Surgical Endoscopy

, Volume 21, Issue 4, pp 659–664 | Cite as

Laparoscopic Roux-en-Y gastric bypass versus laparoscopic vertical banded gastroplasty: results of a 2-year follow-up study

  • M. Goergen
  • K. ArapisEmail author
  • A. Limgba
  • M. Schiltz
  • V. Lens
  • J. S. Azagra



The world’s epidemic of obesity is responsible for the development of bariatric surgery in recent decades. The number of gastrointestinal surgeries performed annually for severe obesity (BMI > 40 kg/m2) in the United States has increased from about 16,000 in the early 1990s to about 103,000 in 2003. The surgical techniques can be classified as restrictive, malabsorptive, or mixed procedures. This article presents the results for 2 years of bariatric surgery in the authors’ minimally invasive center and analyzes the results of the most used surgical techniques with regard to eating habits.


Between January 2002 and January 2004, the authors attempted operations for morbid obesity in 110 consecutive patients adequately selected by a multidisciplinary obesity unit. This represented 43% of all consultations for morbidly obese patients. The patients were classified as sweet eaters or non–sweet eaters. All sweet eaters underwent gastric bypass. The procedures included 70 Roux-en-Y gastric bypasses, 39 Mason’s vertical banded gastroplasties, and 1 combination of vertical gastroplasty with an antireflux procedure. Revision procedures were excluded.


The mean age of the patients was 41.36 years (range, 23–67 years), and 72.3% were female. The mean preoperative body mass index was 44.78 kg/m2 (range, 34.75–70.16 kg/m2). The mean operating time was longer for gastric bypass than for the Mason procedure. Three patients required conversion to an open procedure (2.7%). The two operative techniques had the same efficacy in weight reduction. Early complications developed in 11 patients (10%), and late complications occurred in 9 patients (8.1%). The postoperative length of hospital stay averaged 4.4 days (range, 1–47 days; median, 4 days), and was longer in the gastric bypass group. The mortality rate was zero. Data were available 2 years after surgery for 101 of the 110 patients (91%). Most comorbid conditions resolved by 1 year after surgery regardless of the type of operation used.


With zero mortality and low morbidity, bariatric surgery performed for adequately selected patients is the most effective therapeutic intervention for weight loss and subsequent amelioration or resolution of comorbidities. The patient’s eating habits before surgery play an important role in the choice of the operative technique used.


Bariatric surgery Gastric bypass Laparoscopy Morbid obesity Vertical banded gastroplasty 


