Laparoscopic Silastic Ring Mini-gastric Bypass: a Single Centre Experience
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Laparoscopic mini-gastric bypass (MGBP) represents a simpler alternative to Roux-en-Y gastric bypass. The placement of a silastic ring (SR) may enhance excess weight loss and minimize weight regain. This study reports on the results of a consecutive cohort of patients undergoing SR-MGBP in a single centre.
Short- and medium-term outcomes of 156 consecutive patients undergoing surgery between August 2005 and January 2008 were analysed. Weight loss, comorbidity resolution and morbidity/mortality were assessed.
A total of 156 patients (78% female, 22% male) with a mean (range) age of 44 years (18–63), pre-operative weight of 129 kg (83–197) and body mass index of 46 kg/m2 (35–64) underwent surgery. Eighty-seven percent had pre-operative comorbidities, and median (range) follow-up was 35 months (6–72). Mean (SD) % excess weight loss (EWL) at 6, 12, 24, 36 and 60 months was 74.6 (19.5), 93.4 (21.1), 98.8 (27.6), 93.5 (20.1) and 89 (16.1) respectively. Thirty-seven percent had complete resolution of comorbidities and 67.3% required vitamin/mineral supplementation. Overall, 10.3% patients suffered early complications, of which 7.7% were minor and 2.6% were major. A total of 45.5% patients suffered late complications, of which 34.6% were minor and 10.9% were major. Food intolerance/vomiting, bile reflux and stomal ulcer were seen in 18.6, 10.3 and 7.7% of patients, respectively. Surgical re-intervention was required in 12.8% of patients. There were no deaths.
Whilst SR-MGBP achieves excellent EWL with low mortality, there is a high incidence of food intolerance/vomiting likely related to the silastic ring. The majority of complications were managed with pharmacological and endoscopic intervention, although 13% required reoperation within 5 years.
KeywordsMini-gastric bypass Gastric bypass Excess weight loss Silastic ring
Conflicts of Interest
- 10.Lee WJ, Lee YC, Ser KH. Revisional surgery for laparoscopic minigastric bypass. SOARD. 2011;7(4):486–91.Google Scholar
- 11.Johnson WH, Fernandez AZ, Farrell TM, et al. Surgical revision of loop (“mini”) gastric bypass procedure: multicenter review of complications and conversions to Roux-en-Y gastric bypass. SOARD. 2007;3:37–41.Google Scholar
- 16.Arceo-Olaiz R, Nayvi Espana-Gomez M, Montalvo-Hernandez J, et al. Maximal weight loss after banded and unbanded laparoscopic Roux-en-Y gastric bypass: a randomized controlled trial. SOARD. 2008;5:455–8.Google Scholar
- 17.Fobi MA. Placement of the GaBP ring system in the banded gastric bypass operation. Obes Surg. 2005 Sep;15(8):1196–201.Google Scholar
- 18.Crampton NA, Izvornikov V, Stubbs RS. Silastic ring gastric bypass: a comparison of two ring sizes: a preliminary report. Obes Surg. 1997 Dec;7(6):495–9.Google Scholar
- 19.Conference NIH. Gastrointestinal surgery for severe obesity. Ann Intern Med. 1991;115(12):959–61.Google Scholar
- 21.Fobi M, Lee H, Igwe D, et al. Band erosion: incidence, etiology, management and outcome after banded vertical gastric bypass. Obes Surg. 2001 Dec;11(6):699–707.Google Scholar
- 24.Scozzari G, Trapani R, Toppino M, et al. Esophagogastric cancer after bariatric surgery: systematic review of the literature. SOARD. 2013;9(1):133–42.Google Scholar
- 26.Miguel GP, Azevedo JL, de Souza PH, et al. Erosive esophagitis after bariatric surgery: banded vertical gastrectomy versus banded Roux-en-Y gastric bypass. Obes Surg. 2011 Feb;21(2):167–72.Google Scholar