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Laparoscopic gastric bypass as a reoperative bariatric surgery for failed open restrictive procedures

Initial experience in seven patients

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Abstract

An estimated 2% of men and 6% of women in the United States are morbidly obese. These patients have a mortality rate that is six to twelve times greater than their normal-weight peers. In these extreme cases of overweight, only surgical intervention can produce substantial and sustained weight loss. However, up to 20% of these patients will require reoperation for failure to achieve or maintain an adequate weight loss. Reoperative bariatric surgery can be challenging and has traditionally been performed as an open procedure. We present seven female patients who underwent a laparoscopic Roux-en-Y gastric bypass after failing to achieve their weight-loss goals with prior open restrictive procedures. Their average BMI before surgical revision was 42.2kg/m2. Mean operative time was 4 h 20 min, and length of hospital stay was 4.1 days. There were three complications in two patients and no deaths. Our initial experience suggests that laparoscopic gastric bypass is a safe and feasible reoperative bariatric procedure. Confirmation awaits a larger series of patients with follow-up data.

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References

  1. Balsiger BM, Luque-De Leon E, Sarr MG (1997) Surgical treatment of obesity: who is an appropriate candidate?. Mayo Clin Proc 72: 551–558

    Article  PubMed  CAS  Google Scholar 

  2. Behrns KE, Smith CD, Kelly KA, Sarr MG (1993) Reoperative bariatric surgery: lessons learned to improve patient selection and results. Ann Surg 218: 646–653

    Article  PubMed  CAS  Google Scholar 

  3. Benotti PN, Forse RA (1995) The role of gastric surgery in the multidisciplinary management of severe obesity. Am J Surg 169: 361–367

    Article  PubMed  CAS  Google Scholar 

  4. Benotti PN, Forse RA (1996) Safety and long-term efficacy of revisional surgery in severe obesity. Am J Surg 172: 232–235

    Article  PubMed  CAS  Google Scholar 

  5. Buckwalter JA, Herbst CA, Khouri RK (1985) Morbid obesity: second gastric operations for poor weight loss. Am Surg 51: 208–211

    PubMed  CAS  Google Scholar 

  6. Cates JA, Drenick EJ, Abedin MZ (1990) Reoperative surgery for the morbidly obese: a university experience. Arch Surg 125: 1400–1403

    PubMed  CAS  Google Scholar 

  7. Consensus Development Conference Panel Gastrointestinal surgery for severe obesity. Ann Int Med 115: 956–961

  8. Deitel M (1997) Laparoscopic bariatric surgery [Letter]. Surg Endosc 11: 965 DOI: 10.1007/s004649900499

    Article  PubMed  CAS  Google Scholar 

  9. Gagner M (1999) Laparoscopic gastric bypass [Presentation]. Annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) 23 March 1999, San Antonio, TX, USA

  10. Kfoury E, Vanguri A (1993) Distal Roux-en-Y gastric bypass conversion operation for failed vertical banded gastroplasty. Obes Surg 3: 41–43

    Article  PubMed  Google Scholar 

  11. Linner JH, Drew RL (1992) Reoperative surgery: indications, efficacy, and long-term follow-up. Am J Clin Nutr 55: S606-S610

    Google Scholar 

  12. Lönroth H, Dalenbäck J, Haglind E, Lundell L (1996) Laparoscopic gastric bypass: another option in bariatric surgery. Surg Endosc 10: 636–638 DOI: 10.1007/s004649900117

    Article  PubMed  Google Scholar 

  13. MacLean LD, Rhode BM, Forse RA (1990) Late results of vertical banded gastroplasty for morbid obesity and super obesity. Surgery 107: 20–27

    PubMed  CAS  Google Scholar 

  14. Martin LF, Hunter SM, Lauve RM, O’Leary JP (1995) Severe obesity: expensive to society, frustrating to treat, but important to confront. South Med J 88: 895–902

    Article  PubMed  CAS  Google Scholar 

  15. Potvin M, Gagner M, Pomp A (1997) Laparoscopic Roux-en-Y gastric bypass for morbid obesity: a feasibility study in pigs. Surg Laparosc Endose 7: 294–297

    Article  CAS  Google Scholar 

  16. Standards Committee, American Society for Bariatric Surgery [ASBS] Guidelines for reporting results in bariatric surgery. Obes Surg 7: 521–522

  17. Sugerman HJ, Wolper JL (1984) Failed gastroplasty for morbid obesity: revised gastroplasty versus Roux-en-Y gastric bypass. Am J Surg 148: 331–336

    Article  PubMed  CAS  Google Scholar 

  18. van Gemert WG, van Wersch MM, Greve JWM, Soeters PB (1998) Revisional surgery after failed vertical banded gastroplasty: restoration of vertical banded gastroplasty or conversion to gastric bypass. Obes Surg 8: 21–28

    Article  PubMed  Google Scholar 

  19. Wittgrove AC, Clark GW (1996) Laparoscopic gastric bypass, Roux-en-Y: experience of 27 cases, with 3–18 months follow-up. Obes Surg 6: 54–57

    Article  PubMed  Google Scholar 

  20. Yale CE (1989) Conversion surgery for morbid obesity: complications and long-term weight control. Surgery 106: 474–480

    PubMed  CAS  Google Scholar 

Download references

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Online publication: 6 February 2001

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de Csepel, J., Nahouraii, R. & Gagner, M. Laparoscopic gastric bypass as a reoperative bariatric surgery for failed open restrictive procedures. Surg Endosc 15, 393–397 (2001). https://doi.org/10.1007/s004640000347

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  • DOI: https://doi.org/10.1007/s004640000347

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