  1. 1.
    Deitel M (2003) Overweight and obesity worldwide now estimated to involve 1.7 billion of people. Obes Surg 13: 329–330PubMedCrossRefGoogle Scholar
  2. 2.
    Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL (1998) Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J Obes Relat Metab Disord 22: 39–47PubMedCrossRefGoogle Scholar
  3. 3.
    Mokdad AH, Serdula MK, Dietz WH, Bowman BS, Marks JS, Koplan JP (1999) The spread of the obesity epidemic in the United States, 1991–1998. JAMA 282: 1519–1522PubMedCrossRefGoogle Scholar
  4. 4.
    Flegal KM, Carroll MD, Ogden CL, Johnson CL (2002) Prevalence and trends in obesity among U.S. adults, 1999–2000. JAMA 288: 1723–1727PubMedCrossRefGoogle Scholar
  5. 5.
    Monteforte MJ, Torkelson CM (2000) Bariatric surgery for morbid obesity. Obes Surg 10: 391–401PubMedCrossRefGoogle Scholar
  6. 6.
    Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB (2003) Years of life lost due to obesity. JAMA 289: 187–193PubMedCrossRefGoogle Scholar
  7. 7.
    Li Z, Maglione M, Tu W, Mojika W, Arterburn D, Shugarman LR, Hilton L (2005) Meta-analysis: pharmacologic treatment of obesity. Ann Int Med 142: 532–546PubMedGoogle Scholar
  8. 8.
    Maggard MA, Shugarman LR, Suttorp MS, Li Z, Maglione M, Tu W, Rhodes S, Morton SC, Shekelle PG (2005) Meta-analysis: surgical treatment of obesity. Ann Int Med 142: 547–559PubMedGoogle Scholar
  9. 9.
    Naslund I (1987) Gastric bypass versus gastroplasty: a prospective study of differences in two surgical procedures for morbid obesity. Acta Chir Scand Suppl 536: 1–60PubMedGoogle Scholar
  10. 10.
    Howard L, Malone M, Michalek A, Carter J, Alger S, Van Woert J (1995) Gastric bypass and vertical banded gastroplasty: a prospective randomized comparison and 5-year follow-up. Obes Surg 5: 55–60PubMedCrossRefGoogle Scholar
  11. 11.
    Sugerman HJ, Starkey JV, Birkenhauer R (1987) A randomized prospective trial of gastric bypass versus vertical banded gastroplasty for morbid obesity and their effects on sweets versus non–sweets eaters. Ann Surg 205: 613–624PubMedCrossRefGoogle Scholar
  12. 12.
    Brolin RL, Robertson LB, Kenler HA, Cody RP (1994) Weight loss and dietary intake after vertical banded gastroplasty and Roux-en-Y gastric bypass. Ann Surg 220: 782–790PubMedCrossRefGoogle Scholar
  13. 13.
    Sugerman HJ, Londrey GL, Kellum JM, Wolf L, Liszka T, Engle KM, Birkenhaouer R, Starkey JV (1989) Weight loss with vertical banded gastroplasty and Roux-en-Y gastric bypass for morbid obesity with selective versus random assignment. Am J Surg 157: 93–100PubMedCrossRefGoogle Scholar
  14. 14.
    Howard L, Malone M, Michalek A, Carter J, Alger S, Van Woert J (1995) Gastric bypass and vertical banded gastroplasty: a prospective randomized comparison and a five-year follow-up. Obes Surg 5: 55–60PubMedCrossRefGoogle Scholar
  15. 15.
    Brolin RL, Robertson LB, Kenler HA, Cody RP (1994) Weight loss and dietary intake after vertical banded gastroplasty and Roux-en-Y gastric bypass. Ann Surg 220: 782–790PubMedCrossRefGoogle Scholar
  16. 16.
    Brolin RL (2001) Gastric bypass. Surg Clin North Am 81: 1077–1095PubMedCrossRefGoogle Scholar
  17. 17.
    Olbers T, Lonroth H, Fagevik-Olsen M, Lundell L (2003) Laparoscopic gastric bypass: development of technique, respiratory function, and long-term outcome. Obes Surg 13: 364–370PubMedCrossRefGoogle Scholar
  18. 18.
    Weber M, Müller MK, Bucher T, Wildi S, Dindo D, Horber F, Hauser F, Clavien PA (2004) Laparoscopic gastric bypass is superior to laparoscopic gastric banding for treatment of morbid obesity. Ann Surg 240: 975–983PubMedCrossRefGoogle Scholar
  19. 19.
    Wittgrove A, Clark G (2000) Laparoscopic gastric bypass, Roux-en-Y: 500 patients: technique and results with 3–60 months follow-up. Obes Surg 10: 233–239PubMedCrossRefGoogle Scholar
  20. 20.
    Biertho L, Steffen R, Ricklin T, Horber FF, Pomp A, Inabnet WB, Herron D (2003) Laparoscopic gastric bypass versus laparoscopic adjustable banding: a comparative study of 1,200 cases. J Am Coll Surg 197: 536–547PubMedCrossRefGoogle Scholar
  21. 21.
    Higa K, Boone KB, Ho T, Davies O (2000) Laparascopic Roux-en-Y gastric bypass for morbid obesity: technique and preliminary results of our first 400 patients. Ann Surg 135: 1029–1033Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  • M. Goergen
    • 1
  • K. Arapis
    • 1
    Email author
  • A. Limgba
    • 1
  • M. Schiltz
    • 1
  • V. Lens
    • 1
  • J. S. Azagra
    • 1
  1. 1.Department of General Surgery and the Center for Minimally Invasive SurgeryBariatric Program of the Central General Hospital of LuxembourgLuxembourgLuxembourg

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