight loss after gastric bypass at long term

Pellitero

Pérez-Romero

Martínez

et al. 2015

The American Journal of Surgery

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“…Additionally, vagal efferent signals have been shown to regulate the motility of the gastrointestinal tract directly through cholinergic signaling [86]. To date, the relevance of the vagal nerve for body weight after gastric bypass is incompletely understood [71,77,87]. We demonstrated previously that preserving vagal fibers of the dorsal vagal trunk during the gastric bypass operation may lead to greater and more sustained body weight loss in rats [17].…”

Section: Limb Lengthmentioning

confidence: 99%

Lessons Learned from Gastric Bypass Operations in Rats

2011

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Numerous studies using gastric bypass rat models have been recently conducted to uncover underlying physiological mechanisms of Roux-en-Y gastric bypass. Reflecting on lessons learned from gastric bypass rat models may thus aid the development of gastric bypass models in mice and other species. This review aims to discuss technical and experimental details of published gastric bypass rat models to understand advantages and limitations of this experimental tool. The review is based on PubMed literature using the search terms ‘animal model’, ‘rodent model’, ‘bariatric surgery’, ‘gastric bypass’, and ‘Roux-en-Y gastric bypass’. All studies published up until February 2011 were included. 32 studies describing 15 different rat gastric bypass models were included. Description of surgical technique differs in terms of pouch size, limb lengths, preservation of the vagal nerve, and mortality rate. Surgery was carried out exclusively in male rats of different strains and ages. Pre- and postoperative diets also varied significantly. Technical and experimental variations in published gastric bypass rat models complicate comparison and identification of potential physiological mechanisms involved in gastric bypass. In summary, there is no clear evidence that any of these models is superior, but there is an emerging need for standardization of the procedure to achieve consistent and comparable data.

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Vagal Nerve Dissection During Pouch Formation in Laparoscopic Roux-Y-Gastric Bypass for Technical Simplification: Does it Matter?

Abstract: Pouch formation during RY-BP may be alleviated by simply dissecting the perigastric fatty tissue. In this way the anterior vagal trunk is dissected, however, no influence on clinical, functional and laboratory results occur.

Cited by 30 publications

References 31 publications

Mechanisms Responsible for Excess Weight Loss after Bariatric Surgery

Mechanisms Responsible for Excess Weight Loss after Bariatric Surgery

Baseline circulating ghrelin does not predict weight regain neither maintenance of weight loss after gastric bypass at long term

Lessons Learned from Gastric Bypass Operations in Rats

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